Respiratory Emergencies

What does the hypoxic drive respond to?

Low arterial levels of O2

What is the treatment for someone with a pleural effusion?

No treatment pre-hospital - just sit them upright

Asthma is characterized by trouble getting air a. in b. out

Out

SIGNS AND SYMPTOMS: 1. Coughing spells 2. "Whooping sound" 3. Fever 4. Pediatric patients

Pertussis/Whooping cough

SIGNS AND SYMPTOMS: 1. sudden onset of dyspnea 2. decreased lung sounds when inhaling 3. low SPO2 4. low to normal ETCO2 5. hyperventilation

Pleural effusion

SIGNS AND SYMPTOMS: 1. Dyspnea 2. Chills and fever 3. Cough 4. Dark sputum

Pneumonia

SIGNS AND SYMPTOMS: 1. Sudden chest pain 2. Dyspnea 3. decreased lung sounds on affected side

Pneumothorax

SIGNS AND SYMPTOMS: 1. Sharp, pinpoint pain 2. dyspnea 3. sudden onset 4. After childbirth or surgery 5. tachypnea 6. hemoptysis

Pulmonary embolism

What is COPD?

Slow process of dilation and disruption of airways and alveoli caused by chronic bronchial obstruction

SIGNS AND SYMPTOMS: 1. progressive shortness of breath 2. increased altered level of consciousness 3. jugular vein distention 4. tracheal deviation 5. blood pressure decreased significantly

Tension pneumothorax

What is the treatment for asthma?

Test: albuterol and nonrebreather RW: CPAP 0-5 cm of fluid

Hyperventilation leads to: a. alkalosis b. acidosis

a. alkalosis

If an obstruction of the airway is above the vocal chords, it will have ____ stridor. a. inspiratory b. expiratory

a. inspiratory

Hemoptysis is a symptom of a. pulmonary embolism b. pneumothorax c. pleural effusion

a. pulmonary embolism

Treatment of a patient with exposure to toxic substances begins ____ they are decontaminated. a. before b. after

b. after

During hyperventilation, the CO2 levels a. rise b. drop

b. drop

If an obstruction of the airway is below the vocal chords, it will have ____ stridor. a. inspiratory b. expiratory

b. expiratory

A pleural effusion caused by ___ results from an trauma and does not cause a fever.

blood

Patients with ____, _____, and ____ are at a greater risk for pleural effusions.

cancer, recent surgeries, chest infections

A prolonged seizure that will almost certainly be life-threatening is one that lasts: a. two minutes or longer b. three minutes or longer c. four minutes or longer d. five minutes or longer

d. five minutes or longer

What is the medication used for anaphylaxis?

epinephrine

What causes a pleural effusion?

fluid around the lungs

What is the treatment for patients exposed to carbon monoxide?

high-flow oxygen by a nonrebeather (conscious), or ventilation (unconscious)

What is the one sure-fire way to kill someone with a tension pneumothorax?

lay them down

What is the treatment for a tension pneumothorax?

needle decompression

What is the treatment for a pleural effusion?

oxygen

Wheezing is indicative of a _____ _____ airway obstruction.

partial lower

A pleural effusion caused by ___ results from an infection and causes a fever.

pus

A prolonged seizure for 30 minutes leads to _____.

status epilepticus

COPD OR CHF? Use diuretics to reduce fluid loss around the heart

CHF

SIGNS AND SYMPTOMS: 1. dependent edema 2. rales 3. paroxysmal nocturnal dyspnea

CHF

COPD OR CHF? Barrel chest

COPD

COPD OR CHF? Shortness of breath and wheezing

COPD

COPD OR CHF? Shortness of breath mostly on exertion

COPD

COPD OR CHF? Slow onset

COPD

COPD OR CHF? Thick sputum

COPD

COPD OR CHF? Use home oxygen, bronchodilators, and steroids for treatment

COPD

COPD OR CHF? Usually in long-term smokers

COPD

What is the treatment for acute pulmonary edema?

