Respiratory Emergencies Flashcards
Common conditions in respiratory ED
Acute severe asthma, COPD exacerbation, pneumonia, acute PE, acute pulmonary oedema
What is hypoxia
Oxygen is not available in sufficient amounts at tissue level
What is hypoxaemic hypoxia
Reduced alveolar ventilation, V/Q mismatch, shunt, decreased diffusion
Types of hypoxia
Hypoxaemic, circulatory/ischaemic/stagnant hypoxia, anaemic, histotoxic (CN poisoning)
What does oxygen delivery depend on
Amount of free oxygen in the blood, arterial O2 saturation, haemoglobin and cardiac output.
Acute pathologies of the pleura
Pneumothorax, haemothorax, pleural effusion
Acute pathologies of the alveoli
Pneumonia, pulmonary oedema
Acute pathologies of the airways
Asthma, COPD exacerbation, bronchiectasis
Why are legs raised to increase oxygen flow
Increases preload to the heart to increase cardiac output
How is PE severity graded
Using severity index score - PESI index
Diagnosis of PE
CTPA
Options for treatment of PE
Oxygen therapy, anticoagulation, systemic thrombolysis, percutaneous catheter directed embolectomy, surgical embolectomy, vena cava filters, management of RV function and ECMO
What is CPAP used for
Improving haemodynamics in HF patients, increased functional residual capacity
What is BiPAP used for
Patients with type 2 resp failure such as COPD - it gives inspiratory positive airway pressure with expiratory positive airway pressure
Causes of central cyanosis
Decreased arterial oxygen saturation, polycythaemia, haemoglobin abnormalities
Causes of decreased arterial oxygen saturation
Altitude, lung disease (COPD), V/Q mismatch (PE), right to left shunt (cyanotic ongenital heart disease)
Causes of peripheral cyanosis
Reduced cardiac output (cardiogenic shock, LVF), cold exposure, arterial or venous obstruction
Causes of congenital cyanotic heart disease
Tetralogy of fallot, transposition of great arteries, truncus arteriosus, tricuspid atresia, total anomalous pulmonary venous connection, pulmonary atresia, eisenmenger syndrome
Factors which shift oxyhaemoglobin dissociation curve to the left
Decreased temperature, imcreased pH, decreased 2,3 DPG, increased methemoglobin, presence of sulfhemoglobin
Factors which shift oxyhaemoglobin dissociation curve to the right
Increased temperature, decreased pH, increased 2,3 DPG
What is the hyperoxia test ad how does it help with cyanosis workup
Supplemental source onto a patient with cyanosis - if patient responds well they are likely to havea diffusion deficit. If do not respond they are likely to have a shunt.
What are Cheyne Stokes
Abnormal breathing pattern characterised by progressively deeper and/or faster breathing, followed by a gradual decrease in depth/rate that results in temporary apnoea
What is the definition of dysopnoea
Unpleasant awareness of increased respiratory effort (breathlessness)
Most common causes of dysopnoea in ED
Asthma, COPD, cardiac failure, pneumonia, ILD, psychogenic disorder
