Chapter 15- Respiratory Emergencies

What can cause pleural effusion

It can be caused by an irritation, infection, congestive heart failure, or cancer.

chronic obstructive pulmonary disease (COPD)

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

What can happen to the airway in anaphylactic reactions

The airway can swell so much that total obstruction is possible.

What may the body be doing during hyperventilation

The body may be trying to compensate for acidosis (the buildup of excess acid in blood or body tissues)

Bronchiolitis

Viral illness often caused by RSV;Bronchioles become inflamed, swell, and fill with mucus.

carbon dioxide retention

a condition characterized by a chronically high blood level of carbon dioxide in which respiratory center no longer responds to high blood levels of CO

The seal-bark cough seen in patients with croup is a signal that:

a narrowing of the air passage of the trachea may be in progress

What keeps the lungs inflated?

a vacuum-like pressure in the pleural space

adventitious breath sounds

abnormal breath sounds such as wheezing, stridor, rhonchi, and crackles

Asthma

acute spasm of the bronchioles associated with excessive mucus production and swelling of the mucous lining of the respiratory passages; Produces a characteristic wheezing on exhale caused by partially obstructed airways

What could the EMT do to treat the cough caused by Croup

administration of humidified oxygen.

Asthma attack may be caused by:

allergic reaction to foods or allergens, severe emotional distress, exercise, and respiratory infections

hay fever

allergic rhinitis; Causes coldlike symptoms, including a runny nose, sneezing, congestion, and sinus pressure

If there are multiple people with dyspnea, consider the possibility of...

an airborne hazardous material release.

embolus

anything in the circulatory system that moves from its point of origin to a distant site and lodges there, obstructing subsequent blood flow in that area.

Inhalation inuries can cause _________ that can result in eventual ____________.

aspiration pneumonia; pulmonary edema

In a semiconscious or unconscious patient, obstruction of the airway may be caused by?

aspirations of vomitus or a foreign object, or improper positioning of the head, causing the tongue to block the airway.

What diseases will cause patients to have wheezing?

asthma COPD congestive heart failure/ pulmonary edema pneumonia bronchitis anaphylaxis

Tuberculosis (TB)

bacterial infection that affects the lungs. Patients often complain of fever, coughing, fatigue, night sweats, and weight loss.

pulmonary embolism

blood clot that circulates through the venous system and becomes lodged in the pulmonary artery preventing exchange of oxygen and CO2

People with chronic bronchitis are known as "______________". Why?

blue bloaters; tend to be chronically hypoxic and lethargic

The brain stem senses the level of _____________ in the arterial blood. This level brathing the brain stem stimulates a healthy person to _______________. If this level drops too low, the person automatically does what? If this level rises above normal?

carbon dioxide;breathe; breathes at a slower rate and less deeply; the person breathes more rapidly and more deeply

What is a common toxic gas that effects people outside of the industrial setting?

carbon monoxide

diphtheria

caused by a bacterium that attacks the membranes of the throat.

hyperventilation syndrome

caused by alkalosis (buildup of excess base); often occurs during psychological stress

Respiratory Syncytial Virus (RSV)

causes infection in the lungs and passages

Patients with dyspnea may complain of:

chest tightness or air hunger.

Use caution when administering oxygen to patients with...

chronic lung disease

Hypoxic drive is frequently found in end-stage ___________________.

chronic obstructive pulmonary disease (COPD)

What does acute pulmonary edema result from

congestive failure

What should you look for in patients with RSV

dehydration

Patients with COPD will have "_______" lung sounds.

dry

COPD is used to describe a few lung diseases including ____________ and _____________.

emphysema; chronic bronchitis

Most patients with COPD have elements of either chronic bronchitis or emphysema.

false. tend to have element of both

dyspnea

feeling short of breath or having difficult breathing

Influenza Type A symptoms include

fever, cough, sore throat, muscle aches, headache, and fatigue

vesicular breath sounds

normal breath sounds made by air moving into and out of the alveoli

bronchial breath sounds

normal breath sounds made by air moving into and out of the bronchi

chronic bronchitis

ongoing irritation of the trachea and bronchi; excessive production of mucus that can obstruct small airways and alveoli

