Topic 3 - Dyspnoea Flashcards
1
Q
5 main causes of dyspnoea
A
- Neurological
- Airway obstruction
- Respiratory compromise
- Cardiovascular compromise
- Thoracic muskuloskeletal compromise
2
Q
Mild (partial) airway obstriction management
A
- Reassurance
- Encourage spontaneous efforts to clear airway
- Inappropriate or premature intervention can result in severe or complete obstruction
3
Q
Severe airway obstruction management (concious)
A
- Up to five sharp back blows
- Up to five chest thrusts
- Repeat if required
- Ensure ongoing assessment of airway and concious state
4
Q
Severe airway obstraction (unconcious)
A
- Remove foreign body under direct visualisation
If not:
- O2
- Gentle IPPV
- LMA/ETT
- Appropriate resuscitation
5
Q
Croup and clinical manifestations
A
Croup is a viral ilness that causes inflammatory oedema of the subglottis
- Coroyzal prodrome (URTI), hoarse voice, inspiratory stridor, harsh ‘barking’ cough, widespread wheeze, increased WOB and fever
- Affects children 6mths to 3 years generally
- 2-5 day symptoms, worse at night
- NOTE - nebulised adrenaline is a temporising measure only
6
Q
Croup - differential diagnosis
A
- Inhaled foreign body
- Epiglottitis
- Bacterial tracheitis
7
Q
4 components of bronchospasm in asthma
A
- Bronchospasm
- Inflammation and oedema of airways
- Mucous plugging
- Airway smooth muscle hyperplasia and hypertrophy
8
Q
Asthma classifications
A
- Mild, moderate, severe, life-threatening
- Gradual onset
- Over days or weeks - higher mortality - responds less well to treatment
- Rapid onset
- Often has a precipitating trigger and responds quickly to treatment
9
Q
Electrolyte complications of asthma
A
- Hypokalemia
- Hypocalcemia
- Lactic acidosis
10
Q
Risk factors for life-threatening exacerbations in astma
A
- Prior ICU admission and prior intubation
- Three or more admissions to hospital over the last 12/12
- Currently taking steroids for asthma
- Poor compliance with medications
- NOTE - SpO2 is a POOR indicator of severity - will not decrease until later stages
11
Q
Important patient history factors in asthma
A
- Previous asthma history (including ICU admissions and intubations, number of admissions in the last 12 months etc.)
- Co-existing medical conditions
- Asthma triggers if known and cause of current episode
- Duration of symptoms (? physical exhaustion)
- Medication use and compliance
12
Q
IPPV in asthma
A
- Prolonged expiratory phase
- ADULT: 4-6 b/m
- LARGE CHILD: 8-10 b/m
- SMALL CHILD: 10-15
- INFANT:15-20
13
Q
Asthma Managment
A
14
Q
Main causes of cardiogenic APO
A
- Left ventricular failure (LVF)
- Increased intravscular volume
- Pulmonary venous outflow ovstruction (eg. mitral valve stenosis)
15
Q
Main causes of non-cardiogenic APO
A
- High output states such as:
- Septicemia
- Anaemia
- Thyrotoxicosis
- Systemic increased vascular permiability
- Pancreatitis
- Eclampsia
- DIC
- Burns
- Toxins/environmental
- Submersion
- Toxic inhlation
- HAPE
- Other
- Head injury
- PE
17
Q
APO management
A
18
Q
COPD and exacerbation management
A
21
Q
Anaphylaxis management
A
