Respiratory Emergencies:

  • Principle function = RESPIRATION at alveoli

Asthma

Wheezing on inspiration/expiration

Brochospasm

Anaphylaxis

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flushed skin/Uticaria

Generalized Edema

Decreased BP

Laryngeal edema w/ dyspnea

Wheezing/Stridor

Broncholitis

dyspnea

wheezing, crackles, or rhonchi

coughing

fever

dehydration

Tachypnea

Tachycardia

Bronchitis

Chronic cough (w/ sputum production)

Wheezing

Cyanosis

Cyanosis

Tachypnea

CHF

Pulmonary Edema

Crackles (pulmonary edema)

Orthopnea

Paroxysmal nocturnal dyspnea

Common cold

cough

runny/stuffy nose

sore throat

Croup

fever

  • barking cough *
  • stridor

mostly seen in pediatric patients

Diphtheria

difficulty breathing and swallowing

sore throat

thick, gray build up in throat/nose

fever

Emphysema

barrel chest

pursed lip breathing

dyspnea on exertion

cyanosis

wheezing/decreased breath sounds

Epiglottitis

dyspnea

high fever

stridor: late sign

drooling*

difficulty swallowing

severe sore throat

tripod or sniffing position

influenza type A (flu)

cough

fever

sore throat

fatigue

pertussis (whooping cough)

coughing spells: may last more than a min.

"whooping" sound*

fever

Pneumonia

dyspnea

chills, fever

cough

green, red, or rust-colored sputum

localized wheezing or crackles

Pneumothorax

pleuritic chest pain w/ dyspnea

decreased breath sounds (affected side)

subcutaneous emphysema

Pulmonary embolus

-sharp chest pain
-dyspnea
-tachycardia
-tachypnea
-varying degrees of hypoxia
-cyanosis
-acute chest pain
-hemoptysis (coughing up blood)

clear breath sounds initially

tension pneumothorax

severe shortness of breath

decreased/altered level of consciousness

neck vein distention

tracheal deviation (late sign)

hypotension; signs of shock (late sign)

respiratory syncytial virus (RSV)

cough

wheezing

fever

dehydration*

Tuberculosis (TB)

-fever
-cough
-fatigue
-night sweats
-bloody sputum
-weight loss

-chest pain

Causes for dyspnea:
-pulmonary edema
-hay fever
-pleural effusion
-obstruction of the airway
-hyperventilation syndrome
-environmental/industrial exposure
-CO poisoning
-Drug overdose

caused: inflammation of larynx, pharynx, and trachea, secondary to acute viral infection of upper respiratory tract

age: 6mo-3years

Easily transmittable w/ children

starts w/ cold, cough, and low grade fever that develops over 2 days

responds well to humidified O2, bronchodilators not for couple may worsen symptoms

common cause: bacterial infection

vaccine has decreased incidence of epiglottitis

sudden onset, look ill, report very sore throat, high fever.

will often be found in tripod position and drooling.*

highflown O2, position of comfort, put nothing in mouth

common in young children. infection in lungs and breathing passages, which can leader to more serious problems like bronchiolitis and pneumonia

high contagious

infants w/ RSV often refuse liquid

often occurs due to RSV - results in severe bronchioles

frequent in newborns and toddlers, commonly boys

common in winter/spring

typically at increased risk for developing childhood asthma.

supportive treatment

significant cause of morbidity worldwide

infection in lungs, collects in normal lung tissue, impairing gas exchange

secondary infection from upper respiratory infection

intubation and tracheostomy can increase risk

predisposition:
-residence homes
-recent hospitalization
-chronic disease processes
-immune system compromise
-COPD

lower lung pneumonia:
-fever
-abdominal pain
vomiting

-bacterial pneumonia: severe symptoms more quickly w/ high fever (children have higher risk for seizures)
-viral pneumonia: more gradually and less severe

pulse ox may be low

age: children under 6, highly contagious
-under 6 mo. can be life threatening

vomit or not have appetite,
look for dehydration

adults - not common but can cause severe upper respiratory infection leading to pneumonia in geriatric or immunocompromised

geriatric patients can have cracked ribs from coughing

animal respiratory disease that mutated to humans

H1N1 = pandemic

muscle aches/headaches

bacterial infection - dangerous b/c
many strains are resistant to antibiotics

infects lungs but can be
found in other organs

remain dormant for years

-higher transmission
-prison
-nursing home
-homeless shelters
-IV drug users
-countries w/ high levels

wear gloves, eye protection, and N-95

Acute Pulmonary Edema

heart is injured that it cannot circulate blood properly, left side cannot remove blood as fast as right side brings in, therefore causing a fund buildup in alveoli and in the lung tissue between alveoli and pulmonary capillaries. Edema interferes w/ gas exchange and does not leave enough room for lungs to take a slow deep breath.

typically a result of CHF, but can also be a result of chest trauma, poisoning from smoke/toxins, high altitudes

high BP and low CO often trigger flash pulmonary edema

patients are sick and frightened (literally drowning in fluid)

dyspnea, rapid, shallow respirations,
severe: frothy pink sputum from nose/mouth

cool, diaphertic, cyanotic skin, crackles/wheezing, tachycardia, HTN early but later Hypotension

cold sweats

COPD

slow process of dilation and disruption of airways an alveoli caused by chronic bronchial obstruction

3rd leading cause of death in US

umbrella term: emphysema & chronic bronchitis
-emphysema: loss of elastic material in lungs that occur when alveolar spaces chronically stretch due to inflamed airways and obstruction of airflow in lungs. Walls eventually fall apart leaving large holes in lung that resemble air pockets
-chronic bronchitis: Protective cells and mechanisms that remove foreign particles are destroyed weakening airways

caused by: direct lung and airway damage from infection or inhalation of smoke/toxin. typically caused by smoking

Chronically produce sputum, chronic cough, difficulty expelling air from lungs, long expiration phases, and wheezing. Also crackles, rhonchi, and wheezes, or diminished lung sounds

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COPD vs. CHF

Pulmonary edema (CHF): wet lung sounds (rhonchi, crackles): quicker development of symptoms

COPD: dry lung sounds (wheezes): bronchial constrictions, present w/ shortness of breath, slow onset

Meds: O2, bronchodilators, and corticosteroids

treat patient not lung sounds

acute spasm of bronchioles w/ excessive mucus production and swelling of mucous lining of respiratory passage

Age: highest in 5-17 years

  • wheezing *
  • severe: exhaling is tiring and cyanosis

acute asthma attack: allergic response to food or allergen

between attacks may not breathe normally

severe emotional stress, exervise, and respiratory infections

Hay Fever

coldlike symptoms:
-runny nose
-sneezing
-congestion
-sinus pressure

caused by allergic response

atopic

signs of shock

partial or complete accumulation of air in pleural space

caused by trauma or medical conditions

tall thin men are at higher risk when performing strenuous activities.

-Hypotension
-jugular vein distention
-cyanosis

Pleural Effusion

plea

collection of fluid outside of lung on one/both side of chest

compresses lung(s) and causes dyspnea:
-although can build up for weeks patients typically report dyspnea onset suddenly

hear decreased lung sounds over region of chest wall where fluid has moved lung away from chest wall, typically feel better upright.

blood clot formed in vein that breaks off and moves through venous system

embolus: anything in circulatory system that moves from point of origin to distant cite and lodges, obstructing blood flow in area

patients with LE immobilization at higher risk, pregnancy, active cancer