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Emergency Medicine > Respiratory Distress > Flashcards

Respiratory Distress Flashcards

Quiz 1

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

What is respiratory distress

A

combo of pts subjective sensation of dyspnea w/ physical signs indicating difficulty breathing

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2
Q

What is respiratory failure

A

lungs and respiratory muscles cannot move enough air to adequately oxygenate and eliminate CO2

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3
Q

What s/s are seen in respiratory failure

A

end organ dysfunction

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4
Q

What are end organ dysfunction s/s

A

hypoxia and hypercapnia leading to altered mental status

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5
Q

What are 3 factors leading to impending arrest?

A

pulse oximetry decreased
CO2 Capnography decreased
Arterial or venous blood gas affected

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6
Q

What are the two changes seen in arterial or venous blood gas?

A

decreased O2 followed by increased CO2

decrease pH

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7
Q

What 4 choices are given in impending arrest?

A

Do nothing wait for arrest
BiPAP
Rapid Sequence intubation
Surgical airway

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8
Q

What are the 5 Pros to BiPAP?

A
  • reduces work of breathing
  • Improves pulmonary compliance
  • Recruits alveoli
  • Limited sedation needed
  • Decreased rates of intubation
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9
Q

What are the 4 Cons to BiPAP?

A
  • Exacerbate air trapping
  • Barotrauma can lead to pneumothorax
  • Anxiety
  • Increase intrathoracic pressure
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10
Q

What two things are used in RSI for controlled intubation?

A 
induction agent (sedative)
neuromuscular blocking agent (paralytic)
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11
Q

What drives the decision for RSI or not RSI?

A

TIME AND AIRWAY DIFFICULTY

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12
Q

If the pt is apneic and unresponsive this is considered?

A

a crash airway

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13
Q

When should you prep and review other options for RSI?

A

prior to RSI

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14
Q

What two things are used to access airway difficulty?

A

Mallampati Score

Lemon Score

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15
Q

What is the scale for Mallampati Score

A 
1= easiest
4= most difficult
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16
Q

What does LEMON stand for?

A 
L- look externally
E- evaluate w/ 3 rule
M- Mallampati Score
O- Obstruction
N- neck mobility
17
Q

What is not a necessary priority?

A

identifying underlying etiology

18
Q

What should be done after securing the airway and stabilizing the patient?

A

identifying the underlying etiology

19
Q

If there are signs of a impending respiratory arrest what two things are considered?

A

RSI or BiPAP

20
Q

What things should be in your safety net for a respiratory patient?

A 
Vital signs w/ pulse oxy
O2 supplementation(prior and during)
Patent IV access
EKG
Defib pads
Capnography
Venous or arterial blood gas
21
Q

What should be done on a physical exam?

A 
cardiac
pulmonary
neuro
ent
and pertinent systems
22
Q

What 2 test should be done?

A

EKG and CXR 2 view

23
Q

What labs should be done?

A

ABG or VBG

CBC, Coagulaton Studies (INR, PT, PTT), CMP, Cardio enzymes (Troponin, CK, CK-MB)

24
Q

What s/s is seen in a COPD exacerbation?

A

decreased O2

Increased CO2 retention

25
Q

What is the txt for COPD exacerbation?

A

O2
Neb B-2 agonist/anticholinergic (Albuterol and ipratropium)
PO or IV Corticosteriods
+/- ABx

26
Q

What is the disposition of COPD?

A

improvement in ED
Ability to perform ADL @ home
Walk of life

27
Q

What are s/s of asthma exacerbation?

A

dyspnea, wheezing, chest tightness, and cough w/ hx of asthma

28
Q

Acute sever asthma attack that does not improve w/ usual doses of inhaled bronchodilators and steroids?

A

status asthmaticus

29
Q

Txt for asthma exacerbation?

A

O2
B2 agonist/ anticholi (Albuterol and ipratropium)
PO or IV corticosteroids
+/- Abx

30
Q

Disposition of asthma exacerbation?

A

improvement in ED
ADL
Walk of life

31
Q

S/S of adult respiratory distress syndrome?

A

severe, rapid onset of dyspnea, hypoxemia, and diffuse pulmonary infiltrates leading to respiratory failure

32
Q

What are 5 causes of ARDS?

A 
severe sepsis syndrome/bacterial pneumonia
trauma
multiple transfusions
aspiration of gastric contents
drug overdose
33
Q

Txt for ARDS?

A

Txt etiology
Prepare ventilation once patient fatigues
Fluid restriction and diuretics

34
Q

s/s of CHF?

A

recent hx of chest pain, fluid overload (SOB, dyspnea on exertion, paroxysmal nocturnal dyspnea, cough, edema)

35
Q

Txt for CHF?

A

O2- +/- BiPAP
Diuretics w/ strict IO
Pacing or abortive thxp for dysrhytmias

36
Q

What is the disposition for CHF exacerbation?

A

improvement in ED
ADL
Walk of life
Worsening cardiac function

Emergency Medicine (6 decks)

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