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    respiration respiration Presentation Transcript

    • Respiratory Emergencies Medical First Responder St. John Ambulance 2006 TITLE SLIDE Insert your information directly into the text boxes provided to customize your presentation
    • Objectives
      • Become familiar with the respiratory system
      • Become familiar with the mechanism of breathing
      • Recognize respiratory emergencies
      • Define chronic bronchitis and understand its mechanism
      • Define emphysema and understand its mechanism
      • List the signs and symptoms of COPD
      • Assess and manage a COPD patient
    • Objectives
      • Define asthma and its mechanism
      • Assess and manage an asthma patient
      • Define and understand croup
      • Assess and manage a croup patient
      • Define and understand epiglottitis
      • Assess and manage an epiglottitis patient
      • Define and understand hyperventilation syndrome
      • Assess and manage a hyperventilation patient
    • Anatomy of the Airway
    • Physiology
      • O 2 in atmosphere at 21%, body uses only 5%
      • inspiration is an active process
      • oxygen is transferred to cells at the capillary level
      • without oxygen cells will die and organs shut down
      • brain begins to die within 4-6 minutes
    • Hypoxia
      • Definition - inadequate oxygen supply to cells
      • caused by:
        • outside atmosphere oxygen is decreased
        • airway or lung tissue is obstructed
        • blood does not carry enough oxygen
        • pump failure - heart is not pumping blood
    • Hypoxia – Signs
      • shortness of breath, increased respiratory rate
      • impaired judgment / motor coordination
      • irritability or excitability
      • increased pulse (adult), decreased (child)
      • pale or cyanosed skin colour
      • vomiting, unresponsiveness,
      • convulsions and seizures
    • Hypoxia – Symptoms
      • headache
      • weakness/fatigue
      • loss of memory
      • nausea
    • Asthma
      • A reactive airway disease causing bronchioles to constrict and widespread mucous production within the bronchial tree
      • Triggers may include:
        • foods, medications, cold air, flowers, perfumes, exercise, smoke, anxiety
    • Asthma – Signs and Symptoms
      • anxiety
      • wheezing on expiration
      • continuous coughing
      • chest over-inflated
      • increased pulse rate
      • pursed lips
      • sitting upright or standing
    • Asthma – Treatments
      • primary survey
      • administer 100% oxygen
      • assist ventilations if needed
      • position patient for comfort
      • if known, make sure trigger is removed
      • auscultate the chest
      • if wheezes present ask if meds (puffers) are available
      • EMS transport asap
    • Hyperventilation – Signs and Symptoms
      • anxiety
      • rapid, deep respiration
      • tightness in chest
      • tingling and spasms in hands and feet
      • light headedness
      • very pink, warm, dry
    • Hyperventilation – Treatment
      • Perform primary survey
      • Give oxygen until assessment is complete
      • Rule out diabetes, shock, head injury
      • Verbally control patient’s respiratory rate
      • Cut back oxygen flow rate
    • Chronic Obstructive Pulmonary Disease (COPD)
      • Chronic bronchitis
        • Chronic inflammation of the bronchi with mucous
      • Emphysema
        • The loss of elasticity and the destruction of the aveolar walls
    • Chronic Obstructive Pulmonary Disease - Signs and Symptoms A productive cough for at least 3 months for 2 consecutive years
      • usually overweight
      • bluish complexion
      • accessory muscle use
      • shortness of breath on exertion
      • history of heavy smoking
      • high pitched wheeze on inspiration and expiration with auscultation
    • Emphysema – Signs and Symptoms
      • gasping for air
      • sitting; leaning forward to breathe
      • distended neck veins
      • audible rattles or wheezes cyanosis
      • prolonged exhalation with pursed lips
      • skinny
      • barrel shaped chest
      • cough
    • Chronic Obstructive Pulmonary Disease- Treatment
      • primary survey and secure ABCs
      • administer oxygen
      • position patient
      • vitals and history
      • medications? - Ventolin
      • if shortness of breath only
        • ALERT = 28%
        • VERBAL = 50%
      • painfully responsive or cyanotic = 90 - 100%
      • unresponsive = 90 - 100%
      • Remember - where
      • COPD is present with any other condition …
      • the patient must have the acute problem treated first
        • e.g. heart attack = 100 % oxygen
      • Watch for respiratory depression.
      Chronic Obstructive Pulmonary Disease- Treatment
    • Pulmonary Embolism
      • sudden blockage of blood flow through a pulmonary artery
      • caused by blood clots, air bubble, fat particles
      • oxygen reaches areas of lungs with reduced, or no blood flow
      • severity relates to the size of the artery with the embolism
    • Pulmonary Embolism – Signs and Symptoms
      • sudden onset of unexplained dyspnea
      • stabbing chest pain
      • difficulty breathing / respiratory distress
      • increased breathing and heart rates
      • syncope (fainting)
      • cool, moist skin
      • decreased blood pressure
      • cyanosis and distended neck veins
    • Managing - Pulmonary Embolism
      • maintain open airway
      • initiate positive pressure ventilation
      • oxygen delivered by non-rebreather mask
      • monitor closely for respiratory arrest
      • get medical help and transport immediately
    • Epiglottitis – Signs and Symptoms
      • sore throat
      • fever
      • painful swallowing that leads to drooling are common things to look for.
      • Patients are most commonly sitting bolt upright with a fast pulse and may be disoriented
    • Epiglottitis – Treatment
      • 1. Begin ESM
        • Perform a scene survey
      • 2. Perform a primary survey - ABC
      • 3. Ensure you evaluate the adequacy of respirations: rate, depth, skin color.
      • 4. If you suspect epiglottis do not inspect the airway ! Aggravating the epiglottis could be fatal.
      • 5. Place patient in a position of comfort that will help drainage
      • 6. Supplemental oxygen (humidified if possible).
      • 7. Update EMS