Chapter 6b - Respiratory emergencies Flashcards by Marilou Gélinas

2 majors s/s of respiratory distress

abnormal breathing
abnormal skin colour

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Chief complain of respiratory distress

shortness of breath, dizzy, pain in chest, tingling

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What is dyspnea?

Difficulty breathing

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general treatment of dyspnea

loosen restrictive clothing
semi-sitting/tripod position
O2

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What is hyperventilation syndrome?

Rapid breathing +++, upsets O2/CO2 balance

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Tx for hyperventilation syndrome

Calm down, remove from stimuli
Attempt to slow down breathing
No paper bags, use cupped hands
If cyanotic, paresthesia, lower LOC = give O2

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what is bronchitis

excessive mucous secretions
inflammatory changes
prolonged exposure to irritants

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S/s of bronchitis

sob, cough with sputum

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what is emphysema

lungs unable to effectively exchange CO2/O2

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s/s of emphysema

sob
difficult exhalation
cough
cyanosis
fever
restless
confused
weak

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tx of emphysema

ventilatory support
careful with hyper-oxygenation

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etiology of asthma

allergies, cold dry air, histamine, exercise, psych

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pathogenesis of asthma

muscles contraction, inflammatory reaction
increase mucous production & viscosity
decrease air exchange due to spasm/yelling/secretions

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s/s of asthma

wheeze on exhalation
difficulty breathing
chest tightness
ineffective cough
headache
tight/irritated throat
mild cyanosis

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A silent asthmatic may lead to what?

Can progress to respiratory arrest

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2 types of bronchodilators

short acting
long acting

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short acting inhaler - 2 brands + their roles (2)

ventolin
- bronchodilator
- stimulates beta receptors
atrovent
- brochondilator
- beta agonist

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long acting inhaler - 2 brands

Spiriva
Foradil

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What is the rescue inhaler?

short-acting inhaler

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Corticosteroids can be given via IV with serious asthma attacks

TRUE

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Purpose of the spacer for asthma attacks

better because of the aero chamber

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Purpose of the nebulizer for asthma

Changes asthma medications into a mist so that it can be more easily inhaled into the lungs

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What is PEF

Peak expiratory flow
maximal rate that a person can exhale during a short maximal respiratory effort after a full inspiration

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Green zone asthma action plan (specifications + action)

No symptoms
usual activities
peak flow 80% of personal best

Action: maintain medication use as is

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Yellow zone asthma action plan (specifications + action)

Some symptoms Woken up at night Can only do some of usual activities Peak flow between 50-80% of best Action: Take extra puffs of reliever meds Adjust doses of other asthma meds as per MD direction

Red zone asthma action plan (specifications + s/s)

Asthma attack - need immediate care S/S: - very short of breath - reliever meds not helping - can't do usual activities - in yellow zone at least 24h - sx same or getting worse - PEF is less than 50% of personal best

Action in red zone - asthma action plan

safe place/stress free environment position of comfort/posture of ease take extra puffs of reliever meds/don't wait Use aero-chamber take a dose of oral steroids meds O2 if available Seek care at urgent care facility

When do you call 911/ems for a red zone - asthma (3 criteria)

more than 15 min in red zone cyanotic hard to walk/talk

Can you use an epipen if severe/airway is closing up during an asthma attack?

YES, will help with short duration

What is the method used if no medication (inhalers) is available during an asthma attack?

Coffee (caffeine) Broncho-dilatory effect may last up to 3-4 hours

s/s of opiod overdose

unresponsive breathing laboured, snore-like, ineffective, absent pupils constricted

What medication do you administer right away for opioid response?

Naloxone

If you've administered a dose of naloxone, how much time do you need to wait for the next dose?

3 MINUTES and use the left nostril if you used the right before

name the 2 types of intramuscular injection device for naloxone

vial ampoule

if pulse is present, but no breathing, ventilations + start with ___, progress to ____

pocket mask BVM

First 2 breaths are done with a pocket mask, with or without an OPA

no OPA

Define hypoxia

insufficient oxygen reaches cells of the body

S/S of hypoxia

increased respiration and pulse cyanosis changes in LOC restlessness chest pain

3 basic skills that will help in preventing hypoxia

Open airway Provide adequate ventilation Chest compressions

When using a vial for naloxone, at what angle do you insert the syringe with the needle?

90-degree angle

When using an ampoule for naloxone, at what angle do you need to insert the syringe with the needle?

90-degree angle

Is pre-hospital hyperventilation recommended? why?

No longer, because it has been shown to lower CO2, which causes alkalosis, which prevents transfer of oxygen to the cell

What is the state when you have lower CO2

Alkalosis

Should we hyper-oxygenate patients?

No longer recommended

T or F: Too little and too much oxygen can be helpful

FALSE . CAN BE HARMFUL

___ is ideally measured befre O2 administration

SpO2

Pulse oximeter is now part of what

primary ax

An oxygen saturation level of at least ___% is considered normal for most healthy individuals

95%

A chronic prolonged level or ___ or less indicates potential hypoxemia, or deficiency in oxygen reaching tissues in the body

92% or less

For patients with an acute myocardinal infarction or stroke, do not initiate oxygen therapy in patients with SpO2 ≥ ___

90%

Target range for the SpO2 administration

90-94%

Continue O2 admin if SpO2 is less than or equal to ___

96%

Stop the O2 admin if SpO2 above ___

96%

For acute stroke or MI - do not start O2 admin if SpO2 at or above ___

93%

O2 inhalation

patient breathing but needs supplemental O2

O2 ventilation

patient is not breathing, must be given breathes ideally with supplemental O2

What devices would you use for O2 inhalation supplementation?

Nasal cannula Non- Re-breather mask

Nasal cannula provides what?

Provides atmospheric oxygen 21% + 4% for every liter flow (1-6l/min)

At what value would you start O2 supplementation with the NRB

10L/min

up to what value do you put the NRB

25L/min

Full oxygen cylinder pressure

2 000 psi

Oxygen should have at least ___ on standby

800 psi

Change oxygen cylinder at ___

500 psi

Minimum cylinder pressure remaining to prevent costly maintenance

200 psi

Purpose of the gasket on O2 tank

Prevent leaks

Precautions during oxygen delivery

Do not operate around flames/sparks Do not stand cylinder upright Do not use grease/oil/petroleum products to lubricate Check oxygen flow before placing delivery device on victim

Ideal tank size for sports setting