Pulmonary Emergencies

Question 1

Restrictive conditions

Answer 1

Pulmonary edema
Pleural effusion
ARDS
Neuromuscular disease
Pneumonia
Pneumothorax
Pulmonary Fibrosis

Question 2

Pulmonary edema

Answer 2

Symptoms: dyspnea, anxiety, pink frothy sputum
Treatment: NIV, antihypertensives

Question 3

Pleural effusion

Answer 3

Collection of fluid between pleural layers
Treatment: High Fowler position
Supplemental oxygen
Thoracentesis

Question 4

ARDS

Answer 4

Occurs in response to:
Sepsis
Pancreatitis
Hypovolemic shock
Pulmonary contusion
Burns

Treatment:
Treat underlying position
Prone position
ECMO

Question 5

Obstructive conditions

Answer 5

Asthma
COPD

Question 6

Asthma

Answer 6

Treatment:
Remove trigger, beta-2 agonist, bronchodilators, steroids, vent support, extend expiratory time, ZEEP

Question 7

COPD

Answer 7

Treatment:
NIV
Start at PIP 10 and PEEP 5
Bronchodilators
Corticosteroids
Antibiotics
If intubated
Extend expiration time
Low rate (10-12)
Set PEEP at 75% less than auto-peep

Question 8

V/Q mismatch

Answer 8

Ventilation (V)/Perfusion (Q)
Ventilation disruption: Shunt
Perfusion disruption: dead space ventilation