Respiratory Distress Flashcards
combination of patient’s subjective sensation of dyspnea with physical signs indicating difficulty breathing
respiratory distress
when the lungs and respiratory muscles cannot move enough air adequately oxygenate and eliminate CO2
respiratory failure
what 3 S&S of end organ dysfunction begin to appear in respiratory failure?
hypoxia
hypercapnia
altered mental status
what are 4 findings suggestive of impending arrest?
decreased pulse oximetry
decreased CO2 capnography
decreased O2 followed by increased CO2
decreased pH
what are 5 pros of bilevel positive airway pressure (BiPAP)? (5)
reduce work of breathing
improve pulm compliance
recruit alveoli
limited sedation required
decreased rates of intubation
what are 4 cons of bilevel positive airway pressure? (BiPAP)? (4)
exacerbate air trapping (COPD)
barotrauma = pneumothorax
anxiety
increased pressure = low venous return = high afterload = decreased cardiac output = hypotension
in which condition is BiPAP dangerous in?
COPD
use of an induction agent (sedative) and neuromuscular blocking agent (paralytic) to allow for a controlled emergency intubation
Rapid Sequence Intubation (RSI)
what mallampati score indicates the easiest airway? the most difficult airway?
class 1
class 4
what is the LEMON score to assess airway difficulty?
Look externally
Evaluate 3-3-2 rule
Mallampati score
Obstruction
Neck mobility
what is the 3-3-2 rule?
3 FB incisor distance
3 FB hyoid-mental distance
2 FB thyroid to mouth distance
what is the safety net for a respiratory patient? (4)
vital signs w/ pulse oximetry
O2 supplementation
IV access
EKG
what is the rule of thumb for IV fluids in a respiratory patient?
avoid IV fluids until volume status assessed
what 2 diagnostics should be ordered for the respiratory patient?
EKG
2-view chest xray
what 5 labs should be ordered for the respiratory patient?
ABG/VBG
CBC
CMP
coagulation studies
troponin
work of breathing increased due to higher airway resistance and lung hyperinflation (air trapping)
COPD exacerbation
how do O2 and CO2 levels change in a COPD exacerbation?
decreased O2
increased CO2
what is the treatment for a COPD exacerbation? (3)
supplemental O2
albuterol + ipratropium
corticosteroid (PO/IV)
what can be added to the treatment for COPD exacerbation if the patient has increased sputum volume, change in sputum color, fever, is sus for infection, or has a consolidation on CXR?
antibiotics
a patient presents with dyspnea, wheezing, chest tightness, and cough. Dx?
asthma exacerbation
acute severe asthma attack that does not improve with usual doses of inhaled bronchodilators and steroids?
status asthmaticus
what is the treatment for an asthma exacerbation? what can be added if + fever or sus for infection?
supplemental O2
albuterol + ipratropium
corticosteroids (PO/IV)
antibiotics
what can be used as a rescue for an asthma exacerbation? (2)
low dose ICS + formoterol
severe, rapid onset dyspnea, hypoxemia, and diffuse pulmonary infiltrates leading to respiratory failure
ARDS
