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    Respiratory Emergencies2

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    yeni
    This document provides information on respiratory emergencies including definitions, anatomy, physiology, pathophysiology, patient assessment, and patient management. It discusses various respiratory conditions that can cause inadequate breathing including obstructive issues like foreign body obstruction or restrictive issues like asthma. The summary is as follows: 1) The document outlines various respiratory conditions that can lead to inadequate breathing and discusses the anatomy, physiology, and pathophysiology of respiratory emergencies. 2) It provides guidance on assessing patients with respiratory distress including performing a focused exam to evaluate vital signs, breath sounds, and respiratory effort. 3) The document emphasizes managing patients by providing oxygen, positioning them comfortably, monitoring vitals, and ensuring rapid transport to

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    © All Rights Reserved
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    Respiratory Emergencies2

    Uploaded by

    yeni
    38 views47 pages
    This document provides information on respiratory emergencies including definitions, anatomy, physiology, pathophysiology, patient assessment, and patient management. It discusses various respiratory conditions that can cause inadequate breathing including obstructive issues like foreign body obstruction or restrictive issues like asthma. The summary is as follows: 1) The document outlines various respiratory conditions that can lead to inadequate breathing and discusses the anatomy, physiology, and pathophysiology of respiratory emergencies. 2) It provides guidance on assessing patients with respiratory distress including performing a focused exam to evaluate vital signs, breath sounds, and respiratory effort. 3) The document emphasizes managing patients by providing oxygen, positioning them comfortably, monitoring vitals, and ensuring rapid transport to

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    This document provides information on respiratory emergencies including definitions, anatomy, physiology, pathophysiology, patient assessment, and patient management. It discusses various respiratory conditions that can cause inadequate breathing including obstructive issues like foreign body obstruction or restrictive issues like asthma. The summary is as follows: 1) The document outlines various respiratory conditions that can lead to inadequate breathing and discusses the anatomy, physiology, and pathophysiology of respiratory emergencies. 2) It provides guidance on assessing patients with respiratory distress including performing a focused exam to evaluate vital signs, breath sounds, and respiratory effort. 3) The document emphasizes managing patients by providing oxygen, positioning them comfortably, monitoring vitals, and ensuring rapid transport to

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    38 views47 pages

    Respiratory Emergencies2

    Uploaded by

    yeni
    This document provides information on respiratory emergencies including definitions, anatomy, physiology, pathophysiology, patient assessment, and patient management. It discusses various respiratory conditions that can cause inadequate breathing including obstructive issues like foreign body obstruction or restrictive issues like asthma. The summary is as follows: 1) The document outlines various respiratory conditions that can lead to inadequate breathing and discusses the anatomy, physiology, and pathophysiology of respiratory emergencies. 2) It provides guidance on assessing patients with respiratory distress including performing a focused exam to evaluate vital signs, breath sounds, and respiratory effort. 3) The document emphasizes managing patients by providing oxygen, positioning them comfortably, monitoring vitals, and ensuring rapid transport to

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 47

    Respiratory

    Emergencies
    …or all that wheezes is NOT
    asthma
    Definitions
    Apnea Acidosis
    Dypsnea Alkalosis
    Orthopnea Ventilation
    Tachypnea Diffusion
    Bradypnea Perfusion
    Hypercarbia Respiration
    Anatomy
    Anatomy
    Physiology
    Takes in oxygen
    Disposes of wastes O2 + Glucose

    – Carbon dioxide
    – Excess water

    The Cell

    CO2 + H2O
    Physiology
    Physiology

    Inspiration Expiration
    Active process Passive process
    Chest cavity expands Chest cavity size decreases
    Intrathoracic pressure falls Intrathoracic pressure rises
    Air flows in until pressure Air flows out until pressure
    equalizes equalizes
    Physiology
    Autonomic Function
    Primary drive: increase in
    arterial CO2

