Please enable JavaScript.
Coggle requires JavaScript to display documents.
PNEUMONIA - Coggle Diagram
PNEUMONIA
Causes
Bacteria
e.g. streptococcus pneumonia (common), haemophilus influenza type b
Fungi
Virus e.g. respiratory syncytial
Parasites
Chemical
Aspiration (inhaled stomach contents)
Inhalation (smoke, burns)
Medical Diagnosis
Temperature > 37.8oC (<100oF)
HR > 100bpm
Crackles
decreased breath sounds or bronchial breath sounds
absence of asthma
Clinical Prediction Rule
5 findings = 84 - 91% probability
4 findings = 58 - 85% probability
3 findings = 35 - 51% probability
2 findings = 14 - 24% probability
1 finding = 5 - 9% probability
0 findings = 2 - 3% - still possible
Other diagnostic tests
CXR
CT scan
Blood test
Sputum culture
Pleural fluid culture
Bronchoscopy
Prevalence (epidemiology)
Single largest infectious cause of death in children worldwide - 16% of children under 5 in 2015 (920,136)
345/100,000 people have had one or more episodes of pneumonia
220,000 people receive a diagnosis every year
Affects the youngest and oldest most
472/100,000 children under 5
843/100,000 adults aged 71-80
1,838/100,000 adults over 81
28,952 deaths from pneumonia (5.1% of all deaths + 25.3% of deaths from lung disease) 12,239 were males and 16,712 were females
Classification
Community Acquired Pneumonia (CAP)
Healthcare Associated Pneumonia (HCAP)
Hospital Acquired Pneumonia (HAP)
Ventilator Associated Pneumonia (VAP)
Causes
HAP
MRSA 15%
Pseudomonas Aeruginosa 14%
MSSA 9%
Klebsiella pneumonia 3%
other gram negative rods 9%
Unknown Cause 37%
CAP
Strep C Pneumonia/ Staphylococcus aureus 25%
Virus 10%
Mycoplasma 6%
H influenza 5%
Legionella 3%
Unknown cause 37%
Pneumonia cannot be defined by the infective organism only the setting and risk. knowing which type helps influence the treatment
Complications
Lung abscess
Pleural effusion
Empyema (infection/pus in-between the pleural cavity
Septic Shock
Pathology
Due to infection or chemical or aspiration irritant
during a pulmonary infection,
acute inflammation
results in the
migration of neutrophils
out of
capillaries
and into
alveoli
, these cells
phagocytose and release antimicrobial enzymes and inhibitors
-> more
inflammation and oedema
Stages
Congestion
(inflammatory stage)
1st 24 hours
Characterised by vascular engorgement, intra-alveolar fluid and numerous bacteria. the lung is heavy, boggy and red
Red Hepatisation
(because of liver consistency)
2-3 days
Massive exudation develops with red blood cells, leukocytes and fibrin filling the alveolar spaces. the affected area appears red, firm and airless - with liver like consistency
Grey Hepatization
(loss of red blood cells so not red but still liver consistency)
4-6 days
Progressive disintegration of red blood cells and persistence of a fibrin exudate
Resolution
(when physiotherapy involved)
.> 6 days
Consolidated exudate with the alveolar spaces undergoes progressive digestion to produce debris that is later reabsorbed, ingested by macrophages or coughed up
Signs and Symptoms
Fever, Malaise, muscle ache/fatigue, coughing (productive and non productive), tactile fremitus on palpation (feel secretions), Dyspnoea, pleuritic or chest pain, loss of appetite and rapid heartbeat.
Coughing up of Blood, fatigue, nausea/vomiting, diarrhoea, Wheezing, Confusion
some symptoms relate to inflammation and some relate to lack of o2
Management
General
Antibiotics
O2 Support
Hydration - IV fluids
rest
Analgesics
Cough suppressant medication
fever-reducing medication - keep enzymes working
Prevention through vaccination programs
Physiotherapy treatments
Care needed as it may increase oxygen consumption and demand or cause bronchospasm
treat the clinical signs and symptoms - e.g. SOB
Non production - positioning V/Q, mobilising or no intevention
Productive - sputum clearance techniques including positioning, breathing exercises, adjuncts etc.
Pneumonia is an inflammatory condition of the lung leading to abnormal alveolar filling with consolidation and exudation - normally caused by infection.