EC Chp 17 Respiratory Emergencies Flashcards
Inspiration or Inhalation
An active process which the intercostal muscles and the diaphragm contract, expanding the size fo the chest cavity and causing air to flow into the lungs
Expiration or Exhalation
A passive processs in which the rib muscles and diaphragm relax causing the chest cavity to decrease in size and forcing the air from the lungs
Normal breathing is determined by what 3 things
Rate, Rhythm and Quality
Normal BPM
Adult: 12-20
Child: 15-30
Infant: 25-50
Inadequate breathing from an infant or child
Nasal flaring
Grunting
Seesaw breathing
Retractions between the intercostal muscles.
For Inadequate breathing what can you do to assist
- Pocket face mask with supplimental O2
- Two-rescuer BVM with 02
- Flow Restricted oxygen powered ventilation device
- One resource bag value mask with 02
Adequate rate for artificial ventilation for adults and infants
10-12 breaths for adults
20 per minute for infants and children
When Ausculating lung sounds what should you always do
Listen on both sides during inspiration and expiration
Wheezes indicate?
Very common in asthma and COPD - emphysema and chronic bronchitis
They are high pitches sounds created by air moving through narrowed passages and most commonly heard through expiration
Crackles or bubbling on inspiration is caused by
By fluid in the alveoli or by the opening of closed alveoli
Rhonchi sounds like what?
Lower pitched sounds that resemble snoring or rattling. Which are caused by secreations in larger airways and may be seen in pneumonia or bronchitis or when materials are aspirated in the lungs
(Loser than crackles)
Continuous Positive Airway Pressure (CPAP) is?
A form of non-invasive positive pressure ventilation (NPPV) consisting of a mask and a means of blowing oxygen into the mast to prevent the airway collapse or to helps alleviate difficulty breathing
Common uses for CPAP are?
Pulmonary edema and drowning
In which there is fluid in the alveoli that can be pushed out and back into the capillaries
Contraindications for CPAP are
Mental status or lack of a normal respiratory rate, inability to sit up, hypotension, and inability to maintain a good mask seal.
Nausea, vomiting, penetrating chest trauma, shock, upper GI bleeding, facial trauma
Side effects of CPAP
Cardiac input decreases resulting in drop in BP need to have Systolic BP of 90 mmHg
Hypotension
Pneumothorax (lung collapse
Increased aspiration
Can cause a weak section of the lungs to rupture, especially in patients with COPD and asthma
And drying of the cornea of the eyes
What levels do the CPAP start at?
2-5 cm H20.
What are common conditions under COPD?
Emphysema,
Chronic bronchitis
Black lung
Caused mostly by cigarette smoking.
Chronic Bronchitis means
The bronchiole lining is inflamed and excess mucus is formed.
(Crackles are heard)
emphysema is
When the walls of the alveoli breakdown, greatly reducing the surface area for respiratory exchange and lungs lose elasticity
Combined air laden with Co2 is trapped in the lungs reducing effectiveness of breathing efforts
Asthma
A chronic disease that has episodic exacerbations or flares (affect the patient at irregular intervals).
While emphysema and chronicle Bronchitis continuously effect the patient
What happens in an asthma attack?
The small bronchioles that lead to the air sacs of the lungs become narrowed because of the contractions of the muscles that make up the airway. Mucus is produced and small passages practically close down
The air flow is mainly restrained in one direction
Pulmonary Edema
abnormal amount of fluid accumulated in the lungs. And effects patients with congestive heart failure
Patients with CHF often have both left and right sided heart failure because…
The right side that receives blood from the body also backs up in the systematic circulation which can led to edema in lower parts of the body (legs)
Signs of pulmonary edema
Recent weight gain in just a few days
Anxiety, place and sweaty skin, tachycardia, hypertension,
Respiration’s are rapid and labored and low oxygen saturation.
Treatment for pulmonary edema
High concentrations of oxygen by mask unless the patients breathing is inadequate then you need to ventilate. And keep the patients legs on a depending position (hanging down)
Pneumonia is?
An infection fo one or both lungs abused by bacteria, viruses, or fungi. It results from inhalation of certain microbes that grow in the lungs and cause inflammation. People with COPD and other respiratory diseases are more likely to get it.
Signs and symptoms o Pneumonia
Coughing mucus (yellow, green, or bloody)
Fever, chest pain and severe chills.
Most but not all complain of shortness of breath with or without exertion.
Chest pain that is sharp and PLEURITIC(worsens on inhalation.
May hear crackles in just one region
Pleuritic:
Sharp chest pain that worsens on inhalation.
What is a Spontaneous Pneumothorax?
When a lung collapses without injury or another other obvious cause. And air leaks into the thorax.
This is usually a result of a rupture of a bleb (small section of the lung that is weak).
Bleb
small section of the lung that is weak
Symptoms and signs of spontaneous pneumothorax
A sharp, pleuritic chest pain and shortness of breath.
Tire easily, tachycardic, breath fast and cyanosis
Do NOT provide CPAP
Pulmonary Embolism can be defined as?
When blood clot, air or fat gets stuck in the blood vessel or artery in the lungs. Most common is a blood clot and starts in the vein in the leg or pelvis
A dangerous type of clot is
Deep Vein Thrombosis (DVT)
Occurs a lot in cancer patients and those sitting in one position for an extended period
Other things that can block pulmonary arteries are
Significant amount of air
Marrow of a fractured bone
Signs and symptoms of pulmonary embolus are
Extremely variable making it difficult to tested.
Administer oxygen and keep a high index of suspicion
Epiglottitis
When an infection inflames the area around and above the epiglottis and can occlude or close off the airway.
Do not inspect the throat or agitate it anyway
Epiglottitis was more a of childhood infection but now less common due to
Vaccination haemophilus influenzae type B.
If Epiglottitis is not treated what percent can die?
10%.
Cystic Fibrosis (CF) causes?
A genetic disease that causes a thick sticky mucus that accumulates int he Lungs and Digestive system. The mucus can cause life threatening infections.
No known prevention
Symptoms of CF
Coughing with large amounts of mucus Fatigue Frequent pneumonia Abdominal pain Coughing blood Nausea and weight loss.
Viral Respiratory Infection (common cold)
The most common affliction a person may get.
The cough can be persistence and produce sputum that is yellow or green. It usually for one or two weeks.
Bronchoconstriction and most people with get what?
Constriction or blockage of the bronchi that lead front eh trachea to the lungs. Most people receive an inhaler with meds of a fine powder
Medication used in metered dose can also be administered via a?
SVN or small-volume nebulizer. Allows meds to be taken during multiple breaths over several minutes due to the continuous flow
Used in hospitals and ambulances and prescribed to patients
