Acute Respiratory Failure Flashcards

1
Q

Pulse oximetry

A

Measures amount of hemoglobin that is bound to oxygen (saturation percentage)

Normal is 94% or better

Goal in respiratory distress/failure is to get pulse ox at 90% of better

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2
Q

Oxygen delivery ways

A

Nasal cannula

  • adult flow rates are between 1-6L
  • adding 1 liter increases FIO2 by 4%, starting at 21% (i.e 4L of room air oxygen = 21+ 16 = 37%)
  • use for mildly hypoxic

Non-rebreather mask

  • used usually if patients oxy sat rates don’t increase to stable levels after 6L
  • FIO2 is approximately 70% with this bag (varies based on seal of the bag)
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3
Q

Respiratory failure

A

Defined as inadequate gas exchange due to malfunction of one or more components of respiratory system

Two main types

1) hypoxemia
2) hypercapnic
* note a patient can have both simultaneously*

Signs/symptoms

  • mental altered status
  • extreme fatigue
  • Cyanosis
  • bad ABG values
  • accessory muscle use and supraclavicular retraction
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4
Q

Hypoxemia respiratory failure

A

ABG saturation of less than 90% while received ing increased inspired oxygen

Caused by Impaired alveolar diffusion via inflammation or fibrosis development along the alveolar membrane

Causes = pneumonia, ARDS, PE, pulmonary edema, alveolar hemorrhage

Treatment:

  • treat underlying issue
  • increase oxygen given (both total Liters and type of device)
  • CPAP and BiPAP is most common
  • endotracheal tube is required if they cant breath on their own due to altered mental status/constant vomiting, GCS <8 or complete apnea is seen.
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5
Q

Hypercapnic respiratory failure

A

Unable to ventilate alveoli
- PaCO2 will be > 45mmHg

Results in respiratory acidosis
- every increase in 10 with PaCO2, pH will decrease by 0,08 (vise verse in alkalosis)

Causes =

  • Drug OD
  • obstructive COPD
  • aspiration of foreign bodies
  • neuromuscular diseases (MS and muscular dystrophy are most common)
  • flail chest
  • strokes
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