Who are at high risk for spontaneous pneumothorax?

patients with emphysema and asthma; tall thin men

People with emphysema are known as "____________". Why?

pink puffers;over production of red blood cells; patients purse lips when they exhale to control positive end epiratory pressure, barreled chest, thin

Patients suffering from spontaneous pneumothorax may report ____________ chest pain

pleuritic(sharp, stabbing pain)

Influenze type A can lead to

pneumonia or dehydration

Treatment of oneumonia includes

providing airway support and supplemental oxygen

What is often associated with congestive heart failure

pulmonary edema

What is the principle function of the lungs

respiration

Patients with COPD typically have a history of:

smoking

What are hallmark signs of croup

stridor and a seal-bark cough

hypoxic drive

the brain gradually accomodates high levels of carbon dioxide and then uses a "backup system" to control breathing based on levels of oxygen

emphysema

the loss of elastic material in the lungs as a result of chronic stretching of the alveoli due to inflammed airways and obstruction of airflow out of the lungs

What is carbon dioxide needed for in the body?

to stimulate breathing and help balance pH

Patients with pulmonary edema will have "_________" lung sounds.

wet

Dyspneic patients may have:

Gas exchange obstructed Damaged alveoli Obstructed air passages Obstructed blood flow to the lungs Excess fluid in pleural space

signs and symptoms of croup

-fever -barking cough -stridor -mostly seen in pediatric

signs and symptoms of anaphylaxis

-flushed skin or hives -generalized edema -decreased bp -laryngeal edema with dyspnea -wheezing/stridor

signs and symptoms of tension pneumothorax

-severe shortness of breath -decreased/ altered level of consciousness -neck vein distention -tracheal deviation -hypotension; signs of shock

signs and symptoms of pulmonary embolism

-sharp chest pain -sudden onset -dyspnea -tachycardia -clear breath sounds

signs and symptoms of bronchiolitis

-shortness of breath -wheezing -coughing -fever -dehydration -tachypnea -tachycardia

signs and symptoms of pneumothorax

-sudden chest pain with dysnpea -decreased breath sounds -subcutaneous emphysema

signs and symptoms of asthma

-wheezing on inspiration/expiration -bronchospasm

What diseases will cause patients to have rhonchi lung sounds

COPD pneumonia bronchitis

What can be used to treat RSV by EMTs

Treat airway and breathing problems. Humidified oxygen is helpful.

Croup is typically seen in what patients?

Typically seen in children between 6 months and 3 years of age

What is pneumonia caused by

Can be caused by a virus or bacterium, or by a chemical injury or direct lung injury

The proper exchange of oxygen and carbon dioxide can be hindered by:

-Conditions in the anatomy of the airway -Disease processes -Traumatic conditions -Abnormalities in pulmonary vessels

Upper airway consists of:

-Nose and mouth -Jaw -Oral cavity -Pharynx -Larynx

signs of normal breathing

-a normal rate (adult 12-20 breaths/min; child: 15-30 breaths/min; infant: 25-50 breaths/mi) -a regular pattern of inspiration and expiration -clear and equal breath sounds on both sides of the chest -regular and equal chest rise and fall -adequate depth -unlabored; without adventitious breath sounds

signs and symptoms of emphysema

-barrel chest -pursed lip breathing -dyspnea on exertion -cyanosis -wheezing/decreased breath sounds

signs and symptoms of bronchitis

-chronic cough -wheezing -cyanosis -tachypnea

signs and symptoms of influenza type A

-cough -fever -sore throat -fatigue

signs and symptoms of common cold

-cough -runny nose -sore throat

signs and symptoms of respiratory syncytial virus

-cough -wheezing -fever -dehydration

signs and symptoms of TB

-cough -fever -fatigue -productive/bloody sputum

signs and symptoms of pertussis

-coughing spells -"whooping" sounds -fever

signs and symptoms of congestive heart failure

-dependent edema -crackles -orthopnea -paroxysmal nocturnal dyspnea

signs and symptoms of diphtheria

-difficulty breathing and swallowing -sore throat -thick, gray buildup in throat or nose -fever

signs and symptoms of epiglottis

-dyspnea -high fever -stridor -drooling -difficulty swallowing -severe sore throat -tripod or sniffing

