Respiratory Management :)

Question 1

How do we determine someones degree of distress?

Answer 1

WORK of breathing!

Question 2

What are some examples of work of breathing in patients?

Answer 2

Muscles used in danger of tiring
Chest wall and soft tissue retractions
Nasal flaring
Tracheal tugging
Pradoxial respiratory movement
Pulsus paradoxus

Question 3

How do we report breathing?

Answer 3

RATE
RYHYTHM
VOLUME

Question 4

Biot respirations?

Answer 4

irregular pattern, rate and depth with intermittent patterns of apnea

indicative of severe brain injury or brain stem herination

Question 5

Cheyne-stokes respirations?

Answer 5

cresendo and decresendo breathing
period of apnea in between

Question 6

Agonal respirations?

Answer 6

Irregular gasps few and far in between
Pulseless

Question 7

Kussmaul respirations?

Answer 7

body’s response to metabolic acidosis
seen in pts with diabetic ketoacidosis
- fruit acetone breath odour
- cracked and dry lips/mouth

Question 8

What are symptoms of HYPOXIA?

Answer 8

restlessness
confusion
combative
sedated

Question 9

How do we treat hypoxia?

Answer 9

VENTILATE and increase O2

Question 10

What is cyanosis?

Answer 10

blue discolouration

Question 11

Why is history gathering important for chronic respiratory pts?

Answer 11

because chronic respiratory pts are knowledgable about their condition and past treatments

they know best about their condition!!!!

Question 12

What are some questions for repeating conditions?

Answer 12

Has this happened before?
When? What did they do for you?
Were you hospitalized?
Does this feel the same as last time?

Question 13

Upon physical examination what are we checking for in the neck, chest, abdo, and extremities?

Answer 13

Neck examination
- JVD
- Trachea
Chest and abdominal examination
- Accessory muscle use
- In drawing
- Auscultation
Examination of the extremities
- Edema of the ankles or lower back
- Skin temp

Question 14

What do we need to keep the SPO2 at?

Answer 14

92-96%

Question 15

What should our ETCO2 be for COPD patients?

Answer 15

50-60mmHg

Question 16

What does SPO2 monitor?

Answer 16

% of oxygenated hemoglobin

Question 17

What is a normal ETCO2 range?

Answer 17

35-45mmHg

Question 18

How do you manage dyspnea?

Answer 18

Supportive prehospital care
Airway
O2
Monitor and transport

Question 19

What are the 3 meds we give for bronchoconstriction?

Answer 19

Ventolin
Epinephrine
Dex

Question 20

What are ventilation devices we need to use for patients in respiratory failure?

Answer 20

OPA/NPA
BVM
KING LT

Question 21

Which pt’s can we CPAP?

Answer 21

Bronchitis
Emphysema
NOT asthma

Question 22

What body type is a chronic bronchitis patient present as?

Answer 22

obsese, seated

Question 23

What body type is an emphysema pt present as?

Answer 23

barrel chest
muscle wasting and
pursed lip breathing

Question 24

What do end stage disease patients present as?

Answer 24

sickly appearance, rigors, and chills

Question 25

What is the dose of Ventolin given to pts <25kg? (MDI and NEB)

Answer 25

6 puffs (600 mcg)

2.5 mg

Question 26

What is the MAX # of doses of Ventolin for ANY patient?

Answer 26

3

Question 26

What is the dosing interval for ALL Ventolin administration?

Answer 26

5-15 PRN

Question 26

What route CAN we adminster ventolin in?

Answer 26

MDI (inhaler) or NEB (nebulizer)

Question 26

What is the dose of Ventolin given to pts >=25kg? (MDI and NEB)

Answer 26

8 puffs (800 mcg)

5 mg