Pulmonary Emergencies Flashcards
Normal FiO2 = ???
0.21
O2 sat greater than ___% can harm
98
Drugs that effect respiratory drive
Narcos
Benzos
Medical sedation
COPD patients and divers can have what harmful biproduct accumulate
CO2
What causes direct damage to respiratory drive?
Stroke
Causes of upper airway obstruction
Foreign body Debris Loss of integrity OSA HAE and ACE-I Epiglottitis
Lower airway obstruction effecting the bronchi and bronchioles
Foreign body
Tumor
Mucus plug
Lower airway obstruction effecting the parenchyma
COPD Asthma and Edema Infection Silicosis Irritants
What’s the real goal in respiratory emergencies?
Keep the patient alive long enough to be someone else’s problem
What is an important history question to ask?
Prior history of the same?
Increased HR and RR
Decreased T and BP
CHF –> cold shock
Increased HR/RR/T
Decreased BP
Sepsis –> warm shock
Decreased HR, RR, BP
You have 10 seconds to act
Increased HR, RR, BP
Flash pulmonary edema
O2 Saturation measures what?
Absorption of red and IR light. It is the ratio of oxygenated and deoxygenated hemoglobin
What is the number one environmental solution?
Scene safety
Solution to dilute asphyxiant gases?
Use SCBA-FEMA-USAR team
Solution to a COPD patient with oxygen toxicity?
Titrate FiO2 downard and prepare to intubate.
Why no increased O2 in COPD?
Increased O2 will cause pulmonary vasculature to dilate and blood to shunt. The CO2 cannot be exhaled and the levels rise
Upper airway emergency solution?
Secure connection to outside main stem trachea. Use H and P. NO LABS
Lower airway emergency solutions if the tubes are affected?
Force down foreign body
Intubate bleeding tumor
Use suction, N-acetyle cysteine, or CPPT for a mucus plug
Solutions for lower airway emergency involving the parenchyma
Diagnosis specific** Asthma - heliox CHF - intubate Edema - intubate COPD - steroids or intubation
What must you do with a patient you suspect has a PE?
Risk factor profiling
Diagnostic methods for PE?
CTA*
V/Q scan
Cause of primary spontaneous pneumothorax
Aspiration
Cause of secondary spontaneous pneumothorax
Lung disease such as COPD
Tension pneumothorax diagnosis
Dyspnea, increased HR, decreased BP
Treachea deviated away
Treating tension pneumothorax
Needle into chest
When to perform circothyrotomy?
Pediatrics Occluded upper airway Loss of uper airway bony support Failed ET insertion -Perform B4 loss of vitals!!
What is the solution to the given sources?
- Environment
- CNS
- Supraglottic
- Subglottic
Answers: push, supply, open, provide
Env –> provide
CNS –> supply
Supraglottic –> open
Subglottic –> push
