RESPIRATORY EMERGENCIESAn Introduction

Nose/mouth – pharynx/oropharynx – Larynx – Trachea – Bronchi – Bronchioles – Lungs- Alveoli

The intercostal muscles and the diaphragm contract, increasing the size of the thoracic cavity. The diaphragm moves slightly downward, the ribs move upward/outward and air flows into the lungs

InhalationExhalation is the reverse

ALL IS NORMAL BASED ON………

Rate Rhythm Quality Depth

12-20 regular breath adequate

sounds

Skin is warm/pink/dry

Minute Volume

Normal Minute Volume

12bpm x 500 mL – 150 mL/bpm dead space=

5850mL/minute

INADEQUATE BREATHING Respiratory Distress Respiratory Failure Respiratory Arrest

Inadequate Breathing Defined

Signs of Inadequate Breathing

Respiratory Distress

Respiratory Failure

Respiratory Arrest

Patient Assessment

Rate Rhythm Quality

12-20 Regular Depth (minute volume)

None

Too Fast

Too Slow

Oxygen Therapy

Nasal Canulae

Non-Rebreather

Oxygen Therapy (administration)Examples requiring O2 administration: Respiratory or cardiac arrest Heart attack Stroke Shock Blood loss Lung disease Broken bones Head injuries

Hypoxia

Deprivation of adequate supply of oxygen

Anoxia

Complete deprivation of oxygen

Hypoxemia

decreased partial pressure of oxygen in blood, sometimes specifically as less than 60 mmHg

Hypoxemia is different from hypoxia, which is an abnormally low oxygen availability to the body or an individual tissue or organ. Still, hypoxia can be caused by hypoxemia, and such hypoxia is referred to as hypoxemic hypoxia

Can be cause by. . . . . . .

Alveolar hypoventilationIf the alveolar ventilation is low, there may be

insufficient oxygen delivered to the alveoli each minute. This can cause hypoxemia even if the lungs are normal, as the cause may be outside the lungs (e.g., airway obstruction, depression of the brain's respiratory center, or muscular weakness).

Hypoxia vs. hypoxemia

Hypoxia differs from hypoxemia. In the latter, the oxygen concentration within the arterial blood is abnormally low. It is possible to experience hypoxia and have a low oxygen content (e.g., due to anemia) but maintain high oxygen partial pressure (pO2). Incorrect use of these terms can lead to confusion, especially as hypoxemia is among the causes of hypoxia (in hypoxemic hypoxia).

Partial pressure

In a mixture of ideal gasses, each gas has a partial pressure which is the pressure which the gas would have if it alone occupied the volume

Breathing DifficultiesSigns and Symptoms Shortness of breath Tightness in the chest Restlessness Increased pulse rate Decreased pulse rate (especially in infants and

children) Changes in breathing rate/rhythm

Pale, cyanotic or flushed skin Noisy breathing Inability to speak in full sentences Use of accessory muscles Retractions AMS Coughing Flared nostrils; pursed lips Positioning Barrel chest

Focused History and Physical Exam O P Q R S T Lung sounds

Care Oxygen administration

Respiratory Conditions COPD

EmphysemaChronic BronchitisBlack Lung

CHFHypoxic Drive

NEVER WITHHOLD OXYGEN

Asthma Seen in young and old alike Episodic disease May be triggered by an allergic reaction

When an attack occurs Small bronchioles become narrow Overproduction of thick mucus Small passages practically shut down Flow restricted in one direction

Expiratory wheezes

Air is trapped in the lungs

Assisting with the Inhaler The drug is in the form of a fine powder that become active

when comes in contact with lung tissue Calm your patient Administration check list

Right patientRight medicationRight doseRight routeCheck expiration date

Shake inhaler vigorously several times Make sure patient is alert enough to

properly use Make sure patient exhales deeply Inhale deeply as Inhaler is administered Hold breath as long as possible