CPAP up to 10 cm of liquid

EMPHYSEMA OR CHRONIC BRONCHITIS? Associated with obesity

Chronic bronchitis

EMPHYSEMA OR CHRONIC BRONCHITIS? Decreased ventilation

Chronic bronchitis

EMPHYSEMA OR CHRONIC BRONCHITIS? High ETCO2

Chronic bronchitis

EMPHYSEMA OR CHRONIC BRONCHITIS? High blood pressure

Chronic bronchitis

EMPHYSEMA OR CHRONIC BRONCHITIS? Increased cardiac output

Chronic bronchitis

SIGNS AND SYMPTOMS: 1. Fever 2. Barking Cough 3. Mostly seen in pediatric patients 4. Stridor

Croup

EMPHYSEMA OR CHRONIC BRONCHITIS? Decreased cardiac output

Emphysema

EMPHYSEMA OR CHRONIC BRONCHITIS? Destruction of capillary beds

Emphysema

EMPHYSEMA OR CHRONIC BRONCHITIS? Hyperventilation

Emphysema

EMPHYSEMA OR CHRONIC BRONCHITIS? Low ETCO2

Emphysema

EMPHYSEMA OR CHRONIC BRONCHITIS? Pink skin

Emphysema

EMPHYSEMA OR CHRONIC BRONCHITIS? Wheezes

Emphysema

SIGNS AND SYMPTOMS: 1. Barrel chest 2. pursed lip breathing 3. dyspnea on exertion

Emphysema

SIGNS AND SYMPTOMS: 1. flushed skin or hives 2. generalized edema 3. decreased blood pressure 4. laryngeal edema with dyspnea 5. bronchospasms

Anaphylaxis

SIGNS AND SYMPTOMS: 1. wheezing on expiration 2. bronchospasms

Asthma

EMPHYSEMA OR CHRONIC BRONCHITIS? Low SPO2

Both

EMPHYSEMA OR CHRONIC BRONCHITIS? Normal blood pressure

Both

EMPHYSEMA OR CHRONIC BRONCHITIS? Cyanotic skin

Bronchitis

EMPHYSEMA OR CHRONIC BRONCHITIS? Rhonchi, wheezing, rales

Bronchitis

SIGNS AND SYMPTOMS: 1. Chronic cough 2. Wheezing 3. Cyanosis 4. Productive cough

Bronchitis

COPD OR CHF? Distended abdomen

CHF

COPD OR CHF? Elevated blood pressure

CHF

COPD OR CHF? Jugular vein distention and dependent edema

CHF

COPD OR CHF? Patient may or may not smoke

CHF

COPD OR CHF? Pedal edema

CHF

COPD OR CHF? Pink or frothy sputum

CHF

COPD OR CHF? Quicker onset

CHF

COPD OR CHF? Shortness of breath all the time

CHF

What causes emphysema?

Alveoli are chronically overstretched so they lose their elasticity

COPD OR CHF? Shortness of breath, edema, and weakness

CHF

What causes pulmonary edema, and what condition is it commonly associated with?

- Left side of the heart cannot remove blood from the lung as fast as the right is pumping it, so fluid builds up in the alveoli - Associated with CHF

What is chronic bronchitis, and what causes it?

- chronic irritation of trachea and bronchi - excessive mucus is produced which obstructs the airways and alveoli and leads to alveolar dilation

What is the flow rate for a nonrebreather?

10-15 L/minute

What is the flow rate for a nasal cannula?

2-6 L/minute

SIGNS AND SYMPTOMS: 1. rales or crackles 2. gurgling 3. low SPO2 4. high ETCO2 5. pursed lip breathing

Acute pulmonary edema

Describe a barrel chest and its causes.

Air is trapped continuously, causing the distance from front to back of lung to increase

What is carbon dioxide retention?

Failure of the the respiratory center in the brain to respond normally to elevated arterial levels of CO2