Respiratory Emergencies Flashcards
PE signs of respiratory distress
Anxiety and restlessness Flaring of nostrils Use of neck muscles Use of abdominal muscles for breathing Cyanosis Asymmetrical chest movement Tracheal deviation
Most common causes of respiratory distress
ACS, cardiac arrest Acute heart failure Electric shock drowning suffocation inhalation of poisonous gases head injuries
Common life-threatening causes of acute severe dyspnea
Arrhythmias pericardial tamponade PE Pneumonia Asthma or COPD exacerbation Anaphylaxis and agioedema Poisoning (ie carbon monoxide)
Causes of respiratory compromise in children
airway anomalies epiglottitis uvulitis tracheitis peritonsillar abscess retropharyngeal abscess asthma croup pneumonia pnemonitits foreign body anaphylaxis
Cardiovascular causes of respiratory failure
Congenital heart dz acute decompensated heart failure myocarditis pericarditis arrhythmia MI valve dysfunction shock
HEENT causes of respiratory failure
angioedema anaphylaxis pharyngeal infxns deep neck infxns foreign body neck trauma chest wall rib fractures
Hematologic causes of respiratory failure
Severe anemia
hemolysis
methemoglobiemia
CO poisoning
Neurologic causes of respiratory failure
depressed ventilation from CNS trauma, infxn or seizures
Toxic and metabolic causes of respiratory failure
Drug overdose Alcohol Salicylate poisoning CO poisoning Diabetic ketoacidosis Sepsis
Inspiratory stridor
due to air flow obstruction occurring above the level of the vocal cords due to things such as: foreign body epiglottitis angioedema
Expiratory/mixed stridor
air flow obstruction below the vocal cords
- croup
- foreign body
- bacteral tracheitis
Crackles (rales)
Inter-alveolar fluid
- acute decompensated heart failure (ADHF)
- adult respiratory distress syndrome (ARDS)
- pneumonia
Potential etiologies of JVD w/ lungs that are CTAB
- RHF
- Cardiac tamponade
- PE
Causes of acute pulmonary edema
- cardiac related
- related to near drowning, aspiration pneumonia, smoke inhalation or inhalation of toxins
Croup
Characterized by inspiratory stridor, cough and hoarsness that result from inflammation in the larynx and subglottic airway
Barking cough in children
Fever typically absent, mild upper respiratory tract sxs may be present
First and most important therapy in anaphylaxis
EPINEPHRINE
NO absolute contraindications
IM injections 0.3-0.5 mg preferable in mid-anterolateral thigh
Oxygen delivery in anaphylaxis
6-8 L/min via face mask or up to 100% O2 as needed
Anaphylactoid rxn
A non IGE mediated reaction that resembles anaphylaxis but is not antibody related
Often occurs with first exposure to certain drugs
Dose related toxin with idiosyncratic mechanism rather than an immunologic mediated one
Tx of anaphylactoid rxn
Treated similarly to anaphylaxis w/ immediate use of epinephrine
Panic attack/hyperventilation
May presnet w/ discrete episodes of intense fear that begin abruptly and last for several minutes to an hour
Autonomic sxs can include chest pain or SOB
Epiglottitis
Inflammation of epiglottis and adjacent supra-glottic structures
Can progress to life-threatening airway obstruction w/o tx
Infectious epiglottitis
Cellulitis of epiglottis, arypiglottic folds and other adjacent tissues. Results from bacteremia and/or direct invasion of the epithelial layer by the pathognomic organism
Hallmarks of epiglottitis in children
Abrupt onset and rapid progression (hours) "The three D's" 1. Dysphagia 2. Drooling 3. Distress
What level is FiO2 typically maintained at?
Below 0.5 to avoid oxygen toxicity
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