Respiratory Emergencies.pdf - Respiratory Emergencies Azmat J Khan RN BScN MScN OBJECTIVES Pulmonary Embolism Acute Respiratory Failure Pulmonary

Respiratory Emergencies.pdf - Respiratory Emergencies Azmat...

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Respiratory Emergencies Azmat J. Khan RN, BScN, MScN
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OBJECTIVES Definition Assessment Management Acute Respiratory Failure Pulmonary Embolism Pulmonary Contusion.
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Respiratory Emergencies (RE) Respiratory emergencies may present as a minor problem, such as upper respiratory infection, or impeding respiratory arrest caused by epiglottitis. Rapid assessment and interventions are essential to prevent escalation of respiratory compromise. Because respiratory distress is caused by impaired oxygenation or ventilation, it is an emergent condition, regardless of etiology.
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Acute Respiratory Failure Emergency condition All age Major cause of death Definitions: Acute Respiratory Failure occurs when pulmonary system is no longer able to meet the metabolic demands of the body Hypoxemic Respiratory Failure (Insufficient O2transferred to the blood): PaO250 mm Hg when breathing room air Hypercapnic respiratory failure (Inadequate CO2removal): PaCO2 50 mm Hg.
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Classification of Respiratory Failure
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Brainstem Spinal cord Nerve root Airway Nerve Neuromuscular junction Respiratory muscle Lung Pleura Chest wall Sites at which disease may cause ventilatory disturbance
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FIO2 Ventilation without Perfusion (dead space ventilation) Diffusion Abnormality Perfusion without Ventilation (shunting) Hypoventilation Normal
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V/Q Mismatch: Dead Space Ventilation Alveoli that are normally ventilated but poorly perfused DSV increase: Alveolar-capillary interface destroyed e.g emphysema Blood flow is reduced e.g CHF, PE Over distended alveoli e.g positive- pressure ventilation
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FIO2 Ventilation without Perfusion (dead space ventilation) Diffusion Abnormality Perfusion without Ventilation (shunting) Hypoventilation Normal
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Diffusion Abnormality Less common Abnormality of the alveolar membrane or a reduction in the number of capillaries resulting in a reduction in alveolar surface area Causes include: Acute Respiratory Distress Syndrome (ARDS) Fibrotic lung disease
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FIO2 Ventilation without perfusion (deadspace ventilation) Diffusion abnormality Perfusion without ventilation (shunting) Hypoventilation Normal the air that reaches the alveoli the blood that reaches the alveoli
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Perfusion without Ventilation (Shunting) Intra-cardiac Any cause of right to left shunt E.g. Tetralogy of Fallot(TOF), Eisenmenger Intra-pulmonary Pulmonary haemorrhage or contusion Small airways occluded ( e.g asthma, chronic bronchitis, COPD) Alveoli are filled with fluid ( e.g pulmonary edema, pneumonia) Alveolar collapse (e.g Atelectasis)
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Hyper inflated Lungs : COPD
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Respiratory Failure Symptoms CNS: Headache Visual Disturbances Anxiety Confusion Memory Loss Weakness Decreased Functional Performance Pulmonary: Cough Chest pains Sputum production Stridor Dyspnea Cardiac: Orthopnea Peripheral edema Chest pain
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Clinical Signs
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