    Secondary (hypoxic) drive:


    decrease in arterial O2
    Adequate Breathing
    Normal rate and depth
    Regular breathing pattern
    Good breath sounds on both sides
    of lungs
    Equal chest rise and fall
    Pink, warm, dry skin
    Inadequate Breathing
    Breathing rate < 12 or > 20*
    Shallow or irregular respirations
    Unequal chest expansion
    Decreased or absent lung sounds
    Accessory muscle usage
    Pale or cyanotic skin color
    Cool, clammy skin appearance
    Obstructive Pathophysiology
    • Tongue
    • Foreign body obstruction
    • Anaphylaxis and angiodema
    • Facial trauma and inhalation
    injuries (burns)
    • Epiglottitis and Croup
    • Aspiration
    Restrictive Pathophysiology
    • Asthma
    • COPD
    • Emphysema
    • Chronic Bronchitis
    Diffusion Pathophysiology
    • Pulmonary Edema:
    • Left-sided heart failure
    • Toxic inhalations
    • Near drowning
    • Pneumonia
    • Pulmonary Embolism:
    • Blood clots
    • Amniotic fluid
    • Fat embolism
    Ventilation Pathophysiology
    • Trauma: rib fractures, flail chest, spinal
    cord injuries
    • Pneumothorax, hemothorax, SCW
    • Diaphragmatic hernia
    • Pleural effusion
    • Morbid obesity
    • Neurological/muscular diseases: polio,
    MD, myasthenia gravis
    Control System Pathophysiology

    • Head trauma
    • CVA
    • Depressant drug toxicity
    • Narcotics
    • Sedative-hypnotics
    • Ethyl alcohol
    FBAO
    • Obstruction may
    result from head
    position, tongue,
    aspiration, or foreign
    body.
    • Be prepared to treat
    quickly and
    aggressively.
    • Head-tilt/chin-lift to
    open airway
    Upper Airway Infections
    • Bronchitis
    • Common cold
    • Diphtheria
    • Pneumonia
    • Croup
    • Epiglottitis
    • Severe Acute Respiratory Syndrome
    Upper Airway Infections
    Signs & Symptoms
    • Dyspnea or respiratory distress
    • Seal-bark cough
    • Acute angiodema
    • Excessive salivation
    • Stridor
    • Sniff positioning
    Acute Pulmonary Edema
    • Fluid buildup in lungs .
    • History of CHF
    • High recurrence
    • Signs & symptoms:
    • Dypsnea
    • Frothy, pink sputum
    • Pedal edema, ascities
    • Rales, wheezes
    • Hypertension
    Pedal Edema
    Ascites
    Bronchitis
    • Chronic condition similar to emphysema
    • Reduction in ventilation due to increased
    mucus production.
    • Productive cough, copious sputum
    • “Blue bloaters”
    • Treatment goals: relief of hypoxia, reversal
    of bronchoconstriction
    COPD
    • Damaged lungs from
    repeated infections or
    inhalation of toxic
    agents.
    • Signs & symptoms:
    • Chronic cough
    • Rhonchi, wheezing
    • SpO2 88-92%
    • Clubbing
    • Pursed lip breathing
    Clubbing
    Asthma
    • Common but serious
    disease
    • Acute bronchiole
    constriction with
    increased mucus
    production
    • Signs & symptoms:
    • Wheezing
    • Patient looks tired
    • Cyanosis
    Pneumothorax
    • Spontaneous or
    trauma induced
    • Accumulation of air in
    the pleural space
    • Signs & symptoms:
    • Dypsnea
    • One-sided chest pain
    • Absent or decreased
    breath sounds
    Anaphylaxis
    • Characterized by
    respiratory distress
    and hypotension
    • Usually results from
    body response to
    allergen.
    • Airway obstruction
    due to angiodema is
    major concern
    Pneumonia
    5th leading cause of death in the U.S.
    Infection usually caused by bacteria or
    virus, rare instances fungal
    Patient will present with sick appearance,
    febrile, shaking, productive cough,
    increased sputum.
    Patient with increase respiratory
    rate/effort, tachycardic,
    wheezes/rales/consolidated lung sounds
    Pleural Effusion
    • Collection of fluid
    outside the lung
    • Caused by irritation,
    infection, or cancer
    • Signs & symptoms:
    • Dypsnea
    • Decreased breath
    sounds over effected
    area
    • Positional comfort
    Pulmonary Embolism
    • Blood clot that breaks
    off, circulating through
    venous system.
    • Signs & symptoms:
    • Dypsnea/tachypnea
    • Cyanosis
    • Acute pleuritic pain
    • Hemoptysis
    • Hypoxia
    Pulmonary Embolism
    Hyperventilation
    • Over-breathing resulting in a decrease in
    the level of CO2 (alkalosis)
    • Signs and symptoms:
    • Anxiety
    • Tingling in hands & feet (carpal-pedal
    spasms)
    • A sense of dypsnea despite rapid breathing
    • Dizziness
    • Numbness
    ARDS
    • Pulmonary edema caused by fluid
    accumulation in the interstitial spaces,
    interfering with diffusion causing hypoxia
    (fluid balance)
    • Underlying etiology includes sepsis,
    pneumonia, inhalation injuries, emboli,
    tumors
    • Mortality rate >70%
    • Supportive care at the BLS level
    Patient Assessment
    BSI/Scene Safety
    Initial Assessment (Sick/Not Sick)
    Focused Exam
    Detailed Exam
    Assessment
    Treatment and Plan
    Initial Assessment
    • Initial Impression:
    • Body position
    • Skin signs and color
    • Respiratory rate and effort
    • Mental status
    • Pulse (rate & character)
    • Determine Sick/Not Sick (Oxygen?)
    • Identify and correct immediate life
    threats – ABCS!
    Focused Exam (S)
    Signs and symptoms
    Allergies (med allergies)
    Medications
    Past medical history
    Last meal or intake
    Events leading to call
    Focused Exam (S)
    • Onset
    • Provocation
    • Quality
    • Radiation
    • Severity
    • Time
    Listen to the patient…

