Respiratory Distress Flashcards
Airway assesment
- Suction if needed
- Work of breathing
- Breath sounds
- Position of comfort
- CXR
- IV (not if suspected FB or epiglotitis)
Decreased Breath Sounds
- Consider Pneumonia
- Maintian SpO2 >92%
- May try Albuterol if wheezing is present
- If pt appears Toxic w/ fever and increased WBC/CRP, consider Rocephin (75 mg/kg)
- Contact Medical Control
Bilateral Rales or Wheezing
For Recent URI, fine crackles, or perihilar infiltrates on CXR consider Bronchiolitis
-Nasal suction
-Consider HFNC/CPAP as starting options
-NPO/Maintenance IV fluids
-Albuterol if Hx of RAD
For fluffy infiltrates and/or enlarged heart on CXR, or HX of: Cardiac disease, fluid overload, hepatomegaly, drug reaction, go to CHF protocol
Stridor (Overview)
-Radiograph including lateral neck and CXR with upper neck clearly visible (if ppossible.)
-Racemic Epi (try not to aggitate pt)
Possible Dx: Croup, Foreign body, Epiglotitis, Partial Obstruction.
Stridor (Suspected Croup)
Suspected Croup:
- continue Racemic Epi
- consider Dexamethasone (0.6 mg/kg IV/IM/PO, max dose 16 mg)
Stridor (Suspected Epiglotitis)
- Contact Medical Control
- Contact ENT
- Prepare for OR intubation
Stridor (Suspected Foreign Body)
- Contact Medical Control
- Impending complete obstruction
- Contact ENT
- Prepare for OR removal
Stridor (Suspected Partial Obstruction)
- Contact Medical Control
- Consider ENT consult
- Maintain position of comfort
- Maintain Oxygenation
Wheezing
If asthma diagnosis unknown:
- Albuterol HHN
- If wheezing continues or pt has known/suspected asthmatic, go to Asthma Protocol
Severe Distress/Apnea
GCS 8 or less, SpO2 <90% w/ 100% O2
- Begin BVM ventilation, consider Intubation
- Contact ENT for Suspected FB, Sever Crooup, or Epiglotitis
- Intubation preformed by most experienced person
- Consider NG for abd distention
