8 - Respiratory Emergencies Flashcards
When a patient’s respiratory system is functioning on the hypoxic drive, what may be the result of administering too much oxygen to the patient?
Decrease in respiratory effort
How does pulmonary edema affect the respiration process of breathing?
Build up of fluids causes the alveoli to become submerged, which causes the exchange of O2 and CO2 to become poor
The text describes two situations, “wet lungs” vs. “dry lungs”. The text also gives an example of what may cause each of these situations. List an example of each.
Wet lungs: CHF, pulmonary edema, crackles
Wet lungs are in patients with pulmonary edema; it means there is excess fluid in the lungs.
Dry lungs: COPD, Bronchitis, emphysema, wheezing, stridor, rhonchi
Dry lungs are commonly found in COPD patients. They are dry due to inflammation and irritation.
You are assessing a 13-year old patient who is exhibiting signs of tachypnea and anxiety. She is presenting dizziness, with numbness and tingling in her hands and feet. What is your working diagnosis?
Hyperventilation Syndrome
When a COPD patient is utilizing the hypoxic drive, their impulse to breath is:
Triggered by low O2 levels
Briefly explain the pathophysiology of emphysema.
Atelectasis: alveoli lose elasticity, diminishing their ability to exchange gases
You are treating a 45-year old who is presenting chest pain. The patient states, the pain came on suddenly, it hurts when they move in any direction, it is sharp in nature, does not radiate and is a 9/10 on the pain scale. What is your working diagnosis?
Spontaneous pneumothorax
S/S: Pleuritic chest pain, sudden onset, does not radiate
(644)
*Need to double check
List two life-threatening illnesses that would cause a patient to present with hyperventilation.
Diabetic - w/ a high glucose level (Hyperglycemia)
Severe infection - i.e. sepsis
A 62-year old with a history of emphysema is presenting dyspnea. During your assessment, you notice the patient is unable to follow commands, is cyanotic and has severely labored respirations. How would you treat?
Place in a position of comfort
Supply high flow O2 using a BVM
Rapid Transport
What is pleural effusion?
The collection of fluid outside the lungs on one or both sides of the chest. Limits lung expansion
(644)
What is the treatment for an unconscious patient with a complete severe airway obstruction?
30/2 Chest compressions
Check for visible obstructions, clear if possible
Give oxygen with BVM
The Hallmark signs of croup are what two signs? Croup is commonly seen in what age group?
Seal barking cough
Stridor
6 months to 3 years
(634)
What are the three most common upper airway obstruction sounds?
Stridor,
Gurgling
Snoring
During your assessment of a semiconscious patient, you discover the patient has overdosed on fentanyl. There are gurgling sounds present, and respirations are slow with poor tidal volume. Outline the appropriate treatment for this patient.
Clear and maintain the airway using a suction device to clear fluids.
Since the patient is semiconscious, consider the use of an NPA to help maintain.
Administer Narcan via nasal inhalant then provide high flow O2 using a BVM.
Repeat dosing of Narcan until patient is responsive.
Transport to hospital promptly while checking vitals and giving high quality O2.
Your assessment of an alert 55-year-old with a history of emphysema and CHF reveals facial cyanosis with severely labored respirations. Upon auscultation of the lungs, you hear crackles bi-laterally. Which is the MOST appropriate treatment for this patient? What is your working diagnosis for this patient?
Acute Pulmonary Edema
CPAP, Rapid transport to cardiac center
You are evaluating a 22-year-old who is severely dyspneic. The patient is complaining of a sudden onset of stabbing pain in the left chest that gets worse during inspiration and expiration, the pain is a 10/10 on the pain scale. Upon further assessment, you note bandages on the chest from a recent surgery. These findings are most indicative of what condition?
Pulmonary Embolism
Naloxone
(Pharmacological Description)
Indication - reversal of opioid overdose
Contraindication - known hypersensitivity to drug
Action - opioid antagonist, bonds to opioid receptors
Route - Intranasal
Dose - 2 mg per dose, given every 2-3 minutes as necessary
Side Effect - nausea, vomiting, sweating, tachycardia, increased BP, tremors
What is atelectasis?
Collapse of the alveoli
Give an example of what might cause carbon dioxide levels to drop, in a healthy patient.
If a person is hyperventilating
A 68-year-old patient with a history of COPD complains of dyspnea. There are signs of cyanosis around the lips, the RR is 28, HR is 90, BP is 158/94 and the SpOz is 90%. You decide to administer oxygen at 15 l/m via a non-rebreather mask. Explain what complications may arise from this treatment.
Vasoconstriction (extremely high bp, possible cardiac arrest)
Explain how emphysema causes breathing complications.
Loss of elasticity in the alveolar membrane causes inadequate respiration to occur.
A 23-year-old is exhibiting signs of tachypnea and anxiety. The RR is 34, HR is 114, BP is 128/78, with an SpOz of 96%. The patient is c/o dizziness, with painful spasms in the hands and feet. What is your working diagnosis
Hyperventilation syndrome (646)
List two different signs that would help an EMT select pertussis as a diagnosis for a patient c/o dyspnea?
Strong cough (whooping cough)
Age (common in children)
What are the three most common lower airway adventitious breath sounds and related conditions?
Crackles / Rales: Pulmonary edema
Wheezing: Asthma / COPD
Rhonchi: Pneumonia
Which mnemonic is best used for a patient c/o dyspnea?
PASTE
Progression
Associated chest pain
Sputum
Talking tiredness
Exercise tolerance
Dyspnea: Shortness of breath
You are assessing a patient who is c/o SOB. Your assessment reveals a fever, chronic coughing, night sweats, and recent weight loss. The HR is 102, BP is 114/68, RR is 36 with an SpO2of 98%. Upon learning these findings what should be your next action? What is your working diagnosis for this patient?
Tuberculosis
Wear n95 mask and give patient surgical mask and rapid transport with patient in position of comfort
You are responding to a residence for a patient c/o dizziness. Upon arrival, the scene is safe and the patient states that the entire family is complaining of dizziness, headaches and nausea. Your management of these complaints should include:
carbon monoxide poisoning
Moving the patient’s away from the environment
You are treating a 78-year-old with a history of emphysema and HTN. Your assessment reveals a patient that is anxious, cyanotic and has severely labored respirations with poor tidal volume. The HR is 98, BP is 182/126, RR is 36 with an SpO2 of 89%. The MOST appropriate treatment for this patient is:
CPAP
You are treating a 14-year-old asthma patient who appears frightened, is frantically trying to breathe with no lung sounds heard on auscultation. The patient is cyanotic around the mouth and is lethargic. What is the MOST effective treatment for this patient? What is your working diagnosis?
Status asthmaticus
Call for ALS, Ventilations with BVM, treat with broncodilatador (Albuteral)
You are evaluating a 22-year-old patient who is severely dyspneic. She is complaining of a sudden onset of stabbing pain in her left chest that gets worse during inspiration and expiration. She rates the pain 10/10 on the pain scale. Upon further assessment, you note bandages on her chest from a recent surgery. These findings are most indicative of what condition?
Pulmonary embolism
Albuterol
Indication - Asthma attack
Contraindication - Patient exceeded dosage amount (3)
Action - Beta2 Agonist - Bronchodilator
Route - Inhalation
Dose - Up to three sprays per use
Side Effect - Dizziness
