Chapter 17 respiratory emergencies Flashcards
inspiration
an active process in which the intercostal (rib) muscles and the diaphragm contract, expanding the size of the chest cavity and causing air to flow into lungs
(inhalation)
expiration
(exhaling)
contraindications
anatomic-physiologic
pathologic
anatomic-physiologic contraindications
-mental status so depressed that the patient can not protect their own airway
-lack of a normal respiratory rate
-spontaneous respiratory rate
-inability to sit up
-hypotention
-less than 90 mm gh
incapable to get and maintain a good mask seal
pathologic contraindications
- nausea
- vomitting
- penetrating chest trauma (particularly when pneumothorax is possible)
- shock
- upper gastrointestinal bleeding (or recent gastric surgery
- any conditions that would prevent a good mask seal
portable CPAP
relatively new -common uses are... edema drowning asthma COPD
in which there is fluid in the alveoli that can be pushed back into the capillaries
side effects of CPAP
less blood is able to return to the heart through veins
thus decreasing cardiac output
minimum blood pressure for CPAP usage
a blood pressure of at least 90mm hg
inadequate breathing
breathing that is un able to sustain life
never delay administering O2 when_____?
if patient is having difficulty breathing
patients with an O2 reading of 100% and difficulty breathing
should be administered O2 regardless of O2 saturation
work of breathing (labored breathing)
- retractions
- use of accessory muscles to breath
- flared nostrils
- pursed lips
- 1-2 word sentences would be considered dyspnea
stridor
high pitched sounds that is heard on inhalation (inspiration) upper airway sounds signaling an obstruction
can be heard without a stethoscope
wheezes
high pitched sounds that could seem somewhat musical
common in asthma and COPD like emphysema and chronic bronchitis
-heard during exhalation (signaling a lower airway obstruction)
crackles
fine crackling or bubles heard during inhalation. caused by fluid in the alveoli, or of the opening of closed alveoli
(also known as rales)
rhonchi
lower pitched sounds that resemble snoring or rattling.
caused by secretions in larger airways like pneumonia or bronchitis. (or when material is aspirated into lungs)
generally louder than crackles
emphysema
walls of the alveoli break down, greatly reducing the surface area for respiratory exchange.
the lungs begin to loose elasticity.
asthma
attacks can be brought on by
- insect stings
- air pollution
- infection
- exercise
pulmonary edema
patients with congestive heart failure may experience difficulty breathing because of fluid that accumulates in the lungs, preventing them from breathing adequately
-abnormal accumulation of fluid in the lungs
CHF (congestive heart failure)
patients with CHF often have a both sided heat failure.
-CHF patients might also have JVD, bulging of neck veins, and accumulation of fluid in the abdominal cavity
-can overload the system and leak into the lungs. causing dyspnea
-signs
anxiety
diaphoretic
tachycardia
high BP
fast and labored respirations
low O2 saturation
CHF and pulmonary edema treatment
keep legs dangling to minimize the fluid pressures in the upper body.
high concentration O2 if the patient is breathing adequately
assisted ventilations if needed
CPAP is also effective to push fluid out from the lungs and back to into the capillaries. (where it belongs)
pneumonia
infection in one or both lungs caused by bacteria, virus, or fungi.
symptoms of pneumonia
- coughing up mucus
- fever
- chest pain
- severe chills
on auscultation, crackles may be heard
treatment of pneumonia
EMT can administer O2 through CPAP
-anti biaotics can be given at the hospital
Spontaneous pneumothorax
when a lung collapses without any injury or any other obvious cause.
usually caused by a rupture of a bleb (a weak point in the lungs)
- lungs collapse and air leaks into the thorax
- auscultation is not a good test for this condition, because some patients may sound like they have normal lung sounds.
-pain is sharp pleuritic chest pain, shortness of breath
treatment of spontaneous pneumothorax
treat with O2 like any patient that is suffering from shortness of breath.
-some patients may need a catheter or larger plastic chest tube inserted between the ribs into the plural area. (this catheter would remove the trapped air)
pulmonary embolism
blood clot that travels into the pulmonary system and can cause shock, or cardiac arrest
these clots are called (DVT)
deep vein thrombosis
signs of pulmonary embolism
- sudden onset of sharp pleuritic chest pain
- shortness of breath
- anxiety
- cough (often with bloody sputum)
- sweaty, pale, or cyanotic skin
- tachycardia
- tachypnea
treatment of pulmonary embolism
- administer O2 (keep suspicion of patients who have recently been immobile or history of DVT
- can be avoided by staying active
epiglottits
when the epiglottis closes up due to infection.
caused by swelling and inflammation.
used to be very common in kids, but has dropped due to vaccinations
vaccines against haemophilus influenza type B
symptoms of epiglottits
- sore throat
- painfull and difficult swallowing
- typically patients are found in tripod position
- drooling
treatment of epiglottits
- doing as much as possible to keep the patient calm
- administering O2 without alarming the patient
- not inspecting throat
- child cases have a 10 death rate
- hospital should be notified of the possibility of having the condition
cystic fibrosis
- genetic disease that typically appears in childhood.
- causes thick sticky mucus that accumulates i the lung and digestive system
- can cause life threatening lung and digestive infections
-no known prevention of CF
signs of cystic fibrosis
- coughing w/large amounts of mucus
- fatigue
- frequent occurrences of pneumonia (fever, increased pneumonia symptoms)
- abdominal pain
- coughing up blood
- nausea
- weight loss
viral respiratory infections
- scratchy throat
- sneezing
- runny nose
- fatigue
- possibly fever/chills
treatment:
-O2
alcohol based hand sanitizer
prescribed inhaler
- contains drugs that dilate air passages
- used with a spacer (aero chamber)
- should be at least room temperature
- patient must be alert enough to use inhaler
- exhales deeply before usage
- must hold breath as long as possible after application of medication.
types of meds used in inhalers
-albuterol (ventolin, proventil, volmax)
-levabuterol (xopenex)
-combination inhaler albuterol and ipratropium (combivent)
these are all used in emergency cases to reverse an airway constriction
small volume nebulizer (SVN)
- nebulizes a medication with oxygen and air/liquid
- patient breaths in vapors
- home use with patients suffering from (asthma, COPD)
side effects of nebulizer
some side effects may include
- increased pule rate
- tremors
- nervousness
- jittery feeling
- patient must be breathing deeply enough for the medication to work. (getting to lungs)
patients inability to lie down
usually caused by fluid build up in lungs. a symptom of heart failure (CHF)
patient with difficulty breathing, fever and mucus build up
likely suffering from COPD
patient who had prior history of heart attack and gained weight recently
likely suffering from heart failure (CHF)
ronchi
lower pitched sounds that resemble snoring or rattling
- common in pneumonia or bronchitis
- when material is aspirated into the lungs
