Respiratory Emergencies

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Respiratory Emergencies
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Respiratory Failure

• A condition that occurs when respiratory
• system is unable to adequately exchange
• Oxygen and Carbon Dioxide between
• environment and tissues of the body

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Respiratory Failure

• PaO2 lt 60 mmHg
• PaCO2 gt 50 mmHg

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Types of Respiratory Failure

• Type I
• Oxygenation Failure (Hypoxemic)
• Type II
• Ventilation Failure (Hypercapnic)

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Asthma

• Factors Determine Severe Asthma
• History - Frequent Attacks
• - Excessive use of -
  Bronchodilators
• -
  Steroids
• - Previous admission to ICU

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Asthma

• Physical Examination
• Inability to speak
• Cyanosis
• Respiratory rate gt30/mt
• Heart Rate gt115/mt
• Pulsus Paradoxus gt10 mmHg
• Silent chest

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Asthma

• Blood Gases
• Respiratory acidosis
• Hypoxemia (Low PO2)
• Hypercapnia (High PCO2)

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FVC
100 75 50 25
FEV1
gt 75
NORMAL
FVC
0 1 2 3 4 5 6
7 8
TIME
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FVC
100 75 50 25
FEV1
Airway Obstruction
FEV1
lt 75
FVC
0 1 2 3 4 5 6
7 8
TIME
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Asthma

• Treatment
• Oxygen by Mask
• Salbutamol (Ventolin) inhaler
• Aminophylline I.V
• Corticosteroids

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Pulmonary Edema

• Risk Factors
• - Ischemic Heart Disease
• Smoking
• DM
• HTN
• ?Lipids
• - Rheumatic Heart Disease
• Symptoms
• - Shortness of Breath
• - PND
• - Orthopnea

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Pulmonary Edema

• Physical Examination
• - Gallop Rhythm
• - ?JVP
• - Basal
  Crackles
• - Lower Limb Edema
• Investigations - CXR,ECG,ECHO
• Treatment - Oxygen
• - Diuretics
• - Digoxin
• - After load Reduction

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Pneumothorax

• Traumatic
• Spontaneous
• -Tall Thin

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Pneumothorax

• Treatment
• Immediate Needle Insertion
• (Second Intercostal Space)

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Pneumothorax

• Treatment
• Chest Tube Insertion

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Pneumonia

• History - Cough
• - Shortness of Breath
• - Fever
• - Sputum
• Examination - Dullness
• - ? Vocal fremitus
• - Bronchial
  Breathing
• - Crackles
• Treatment - Oxygen
• - Antibiotics

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Pulmonary Embolism

• Predisposing factors
• - Immobilization
• - Recent surgery
• - Hyper coagulable state

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Massive Pulmonary Embolism

• Treatment
• Thrombolytic Therapy
• Heparin
• Warfarin

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Acute Respiratory Distress Syndrome

• Causes
• - Aspiration Pneumonia
• - Near Drowning
• - Chest Trauma
• - Severe Pneumonia

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Atelectasis

• Causes
• Foreign body
• Endobronchial lesion
• Excessive secretions

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Respiratory Failure

• Type II
• Ventilation Failure (Hypercapnic)

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Causes Of Respiratory Failure Outside The Lung
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Respiratory Failure

• COPD
• Causes
• Emphysema
• Chronic Bronchitis

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Shortness of Breath on Exertion
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Pursed Lip Breathing
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FVC
100 75 50 25
FEV1
gt 75
NORMAL
FVC
0 1 2 3 4 5 6
7 8
TIME
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FVC
100 75 50 25
FEV1
Airway Obstruction
FEV1
lt 75
FVC
0 1 2 3 4 5 6
7 8
TIME
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COPD

• Treatment
• Oxygenation
• Ventolin Inhalation
• Atrovent Inhalation
• Steroids
• Antibiotics

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END