Cardiorespiratory and Critical Care - Respiratory Emergencies

Question 1

What is dyspnoea?

Answer 1

difficult or laboured breathing

Question 2

What is tachypnoea?

Answer 2

increased rate of respiration

Question 3

What is orthopnoea?

Answer 3

patient is in an upright postion with the neck extended to allow easier breathing

Question 4

What is hypoxaemia?

Answer 4

lack of oxygen in the blood

Question 5

What is hypercapnia?

Answer 5

too much CO2 in the blood

Question 6

What are physiological causes of tachypnoea/dyspnoea?

Answer 6

stress, pain, excitement, exercise

Question 7

What is included in the upper airway?

Answer 7

nasal passages, pharynx, larynx, trachea

Question 8

What is stertor?

Answer 8

snoring sounds

Question 9

What is stridor?

Answer 9

harsh, high pitched breathing sounds

Question 10

What complication is common with stridor?

Answer 10

laryngeal paralysis

Question 11

What are the upper airway causes of dyspnoea?

Answer 11

laryngeal paralysis, BOAS, neoplasia, polyps, foreign bodies, inflammation, tracheal collapse

Question 12

How do you treat upper airway dysnoea?

Answer 12

intubation and GA

Question 13

What is involved in the lower airway?

Answer 13

bronchi and bronchioli

Question 14

What types of sound will you hear on ausculation with lower airway dyspnoea?

Answer 14

harsh, wheezes, crackles

Question 15

What could cause harsh lung sounds?

Answer 15

brochoconstriction causes wheezes and secretions cause crackles

Question 16

What are the lower airway causes of dyspnoea?

Answer 16

asthma, bronchitis, smoke inhaltion, bronchopeumonia, chronic obstructive pulmonary disease

Question 17

What are the lung parenchymal cuases of dyspnoea?

Answer 17

pulmonary oedma, pneumonia, haemorrhage. contusion, neoplasia, thromboembolism, parasites

Question 18

What will you see with a restricted pattern of breathing?

Answer 18

increased rate but reduced depth of inspriation because the lungs cannot expand

Question 19

What are the pleural space causes of dyspnoea?

Answer 19

pneumothorax, pleural effusion, masses, diaphragmatic hernia

Question 20

What causes pleural effusions?

Answer 20

Haemorrhage, infection (pyothorax), neoplasia. heart failure and chylothorax

Question 21

What would you find when ausculating a patient with effusions?

Answer 21

• muffled heart and lung sounds ventrally
• normal lung sounds dorsally

Question 22

What would you do/look at when a patient comes in with dyspnoea?

Answer 22

• provide oxygen
• perfrom physical exam
• is it upper or lower respiratory tract
• respiratory rate and effort
• muscous membranes
• heart rate, arrhythmias, heart murmur
• peripheral pulses

Question 23

What is the goal of oxygen supplementation?

Answer 23

to increased oxygen content in arterial blood and delivery to tissue

Question 24

What are the determinants of oxygen delivery?

Answer 24

• haemoglobin concentration
• blood oxygenation
• cardiac output

Question 25

What are the methods of oxygen supplementation?

Answer 25

• flow by, masks, nasal prongs, oxygen catheter, collar, oxygen cage, intubation, ventilation

Question 26

What are the disadvantages of oxygenating with an oxygen cage?

Answer 26

• can get humid
• may need to check temperature regularly
• carbon dioxide build up

Question 27

What are the advantages of oxygenating with an oxygen cage?

Answer 27

• can control the temperature, add in ice packs etc
• better controlled overall
• can adjust amount of oxygen in cage
• space for patient to move around in

Question 28

What is the aim for oxygen supplementation?

Answer 28

resolution of life threatening hypoxaemia and relief of respiratory distress

Question 29

How should you administer oxygen therapy?

Answer 29

slowly at first, lowest oxygen level patient can tolerate

Question 30

How long can patients be on 100% oxygen?

Answer 30

no longer than 12-24 hours

Question 31

How can you monitor patients on oxygen therapy?

Answer 31

physical exm, arterial blood gas, pulse ox

Question 32

What should you look at during the physical examination?

Answer 32

respiratory rate and effort
mucous membranes - colour, hydration status, crt
heart rate
peripheral pulses
anxiety

Question 33

What does arterial blood gas measure?

Answer 33

PaO2 - partial pressure of oxygen

Question 34

Where can you take an arterial blood gas from?

Answer 34

dorsal metatarsal, femoral artery

Question 35

What is a normal PaO2?

Answer 35

100mmHg (room air)
500mmHg (100% oxygen)

Question 36

what PaO2 is seen in hypoaemia?

Answer 36

<80mmHg

Question 37

What does a pulse ox measure?

Answer 37

peripheral oxygen saturation and haemoglobin oxygen saturation

Question 38

What are the advantages of using a pulse ox?

Answer 38

it is non-invasive

Question 39

What can you do to fix a pleural effusion?

Answer 39

• Stabilise = sedate, thoracocentesis (catheter in dogs, butterfly in cats), collect sample for cytology, culter and biochemistry

Question 40

Important things to remember when taking an arterial blood gas sample

Answer 40

• specific syringes - needs to be arterial and not venous
• syringes are airtight and must be analysed straight away
• pressure must be applied to the punctured vessel

Question 41

What type of blood is arterial lood gas analysis looking at?

Answer 41

oxygenated blood

Question 42

What type of blood is venous blood gas analysis looking at?

Answer 42

deoxygenated blood