Dyspnea can be caused by many different conditions:

1. Common cold 2. Asthma 3. Heart failure 4. Pulmonary embolism

A. The respiratory system consists of all structures that contribute to breathing, including:

1. Diaphragm 2. Chest wall muscles 3. Accessory muscles of breathing 4. Nerves from the brain and spinal cord to those muscles

epiglottitis

Bacterial infection causing inflammation of epiglottis

Air travels through trachea into lungs to:

Bronchi (larger airways) Bronchioles (smaller airways) Alveoli (where actual exchange takes place)

pleural effusion

Collection of fluid outside the lung that results in compression of the lung and dyspnea

Pulmonary embolism may occur as a result of:

Damage to the lining of the vessels A tendency for blood to clot unusually fast Slow blood flow in a lower extremity (often the result of long-term bed rest)

Hyperventilation

Overbreathing to the point that arterial carbon dioxide falls below normal

Pertussis

Patients will be feverish and exhibit a "whoop" sound after a coughing attack.

how to treat patient with epiglottis?

Position comfortably, provide high-flow oxygen, and do not put anything in their mouths.

How to treat patients with bronchiolitis

Provide oxygen therapy and frequently reassess for signs of respiratory distress.

Patients often have dyspnea or hypoxia with:

Pulmonary edema Hay fever Pleural effusion Obstruction of the airway Hyperventilation syndrome Environmental/industrial exposure Drug overdose cardiopulmonary disease

e. Signs and symptoms of pneumonia include:

Rapid or labored breathing (in children) ii. Blue or gray lips or fingernails iii. Fever iv. Dry skin v. Decreased skin turgor vi. Exertional dyspnea vii. Productive cough with green,red, or rust colored sputum viii. Chest discomfort and pain ix. Headache x. Nausea and vomiting xi. Musculoskeletal pain xii. Weight loss xiii. Confusion xiv. Diminished breath sounds localized wheezing or crackles

Anaphylactic reactions

Severe allergic reaction characterized by severe airway swelling and dilation of the blood vessels

Acute Pulmonary Edema

The left side of the heart cannot remove blood from the lung as fast as the right side delivers it. This results in fluid build up within the alveoli and in the lung tissues

Altered mental status may be a sign that the brain is dysfunctional because of sever ____________.

hypoxia

Hyperventilation Can cause symptoms of panic attack:

i. Anxiety ii. Dizziness iii. Numbness iv. Tingling of the hands and feet v. Painful spasms of the hands and/or feet (carpopedal spasms)

Signs and symptoms of pulmonary emboli include the following:

i. Dyspnea ii. Tachycardia iii. Tachypnea iv. Varying degrees of hypoxia v. Cyanosis vi. Acute chest pain vii. Hemoptysis

Patients will sometimes have elevated levels of carbon dioxide in their arterial blood. Causes?

i. Exhalation process may be impaired by lung disease. ii. The body may naturally produce too much carbon dioxide.

Pneumonia

infection of the lungs

Croup

inflammation and swelling of the pharynz, larynx, and trachea; often secondary to an acute viral infection of the upper respiratory tract

What can cause pulmonary edema besides heart disease?

inhaling large amounts of smoke or toxic chemical fumes, traumatic injuries to the chest, and exposure to high altitudes can produce pulmonary edema.

Spontaneous Pneumothorax

medical conditions that cause an accumulation of air in pleural space.

Bacterial pneumonia presents more________________ while viral pneumonia presents more __________________.

more quickly; more gradually