Respitory Emergency Flashcards
What does the term “arrest” refer to?
Stopping/ceasing
Functions of respiratory System
- extract oxygen from atmosphere
- Excrete carbon dioxide
- temperature control (to a small degree)
Components of the respiratory system
- nose
- pharynx
- Larynx
- trachea
- bronchus
- bronchioles
- alveoli
What increases breathing rate?
Exercise/temperature/shock/lung function/drugs
Where in the respiratory system does gas exchange take place?
Alveoli
What is the normal breathing rate of an adult?
12-20BPM
What is the normal breathing rate of a child?
20-30
What is the normal breathing rate of an infant?
20-30BPM
WRONG
What is the normal breathing rate of a newborn?
30-50BPM
What decreases normal breathing rate ?
- head injury
-physical fitness of patient - Drugs
- Agonal respirations
- Rest
What percentage of air composition is oxygen?
20%
What percentage of oxygen is in expired air?
16%
What makes us breathe?
Chemoreceptors
What are chemoreceptors?
They are situated in the arch of the aorta and carotid bodies are very sensitive to changes in levels of carbon dioxide
What will happen if there is an increase in carbon dioxide?
Breathing rate will increase
What makes us breathe?
- chemoreceptors pick up high levels of CO2
- the respiratory centre tells the diaphragm and accessory muscles to contract
- breathing rate may increase
What is hypoxic drive?
The peripheral chemo receptors are sensitive to the levels of oxygen in the body. They will send a signal to breathe when the partial pressure of oxygen begins to fall
What is hypoxia?
a state in which oxygen is not available in sufficient amounts at the tissue level to maintain adequate homeostasis
What is Chronic Obstructive Pulmonary Disease
COPD
Level of carbon dioxide is chronically elevated
What diseases cause COPD?
- emphysema
- bronchitis
- asthma
What is emphysema?
a chronic obstructive pulmonary disease that damages the air sacs in your lungs and makes it hard to breathe
What is bronchitis?
an infection of the main airways of the lungs (bronchi), causing them to become irritated and inflamed
What is asthma?
a condition in which your airways narrow and swell and may produce extra mucus
What is Respiratory arrest?
The complete cessation of breathing by the patient
What is inadequate breathing?
Is usually defined as a rate of below 10 and above 29 with signs of distress or shock
What causes respiratory arrest?
- blockage is the respiratory tract I.e FBAO/blood/vomit
- chest or lung trauma
- paralysis of respiratory nerves I.e drug overdose
What causes respiratory arrest?
COPD
- emphysema
- Bronchitis
EPISODIC
- asthma
Signs of respiratory depression secondary to narcotic overdose
- respirations reduced and shallow
- other clues include pinpoint pupils
- if detected the effects can be reversed
(CALL ALS)
What does the term “pink puffers” refer to
Patients with emphysema tent to have pink skin, pursed lip oh expiration, thin
How does a emphysema patient present?
- usually thin
- pinky skin colour
- tachypnea/dyspnea
- right sided heart failure may be present
- pursed lips on expiration
- well developed chest “barrel chest”
What does tachypnea mean?
Rapid and shallow breathing
What is dyspnea?
DIS-A-PNEA
Sensation of running out of air and not being able to breathe fast/deeply enough
What is Bronchitis?
A form of COAD (chronic obstructive airway disease) characterised by excess mucus production in the airway
Is bronchitis viral or bacterial?
It’s can be either
What does COAD stand for?
Chronic Obstructive Airway Disease
What is an exacerbation of COPD defined as?
An event in the natural course of the disease characterised by a change in the patient’s baseline dyspnoea, cough and/or sputum beyond day-to-day variability sufficient to warrant a change in management
What is bronchitis?
There is reduced surface area for gas exchange
Productive cough (greeny yellow in colour, often brown because of smoking)
How to patients with bronchitis usually present?
Usually over weight
Often referred to as “blue bloaters”
How does a patient with asthma present?
Tripod position
Expiratory wheezes
Most common in children
How are asthma attacks induced?
By triggers:
Stress/environment/exercise/certain drugs
What is status asthmaticus?
A prolonged attack which may become life threatening
What are concerns with a quiet asthmatic?
Very little air going in or out
Typically repetitive condition
What is the function of a brown inhaler
Prevention inhaler
What is the function of a blue asthma inhalers?
Rapid relief
What is a nebulizar
A drug delivery system administered via mask as a mist
Treatment for Respiratory Emergency
- provide Basic Life Support (BVM if necessary using 100% exigen
- administer oxygen to relieve hypoxia - monitor vital signs
- position for comfort (usually upright)
- note medications
- keep patient calm
What is stridor?
a variable, high-pitched respiratory sound that can be assessed during breathing
What is bronchiolitis?
Type of chest infection
Signs and symptoms of bronchiolitis
- can be difficult to distinguish from asthma
- child’s age can be a clue
During a foreign Body Airway Obstruction what is done after each cycle of CPR?
Open mouth and look for object, if visible, make one attempt to remove
How does stridor present?
Harsh sound produced near or at the larynx by the vibration or upper airway structure, and is predominantly
Causes of stridor?
- croup
- epiglottis
- acute bacterial tracheitis
- FBOA
What are signs of croup?
- hypoxia/cyanosis
- marked respiratory distress
- stridor
- irritability or lethargy
- marked increased respiratory rate
*if persistent treat as Severe
* if intermittent treat as moderate
After how many minutes can nebulised adrenaline be repeated?
30
thefuck
What is the maximum dexamathasone dose that can be administered in 72hrs?
600mcg/Kg
What is a tracheostomy?
An opening in the front of the neck that is made to allow for an airway for patients who cannot breathe. Diseases such as cancer may require this procedure
What is a temporary tracheostomy used for?
When there is a blockage or injury to the windpipe. Also can be used for Severe pneumonia/heart attack/stroke
What is a permanent tracheostomy used for?
When part of the trachea needs to be removed due to a disease eg. Cancer
What is a tracheostomy?
A hole is created into the trachea through an incision through the neck
When is a tracheostomy used for?
To treat airway obstruction
When would you use humidified O2
- stridor
- inhalation burn
- long term use (greater than 30 mins)
