1249 Respiratory Distress

Question 1

5 things to consider for acute respiratory distress

Answer 1

1. FBO
2. Epiglottitis/Croup
3. Spontaneous pneumothorax
4. inhalation injury
5. Pulmonary embolism

Question 2

Stridor

Answer 2

1. BASE CONTACT
2. Severe respiratory distress and Croup:
   EPI 1:1000 HHN
   1y/o 5mg in 5ml x 1
   Hold for HR >200

Question 3

WHEEZING

Answer 3

Albuterol
5mg HHN x 2
40y/o or preg due to cardio effects

Question 4

RALES/CRACKLES

Answer 4

NTG 
0.4 SBP >100
0.8 SBP >150
1.2 SBP >200 
MR 3-5 x 2 
If wheezing 
ALB 5mg HHN (can be given simultaneously w/NTG) 
BASE CONTACT

Question 5

What if the HHN bowl is only 5ml?

Answer 5

The 5mg can divided in 1/2 and given in 2 TX

Question 6

Consider CPAP for who?

Answer 6

Moderate to severe respiratory distress

> 14 y/o

SBP > 90mmHg

Question 7

POOR PERFUSION

Answer 7

1. BASE CONTACT
2. NS fluid challenge 10ml/kg in 250ml increments
3. Dopamine 400mg/500ml
   NS IVPB at 30gtts/min titrate to SBP of 90-100mmHg & signs of adequate perfusion max 120gtts/min
4. Consult w/ base physician strongly recommended