Respiratory Emergencies

Question 1

What is the difference between T1 and T2 respiratory failure?

Answer 1

T1 = normal or low PCO2 
T2 = high PCO2

Question 2

What is the cause of T1 respiratory failure?

Answer 2

V/Q mismatch

Question 3

What is the cause of T2 respiratory failure?

Answer 3

Alveolar hypoventilation

Question 4

How can you tell a hyper inflated chest on CXR?

Answer 4

6+ anterior ribs showing

10+ posterior ribs showing

Question 5

What are 5 signs of a life threatening asthma attack?

Answer 5

CHEST

Cyanosis, Hypotension, Exhaustion (confused, normal PCO2), Silent chest, Tachy/brady arrhythmia

Question 6

List immediate management for asthma

Answer 6

O2 - get sats to 98%
Bronchodilators such as salbutamol
Steroids such as prednisolone

Question 7

How can you tell if respiratory failure is compensated?

Answer 7

Normal pH

Question 8

How does acute management of COPD differ from asthma?

Answer 8

Give O2 but aiming for sats of 94-98%
Then the same:
Bronchodilators such as salbutamol
Steroids such as prednisolone

Question 9

Worsening SoB, unilateral chest pain is…

Answer 9

PE

Question 10

How do you diagnose a PE?

Answer 10

CT pulmonary angiogram

Question 11

What is the Tx for PE?

Answer 11

ABCDE
If stable, Wells score and give LMWH
If unstable, call for help, IV fluids, O2 and admit for thrombolysis

Question 12

List causes of pulmonary oedema

Answer 12

Heart failure, arrhythmia, MI
AKI
ARDS

Question 13

What is the Tx for pulmonary oedema?

Answer 13

Sit up right and ABCDE
Give high flow O2 if hypoxic
Treat cause - eg beta blocker for arrhythmia

Question 14

How does a tension pneumothorax look on CXR?

Answer 14

Tracheal deviation away from affected side

Loss of lung markings on affected side

Question 15

What is the Tx for tension pneumothorax?

Answer 15

Emergency needle decompression
High flow O2
Chest drain