1. RESPIRATORY EMERGENCIES
An Introduction

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

3. 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………

4. Tidal Volume
The amount of air moved into or out of the lungs in a single breath
Normal is 500 ml

5. Minute Volume
The amount of air moved in or out of the lungs in one minute minus dead space
mV= RR x vT – dead space (150) ml

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

7. Rate Rhythm Quality Depth
regular breath adequate
sounds
Skin is warm/pink/dry

8. INADEQUATE BREATHING
Respiratory Distress
Respiratory Failure
Respiratory Arrest

9. Inadequate Breathing Defined
DELETE NOTE

10. Signs of Inadequate Breathing
DELETE NOTES

11. Respiratory Distress
DELETE NOTE

12. Respiratory Failure
DELETE NOTE

13. Respiratory Arrest

14. 12-20 Regular Depth (minute volume)
Patient Assessment
Rate Rhythm Quality
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

18. 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

19. 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

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

21. Pulmonary Edema
Abnormal collection of fluid in the alveoli
Left-sided heart failure
orthopnia

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

23. 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

24. 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

25. 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

26. CPAP
Continuous Positive Airway Pressure
Forcing air or oxygen into the lungs when a patient has inadequate breathing
Relatively low pressures are used

27. Indications
CHF
Pulmonary Edema
Effects
Prevents the alveoli from collapsing at the end of exhalation
Push fluid out of the alveoli back into the capillaries

28. Contraindications
Anatomic-physiologic
Depressed mental status; patient cannot protect
the airway or cannot follow instructions
Lack of normal, spontaneous respiratory rate; CPAP does not increase respiratory rate
Inability to sit up
Inability to get and maintain a good mask seal

29. Pathologic contraindications
Nausea and vomiting
Penetrating chest trauma
Shock
Upper GI bleed
Recent gastric surgery
Inadequate mask seal; malformation, burns,trauma

30. Other contraindications to consider
Claustrophobia
Cannot tolerate
History of inability to use CPAP
Secretions requiring frequent suctioning
History of pulmonary fibrosis

31. Hypotension
CPAP provides a constant pressure throughout the respiratory cycle hampering venous return
During normal inspiration pressure is decreased enough to allow blood to return to the heart
B/P should be monitored frequently and should be >90/systolic