Respiratory Emergencies Flashcards
What are two potential causes of cardiogenic pulmonary edema?
Myocardial infarction and congestive heart failure
Permanent abnormal enlargement of the air spaces distal to the terminal bronchioles and associated destructive changes of the alveolar wall is known as what respiratory illness?
Emphysema
The presence of a barrel chest and clubbing of the fingers is suggestive of what respiratory condition?
Chronic obstructive pulmonary disease (COPD)
The classic signs and symptoms of fever, sputum production, productive cough, dyspnea, tachycardia and pleuritic chest pain are indicative of what respiratory illness?
Pneumonia
What is the most definitive diagnostic tool in asthma?
Peak flow
What is Ipratropium bromide (Atrovent) and why is it given with beta2 agonists?
Anticholinergic used to reverse cholinergically mediated bronchospasm, blocks vagal tone to larger airways, dries secretions and when given with beta2 agonists, provides additive effects
Male smokers in their twenties with tall stature are at greatest risk for what pulmonary emergency?
Primary spontaneous pneumothorax
What are normal arterial blood gas values?
pH 7.35-7.45, PaO2 80-100 mmHg, PaCO2 35-45 mmHg, HCO3- 22-26 mEq/L
What are the accepted arterial blood gas values indicative of acute respiratory failure?
PaO2 less than 60 mmHg and PaCO2 greater than 50 mmHg and arterial pH less than 7.30 on room air
Interpret the following arterial blood gas and provide a cause: pH 7.28, PaO2 88 mmHg, PaCO2 51 mmHg, HCO3- 24 mEq/L
Acute uncompensated respiratory acidosis potentially from hypoventilation secondary to drug ingestion, COPD, pulmonary edema, respiratory arrest
Interpret the following arterial blood gas and provide a cause: pH 7.49, PaO2 98 mmHg, PaCO2 20 mmHg, HCO3- 24 mEq/L
Acute uncompensated respiratory alkalosis potentially from hyperventilation, CNS infection/trauma, carbon monoxide poisoning
What are the clinical manifestations of asthma?
Dyspnea, cough, wheezing, prolonged expiratory time, reduced peak flow
What mechanical ventilator settings are frequently adjusted specifically for the treatment of adult respiratory distress syndrome (ARDS)?
Incrementally elevated levels of positive end expiratory pressure (PEEP), inversion of inspiratory/expiratory (I:E) ratio, limited peak inspiratory pressures (PIP), reduced tidal volume delivery
A patient presents with an elevated end tidal CO2 what should the critical care paramedic consider as a cause?
Any condition that elevates carbon dioxide, decreases alveolar ventilation, or equipment malfunction
Corticosteroids work on what portion of the asthma cascade?
Inflammation and edema
What is the most recognizable and reversible cause of hypoventilation?
Foreign body airway obstruction
If the chronic bronchitis patient produces more sputum then they are able to eliminate, what adventitious lung sound will be auscultated?
Rhonchi
Pulmonary edema is a direct result of failure of which heart chamber?
Left ventricle
COPD patients that breathe with pursed lips are essentially mimicking what mechanical ventilator setting?
Positive end expiratory pressure (PEEP)
What type of medication is primarily used for the treatment of pneumonia?
Antibiotics
What are the classic early signs of asthma?
Dyspnea, expiratory wheezing, cough, tachycardia, and chest tightness
What should be evaluated when assessing a patient with a respiratory complaint?
Level of consciousness, pallor, cyanosis, vital signs, breath sounds and work of breathing to include nasal flaring, grunting, accessory muscle use
In what instance would fluctuations in pulse oximetry, capnography, and auscultation of lung sounds be minimal with pneumothorax?
When the degree of lung collapse is minimal
Interpret the following arterial blood gas and provide a cause: pH 7.58, PaO2 92 mmHg, PaCO2 33 mmHg, HCO3- 30 mEq/L
Acute uncompensated metabolic alkalosis potentially from severe vomiting, diarrhea, gastric suction, diuretics
What is the purpose of administration of magnesium sulfate in patients with acute bronchospasm?
Bronchial smooth muscle relaxation
Interpret the following arterial blood gas and provide a cause: pH 7.14, PaO2 89 mmHg, PaCO2 35 mmHg, HCO3- 16 mEq/L
Acute uncompensated metabolic acidosis potentially from diabetic ketoacidosis, renal failure, lactic acidosis
What are the ominous signs of the need to intubate?
Near exhaustion, lethargy, somulence, apnea, shallow or irregular respirations; limited air movement (decreased tidal volume)
What is the next course of action in the respiratory distress patient that does not respond to oxygen delivery and pharmacology?
Intubation and mechanical ventilation
What are the six causes of oxygenation failure resulting in hypoxemia?
Hypoventilation, ventilation/perfusion mismatch, intrapulmonary shunting, cardiogenic shock, diffusion defects, and low FiO2
Why are beta2 agonists beneficial in asthma?
Relaxation of bronchial smooth muscle, inhibition of chemical mediator response, and promotion of mucociliary clearance
Pulmonary emboli results in hypoxemia through what mechanism?
Ventilation/perfusion mismatch
What medications are commonly used in the treatment of pulmonary embolus?
Heparin. Also LMWH (e.g. Lovenox) and warfarin. Fibrinolytic therapy may be used in critically ill patients with acute PE.
A pulse oximetry of 90% correlates with an approximate arterial oxygenation level of?
PaO2 60mmHg
