Breathing

Question 1

Acute respiratory failure
Criteria

Answer 1

pO2 <50mmHg +/- pCO2 >45mmHg

Question 2

Acute respiratory failure
Hypoxic Respiratory Dx

Answer 2

Diffusion problem: pneumonia, ARDS
V/Q mismatch: PE, Asthma, COPD
Shunt
Low ambient FiO2: high altitude
Alveolar hypoventilation

Question 3

Acute respiratory failure
Hypercarbic Respiratory Failure, Normal Lungs Dx

Answer 3

Disorder of respiratory control: overdose, brainstem lesion, CNS disease
Neuromuscular disorders: muscular dystrophy, GBS, Myasthenia Gravis,
ALS
Anatomic: trauma, ankylosing spondylitis, kyphosis/severe scoliosis

Question 4

Hypercarbic Respiratory Failure, Abnormal Lungs

Answer 4

Increased airway resistance: AECOPD, asthma exacerbation
Decreased gas exchange: scarring, IPF

Question 5

Respiratory Failure
Look

Answer 5

Mental status
Colour
Chest wall movement, accessory muscle use
Paradoxical abdominal movement

Question 6

Respiratory Failure
Listen

Answer 6

Auscultate for breath
sounds
Signs of obstruction
Air entering or
escaping
Wheeze and stridor

Question 7

Respiratory Failure
Feel

Answer 7

Tracheal deviation
Crepitus
Flail segments
Chest wounds

Question 8

Respiratory Failure
Management of Patient
Spontaneously Breathing Patient

Answer 8

Nasal prongs
Face mask, Non-rebreather face mask
High flow nasal oxygenation (i.e. MaxTech)

Question 9

Respiratory Failure
Management of Patient
Temporizing Measures for Inadequate Ventilation

Answer 9

Bag-valve mask +/- nasal airway
CPAP/BiPAP: acute exacerbations of CHF, COPD, asthma

Question 10

Respiratory Failure
Management of Patient
Definitive Measures for Inability to Maintain/Protect Airway

Answer 10

Oro-tracheal intubation
Surgical airway

Question 11

Respiratory Failure
Management of Patient
Additional Modalities

Answer 11

Needle or finger thoracostomy for tension pneumothorax
Chest tube to drain pleural effusion/hemothorax/pneumothorax