Acute Respiratory Situations Flashcards
What do you do first for a child in respiratory distress?
ABC’s, oxygen!!!
Nasal Cannula
Used in liter flow, usually 1-4 liters
High flow Nasal Cannula / Heated high flow nasal cannula
Used for infants and children who require additional support for ventilation and not yet positive pressure
Face Mask
Non-rebreather offers close to 100% oxygen
Venturi-mask
Dial in desired amount of oxygen based on colored, named device and liter flow
Plain face mask
Liter flow from delivery device or use of blender to dial in exact amount of desired oxygen
Intubation indications
- High oxygen requirement (80-100% O2)
- Failure to ventilate
- Rising CO2 (greater than 50 acutely), acidosis
- Altered neurologic status with respiratory depression
- GCS
Rapid Sequence Intubation
- For Neurological injury or other reasons
- Medications include: Rocuronium, vecuronium, etomidate, lidocaine
Noninvasive Positive Pressure Ventilation
Management of hypoxia, improved gas exchange, supports fatigued ventilatory muscles, provides positive pressure support as single inspiratory pressure (CPAP) or bilevel with inspiratory and expiratory settings (BiPAP)
Invasive Ventilation
- Short term v. long term indications
- Acute indications and weaning settings
- Settings include volume or pressure control, rate, inspiratory to expiratory ratios, inspiratory time, rate and oxygenation
- (review in Bolick and Reuter-Rice)
Tracheostomy - Indications
Upper airway, lower airway, cardiac, congenital defects, degenerative disease, etc
Tracheostomy - Short term complications
Bleeding, dislodgement, infection, air leaks, mucosal injury
Tracheostomy - Long term complications
Stenosis of the trachea, occlusion, granuloma formation, vocal cord fusion, etc
Tracheostomy - Immediate Post op management
Diligent attention to maintain position, typically first change is done by surgeon in 5-7 days