    …they will tell exactly what is


    wrong!
    Focused Exam (O)
    • Vital signs:
    • Skin (signs of adequate perfusion)
    • Level of consciousness
    • Respiratory rate and effort
    • Lung sounds (SpO2?)
    • Pulse rate and character
    • Blood pressure (bilateral?)
    • Pupillary reaction
    Focused Exam (O)
    Crackles (Rales) Stridor
    CHF FBAO
    Pneumonia Croup
    Anaphylaxis
    Rhonchi Epiglottitis
    Airway burn
    Pneumonia
    Aspiration
    Wheezing
    COPD Asthma
    Sometimes Asthma CHF
    COPD
    Focused Exam (O)
    • Based upon your clinical findings.
    • Observe the patient while they
    are talking to you, note any
    distress.
    • Watch for critical signs: JVD,
    tracheal deviation, paradoxial
    chest movement.
    Detailed Exam
    • Complete and thorough head,
    neck-to-toe exam with non critical
    patients.
    • Elicit further information and
    necessary interventions.
    • Key in on critical signs!
    Assessment (A)
    This is your best guess (or rule out) as
    to what is going on with the patient.

    It is based upon YOUR Subjective and


    Objective findings and should help
    you develop and implement a Plan.
    Plan
    Medics?
    ABC’s/Monitor vitals
    Patient in position of comfort.
    Oxygen via ?
    Assist with medications.
    Maintain body temperature.
    Calm and reassure.
    Minimize patient movement.
    Rapid transport!
    PT Management (P)
    Golden Rules:

    • If you are thinking about giving O2, then give it!

    • If you can’t tell whether a patient is breathing


    adequately, then they aren’t!

    • If you’re thinking about assisting a patient’s


    breathing, you probably should be!

    • When a patient quits fighting it does not mean


    that they are getting better!
    Tools of the Trade

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