Appropriate assessment of the respiratory system begins with a good understanding of how this vital system functions. Perform an initial assessment by evaluating the patient's general appearance, patency of the airway and work of breathing. Vital signs, including pulse ox measurement, must be gathered early. Evaluation of the respiratory effort should include the inspection, palpation and auscultation. Detection of adventitious breath sounds, such as rhonchi, rales, wheezes and pleural friction rub is obviously important. When you've completed a good assessment and rendered appropriate treatment, both the patient and the EMT can breathe a little easier.