Respiratory Emergencies (1).pdf - Respiratory Emergencies Acknowledge Erum Kabani Kiran Ali Azmat Jehan OBJECTIVES Pulmonary Embolism Acute Respiratory

Respiratory Emergencies (1).pdf - Respiratory Emergencies...

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Respiratory Emergencies Acknowledge Erum Kabani & Kiran Ali & Azmat Jehan
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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 Hypoxaemic Respiratory Failure (Insufficient O 2 transferred to the blood): PaO 2 50-60 mm Hg when breathing room air Hypercapnic respiratory failure (Inadequate CO 2 removal): PaCO 2 45-50 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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Physiological Condition of Respiratory Alterations Hypoxemic (oxygenation failure): Ventilation Perfusion mismatch (V/Q mismatch) Shunting Diffusion abnormality Alveolar Hypoventilation
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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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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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F I O 2 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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Hyper inflated Lungs : COPD
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Hypercapnic Disorders Imbalance between ventilatory supply and ventilatory demand. Obstructive Disorders resulting in CO2 retention
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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 Tachypnoea RR > 35 Breath /min Accessory muscles, Recession, Nasal flaring Respiratory Compensation HR BP, sweating Sympathetic Stimulation Altered mental state HR and BP (late) PaO2 + PaCO2 acidosis ⇨ ⇑ ICP Disorientation, Headache, Asterixis, Coma Tissue Hypoxia Cyanosis Haemoglobin Desaturation
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  • Fall '19
  • Respiratory¬†distress, Pulmonary contusion

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