Respiratory conditions and differentiation Flashcards
On inspection what are we looking for?
Clubbing (possible chronic hypoxia),
cynosis
, tracheal deviation,
tar staining (chronic smoking),
tremours
any chest deformioties (concave, barrel chest).
Is there any accessory muscle use?
What do you do on palpation?
Is there equal chest expansion?
Is there any pain?
On percussion what are we listening for?
Dullness indicates fluid
hyperesonance indicates air trapping
Define a pneumothorax
Rerfers to the air in the pleural cavity.
Breaks the fluid bond between the pleure and allows the elastic fibres to recoil resulting in a collapsed lung.
What is the IPPA for a pneumothorax?
I - Consider assymetrical movement of the chest
P - Pain may be present on the affected side, dependant on the severity may only be one side chest movement, tracheal devaition?
P - hyperresonance may be present on the affected side
A - Reduced air entry or silent dependant
What is the management for a pneumothorax?
Simple - Manage ABCs, Oxygen if needed, Pain relief, transport
Tension - Manage ABCs, apply oxygen, needle decompress, pain relief, convey to ED and PRE ALERT
What is the management for Asthma?
Salbutamol
Iprotropium Bromide
Hydrocortisone/ prednisolone
Adrenaline 1 in 1000 IM
What questions can we ask in regards to breathing with asthma?
Has the breathing woke you up overnight?
What receptors does salbutamol target
Beta 2 receptors
What are the different sputum colours?
Clear - indicates COPD
Yellow - indicates acute LRTI or asthma
Green - Current infection, acute disease or exacerbation of copd
Red/brown - Blood
What is the assessment and considerations for a PE
If the patient is on any oral contraception there is an increased risk of a PE.
If the patient has any calf pain, swelling or redness
If the patient has any ECG changes - T wave inversion, new right axis deviation and/ or RBBB
If the breathlessness was instant
WELLS score
What are the common symptoms with croup
General onset
Runny nose
Barking cough
Fever
Sore throat
What is the medication we can give for croup
Dexamethasone
What is finger clubbing due to?
The overgrowth of soft tissue in the terminal phalanx which increases the lateral and longitudinal curvature of the nail
If finger clubbing is present what could this be a sign of?
In adult patients this should prompt consideration of lung cancer or pulmonary fibrosis.
What is pulmonary fibrosis?
Lung disease that occurs when lung tissue becomes damaged and scarred. This thickened, stiff tissue makes it harder for the lungs to work properly.
What is a common cause of asterix?
Respiratory failure with carbon diaxide retention is one of the causes of a coarse tremour of the outstretched hands.
Why is it important to check JVP after the eyes?
JVP is raised in many patients with pulmonary hypertension and can be raised in those with a tension pneumothorax or a large PE.
What does tracheal deviation away from the affected side indicate?
A tension pneumothorax
What does chronic tracheal deviation towards the affected side indicate?
Occurs with the loss of lung volume in the upper lobe
