Respiratory Emergencies Flashcards
(19 cards)
COPD
Chronic Obstructive Pulmonary Disease
Chronic bronchitis and Emphysema
Chronic Bronchitis
-“Blue Bloater”
- Typically overweight
- Productive cough with sputum
- Coarse rhonchi
- Chronic cyanosis
- Mild, chronic dyspnea
- Resistance on inspiration and expiration
Emphysema
“Pink Puffer”
- Thin, barrel-chest appearance
- Nonproductive cough
- Wheezing and rhonchi
- Pink complexion
- Extreme dyspnea on exertion
- Prolonged inspiration (pursed-lip breathing)
- Clubbing of fingers
Asthma
Two-pronged issue: bronchoconstriction and inflammation
Prehospital treatment:
- bronchodilation =(albuterol)
- reducing inflammation (steroids). I
-severe cases, epinephrine = additional bronchodilatory effects and nebulized magnesium sulfate to act as a smooth muscle relaxer
Asthma
- Bronchonstriction and inflammation
- Dyspnea
- Intercostal retractions
- Decreasing LOC
- Inability to speak in complete sentences
- Tachycardia
- Tachypnea
- ETCO2 > 45mmhg
Status Ashmaticus
- Severe, prolonged asthma attack that has not been stopped with repeated doses of bronchodilators
Pneumonia
- Infection that causes an acute inflammatory response
- Bacterial, viral, or fungal
- Productive cough
- Pleuritic Chest pain
- Tachypnea
- Wheezing, crackles, or rhonchi
- Fever
- Fatigue
ARDS
Acute Respiratory Distress Syndrome (ARDS)
- Form of hypoxemic respiratory failure
- Results in non-cardiogenic pulmonary edema
- Significant pulmonary edema leads to severe hypoxemia, intrapulmonary shunting, reduced lung compliance, and irreversible lung damage - 65% mortality rate
Pulmonary Embolism
Rapid onset of difficulty breathing and chest pain - especially high suspicion in the patient without a significant cardiac or respiratory history
Pulmonary Embolism Common patients
- Bedridden (chronically or after surgery)
- Long flights
- History of deep vein thrombosis (DVT)
Female patient (teens - 40’s) on birth control
- increased estrogen and progesterone = increase blood clots - History of smoking
Pulmonary Embolism Sign & Symptoms/Treatment/
Additional
- Rapid onset of dyspnea
- Cough
- Pain
- Anxiety
- Hypertension
- Tachypnea
- Tachycardia
- Crackles, wheezes, rhonchi
Treatment: Identification and Rapid transport
Additional:
Right Axis Deviation
S1 Q3 T3
S-wave lead 1
Q-wave in lead 2
T wave lead 3
Obstructive shock
PE will develop into obstructive shock
Once patient has entered shock state -> administer 20mL/kg fluid boluses, repeating as needed to support BP
Hyperventilation Syndrome
- Coach patient to calm down
- Produced by anxiety or panic attack
Other potential causes
- Hypoxia
- Cardiac or pulmonary disease
- Infection/fever
- Pain
- Pregnancy
- Drug use
Hyperventilation Syndrome Signs & Symptoms
- Dyspnea
- Tachypnea
- Chest pain
- Carpopedal spasms
Simple Pneumothorax
- Presence of air in the pleural space
- Could be caused spontaneously or by trauma
- Breath sounds may be diminished or absent
- Patient may be becoming dyspneic and restless
- Tachypnea
Tension Pneumothorax
- Accumulation of air in the pleural space that causes “tension” (obstruction)
- JVD
- Hyper-resonance on percussion
- Subcutaneous emphysema
- Patients will become hypotensive in late stages (obstructive shock)
High Altitude Emergencies
- Acute Mountain Sickness
- HACE (High altitude cerebral edema)
- High Altitude Pulmonary Edema (HAPE)
Acute Mountain Sickness
- Common high altitude illness
- Person ascends rapidly to altitude to > 5,000 - 7,000 feet
- Headache, nausea, vomiting, weakness, dizziness, fatigue, difficulty sleeping, tachycardia, bradycardia, postural hypotension, ataxia
- Ataxia is a key sign of development to HACE
High Altitude Pulmonary Edema (HAPE)
- Caused by increased pulmonary artery pressure
- Symptoms usually begin 24-72 hours after the exposure to high altitudes
- The most lethal of the altitude illness
- Progressive cough, hypoxia, tachypnea and weakness at altitudes > 8,000 feet
- May develop crackles, wheezes, rhonchi, tachycardia, cyanosis.
- Oxygen administration and descent to altitude < 500 feet is essential
