Respiratory Emergencies
Anatomy of the Respiratory System
Inspiration Exhalation
Regulation of Ventilation Body is a constant changing environment Chemoreceptors monitor bodies CO2 levels and adjust respirations to correct highs and lows. Hypoxic drive is back-up system if normal system breaks down. (COPD)
Chief Complaint SOB Common EMS Response Initial Assessment Appearance LOC ABC’s
Signs of Adequate Breathing Normal Rate 12 – 20 breaths/min Regular pattern, with smooth flow of air Clear and equal breath sounds bilaterally Regular and equal chest rise and fall Adequate depth (tidal Volume)
Signs of Inadequate Breathing Labored breathing Altered LOC Respiratory rate less than 12 or greater than 20 with dyspnea Irregular Rhythm (Cheyne Stokes, Kussmaul, Ataxic pattern) Inequal chest expansion. Shallow breathing Skin Condition Retractions
Factors Effecting Respiration External factors Elevation Oxygen levels Toxic chemicals Confined Spaces Internal Factors Medical conditions Non functioning Alveoli Fluid in lungs Circulatory problems Metabolic problems
Foreign Body Obstruction Partial If able to talk or cough forcefully allow person to attempt to relieve on there own. If poor air exchange and weak cough provide immediate intervention Complete Abdominal thrusts If pulseless and apneic begin CPR. Use tongue jaw lift and check back of oropharynx for foreign body No blind finger sweeps
Other Obstructions Dental Appliances Facial injuries If well fitting and in place leave in If loose remove to prevent obstruction Facial injuries Blood may need to be suctioned Broken teeth removed
Oxygen Delivery Nasal Cannula Non Rebreather Bag Mask with reservoir 1-6 lpm 24%-44% Non Rebreather 10 -15 lpm up to 90% Bag Mask with reservoir 15 lpm 100% Mouth to Mask 15 lpm 55%
Ventilation Rates Adults Children and Infants 1 breath every 5 – 6 seconds Children and Infants 1 breath every 3-5 seconds
CPAP Indications Contraindications Awake & Alert Over 12 Patent airway GCS>10 BP above 90 systolic 2 of following Retrations/Accessory muscle use Resp rate >24 Pulse Ox <92% Inability to speak in complete sentences Contraindications GCS <11 Respiratory Arrest BP <90Systolic Suspected Pneumo Tracheostomy Foreign body obstruction Facial deformity or trauma Actively vomiting Recent neuro, facial or gastric surgery Chest head or face trauma