RESPIRATORY EMERGENCIES

2. RESPIRATORY EMERGENCIES An Introduction

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

4. 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 Inhalation Exhalation is the reverse ALL IS NORMAL BASED ON………

5. Rate Rhythm Quality Depth 12-20 regular breath adequate sounds Skin is warm/pink/dry

6. Minute Volume

7. Normal Minute Volume 12bpm x 500 mL – 150 mL/bpm dead space= 5850mL/minute

8. INADEQUATE BREATHING • Respiratory Distress • Respiratory Failure • Respiratory Arrest

9. Inadequate Breathing Defined

10. Signs of Inadequate Breathing

11. Respiratory Distress

12. Respiratory Failure

13. Respiratory Arrest

14. Patient Assessment Rate Rhythm Quality 12-20 Regular Depth (minute volume) None Too Fast Too Slow

15. Oxygen Therapy Nasal Canulae Non-Rebreather

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

17. Hypoxia Deprivation of adequate supply of oxygen • Anoxia Complete deprivation of oxygen

18. 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. . . . . . .

19. Alveolar hypoventilation If 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).

20. 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).

21. 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

22. Breathing Difficulties Signs 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

23. 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

24. Focused History and Physical Exam • O P Q R S T • Lung sounds Care • Oxygen administration

25. Respiratory Conditions • COPD Emphysema Chronic Bronchitis Black Lung • CHF Hypoxic Drive NEVER WITHHOLD OXYGEN

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

27. 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

28. 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 patient Right medication Right dose Right route Check expiration date

29. 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