Respiratory Conditions Flashcards
What is respiratory compromise
Occurs when the blood contained in the capillaries of both lungs stops or interrupts its normal process of oxygen absorption.
Blood isn’t oxygenated.
This leads to lack of oxygen in the blood stream - vital organs and body tissues receive inadequate supply - hypoxia. They will ultimately fail and cease to function.
Doesn’t happen straight away. But danger of brain damage within 2-3 mins
Respiratory compromise affects the…
Respiratory tract (nose to lungs) Respiratory mechanism (ribs, Intercostal muscles and diaphragm) Respiratory centre (in the brain).
What are the 5 Causes of respiratory compromise?
Obstruction of air passages
Chest or lung trauma (injury as opposed to medical cause)
Paralysis of respiratory nerves (don’t get to where they are supposed to be or don’t get sent)
Non oxygen atmosphere
Lung disease and illness
Obstruction of air passages - how and what happens
Obstruction by…
Tongue during unconsciousness
Maxillo facial injuries (injuries to front of face)
Blood and vomit
Inhaled foreign bodies e.g food and false teeth
Suffocation
External pressure to the neck (hanging or strangulation )
Drowning
Internal swelling of the throat tissues (burns, scalds, stings, anaphylactic reaction, disease)
What can Chest or lung trauma result from?
External compression - sand, masonry, damaged vehicle and crowd pressure
Blast injury
Paralysis of respiratory nerves and muscles may arise from…
Electrocution Head or spinal injuries Poisons such as cyanide, week killers and toxic fumes Drugs such as barbiturates and morphine Disease such as tetanus and polio
Non oxygen atmospheres can result from…
Gases e.g carbon monoxide are absorbed by the bloodstream and progressively replace oxygen.
Chemical fumes
Smoke
Altitude
Lung disease and illness can lead to chronic respiratory failure…
Emphysema Pulmonary oedema Acute pneumonia Asthma/bronchitis Continuous fits
How do we recognise what is going on? Obstruction
Difficult and noisy breathing (disponea) Cyanosis (skin colour starts to go blue) Dilated pupils (getting bigger) Congestion of the veins in the head and neck Fits Gradual loss of consciousness Petechial haemorrhage
Signs (when there is a paralytic origin)
Progressive deterioration in rate and depth of breathing (quiet unless obstructed by tongue).
Increasing cyanosis
Dilated pupils
Gradual loss of consciousness
Management
Ensuring an open airway (using appropriate position techniques)
Commencing cardiopulmonary rescuitation if neccessary
Administer high flow oxygen /(target SP02 94-98%)
Placing the patient in the recovery position if unconscious or semi recumbent if conscious
Reassure the patient
Respiratory diseases cause hypoxia how?
Block airway
Or impaired perfusion of the alveoli. (Messes up external respiration)
Obstructive airway conditions
COPD (chronic obstructive pulmonary disease)
ASTHMA
These conditions cause obstruction in the pulmonary tissues reducing free flow of air into the lungs.
What is COPD?
Airway obstruction mainly in smoker or ex smokers
E.g
Chronic Bronchitis
Emphysema
Approx 3.7 million people with COPD in UK but only 90,000 diagnosed.
Fifth biggest killer kills about 30,000 a year.
Chronic = over time, a,ways there?
Acute =
Sign vs symptom
Symptom - something the patient reports
Sign - something you can see
COPD sign and symptoms
Not all patients may have these and don’t have all of them
Easily fatigued Frequent respiratory infections Use of accessory muscles to breathe Orthopneic (difficulty when lying down) Thin in appearance Wheezing Dyspnea Chronic cough (long term) Digital clubbing -
What is bronchitis?
Inflammation of the mucous membranes in the bronchial tubules, caused by bacterial or viral infections.
Have more goblet cells than a normal person.
Acute bronchitis can be common in very young and the elderly and normally short lived.
What is acute bronchitis
In previously healthy individuals it is often viral.
Bacterial infections with organisms such as strep. Pneumonia and H influenza is a common sequel to viral infections in smokers and those with COPD.
Damage caused by irritation of the airways leading to inflammation and neutrophils (WBC) infiltrating the lung tissue.
Mucosal hylersection is promoted by a substance released by neutrophils.
Further obstruction to airways caused by goblet cells.
Things to look for in acute bronchitis
Initially irritating, unproductive cough together with discomfort behind sternum.
Tightness of the chest with associated respiratory wheeze and shortness of breath.
Cough becomes productive, the sputum being yellow suggestive of live neutrophils or green suggesting dead neutrophils.
Mild fever
Crackles heard upon auscultation (in bronchi region about T5)
What is chronic bronchitis
Productive cough on most days for at least 3 months of the year for more than one year.
Inflammation of the bronchus and bronchioles leading to enlargement of mucous secretion glands which can block airways and only cleared by patient coughing the obstruction up.
Blue and bloated
May not appear breathless but will be even after minimal effort.
May have pitting Odema.
If hypoxia is severe then levels of consciousness may be decreased.
