Respiratory Emergencies Flashcards
what are the phases of capnography?
Phase 1: beginning of exhalation (the air that is in the dead space)
Phase 2: CO2 from larger bronchioles resulting in upslope
Phase 3: Alveolar plateau, and end tidal CO2
Phase 0: Inhalation
what can cause the CO2 number to be low?
Hyperentilation Hypoperfusion metabolic acidosis decrease metabolism PE
what do red blood cells break down to?
Bilirubin (dead red blood cells)
what does mild tachypnea mean? and what is the biggest problem with this finding?
Pt is compensating (normal SpO2), and often overlooked until its too late.
what is a peak flow meter?
a device that allows there to be a measurement of how powerful a pt can blow out.
Peak Expiratory Flow Rate (PEFR)
will kids out grow asthma?
yes, usually around the age of 8
What are the cartilaginous rings?
the rings that make up the trachea.
Good because they wont collapse when breath in
Bad because they can swell outward, they inflame inside.
what does it mean if they have a thick green or brown sputum when cough?
pneumonia or infection
what does it mean if a pt has hemoptysis?
TB or carcinoma/cancer
what does it mean if they pt has a pink frothy sputum when they cough?
pulmonary edema
what does a shark fin CAPNO mean?
broncho constriction (they have to use muscle to blow out, slow expiration)
what is a reverse shark fin CAPNO mean?
They have a neuromuscular disease (Guillan Barre, Myasthenia Gravis) Where no they use the muscles to pull air in more than normal (slow and prolonged inhalation, and quick exhale)
what are some things that can cause hypoventilation?
overdose, alcohol, sedatives, analgesics, stroke, seizures
what is the big key differences between rhonchi and rales?
Rhonchi are wet sounding and are more midline and in the bigger airways.
Rales are wet also, but that crackle sound is more peripheral, fluid in the alveoli.
what is the steeple sign?
Its the X-ray finding of swelling of the cricoid ring, where you find croup.
what are differentials you can consider rather than croup?
- foreign body
- epiglottitis
- allergic reaction
- Tracheitis
what is Hering-Breuer?
a reflex/ stretch receptor on your lungs to keep your lungs from over inflating.
what is the minuet volume?
the amount or air moved in and out of the lungs each minute
MV= tidal volume x respiratory rate
Is Epiglottitis a rapid or slow onset?
High or low fever?
virus or bacteria?
rapid
High
bacteria
In croup, what is narrowing?
larynx and the cricoid cartilage
What is tracheitis?
Bacterial Infection of the trachea.
Looks like croup (has a higher fever), but wont respond to the same treatments.
What is peritonsillar abscess?
its infection and puss filled abscess to the tonsils.
S/S: difficulty swallowing
“hot potato voice”
what is bronchiolitis?
inflammation to the bronchioles.
Viral infection: Respiratory Syncytial virus (RSV)
S/S: less than 2 yo usually, wheezing, crackles, nose flailing, dehydrated.
Tx: O2, suction nose
What is ARDS?
acute (adult) respiratory distress syndrome
alveoli damaged, lack of gas exchange, resp failure, hypoxia.
Tx: CPAP/PEEP
what will long term treatment be for a small PE?
Heparin or Coumadin
what are some things to ask your patient if you suspect a PE?
- stagnant life style?
- recent surgery?
- Hx of DVT?
- A fib?
- birth control?
- clotting issues or hx?
why will capno be low on a PE patient?
an air embolism can decrease the amount of CO2 being released, its being blocked (there is more alveolar dead space, not getting rid of CO2)
why would there be a higher number of CO2?
The pt is not breathing fast enough, and the body is still metabolizing (so there is a build up of CO2 in the lungs) and is being blown off.
what is one concern that we should always assume with a COPD pt and their condition of breathing is worse one day?
infection
- COPD pt are prone to infection because they can not get air out.
what is Alpha 1 antitrypsin
smoking break down alpha 1 antitrypsin
is the protective enzyme that prevents breakdown of the alveoli
