Ards
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Acute Respiratory Distress Syndrome (ARDS) is a sudden, progressive lung disease characterized by acute lung inflammation and diffuse injury to the alveolar-capillary membrane. It is caused by lung insults like bacteria, trauma, or other medical conditions. Early signs include rapid, shallow breathing and hypoxemia. Treatment goals are respiratory support, treating the underlying cause, and preventing complications. Management involves mechanical ventilation with positive end-expiratory pressure, sedatives, and treating any shock or infection.
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Acute respiratory distress syndrome (ards)
The document provides information about Acute Respiratory Distress Syndrome (ARDS) including its definition, pathophysiology, diagnosis, management, and prognosis. ARDS is defined as rapid onset hypoxemia and diffuse pulmonary infiltrates leading to respiratory failure. It is caused by direct lung injury from conditions like pneumonia or indirect injury from sepsis or trauma. Diagnosis involves criteria of acute onset, hypoxemia with PaO2/FiO2 ≤200, and no heart failure. Management focuses on treating the underlying cause and providing ventilator support using low tidal volumes per the ARDSNet protocol to reduce ventilator-induced lung injury. Prognosis depends on risk factors and mortality ranges from 26-44%.
Hypoxemia for residents, 2 19-15
The document discusses the physiological causes of hypoxemia, including hypoventilation, ventilation-perfusion (V/Q) mismatching, and diffusion impairment. Hypoxemia can result from decreased alveolar ventilation leading to higher PaCO2 and lower PAO2, or from V/Q mismatching like shunts or dead space. Disease states like COPD, pulmonary edema, and fibrotic lung disease cause hypoxemia through various combinations of V/Q mismatching and diffusion impairment. Understanding the alveolar gas and ventilation equations is key to determining the root cause and response to hypoxemia in clinical practice.
Pulmonary edema & Management
Pulmonary Oedema is accumulation of fluid in lungs. It can be due to cardiogenic or non-cardiogenic causes. This presentation was a class presentation and discussed its management alongwith diagnosis.
Acute respiratory distress syndrome
This document provides information on Acute Respiratory Distress Syndrome (ARDS), including its history, definitions, pathophysiology, management, and related concepts like ventilator-induced lung injury. Some key points:
- ARDS was first described in 1967 and its definition has evolved, with the most widely used being the Berlin Definition from 2012.
- It is characterized by diffuse pulmonary edema and inflammation due to direct lung injury or indirect causes like sepsis.
- Management focuses on treating the underlying cause, protective lung ventilation with low tidal volumes, permissive hypercapnia, prone positioning, and recruitment maneuvers.
- Adjunctive techniques aim to prevent ventilator-induced lung injury from
ARDS
This document discusses ARDS (acute respiratory distress syndrome), including its history, definitions, pathophysiology, and evidence-based treatment strategies. ARDS is characterized by diffuse pulmonary inflammation and reduced lung compliance. Traditional ventilator strategies have been shown to cause ventilator-induced lung injury, so current recommendations focus on lung-protective ventilation with low tidal volumes and high PEEP. Additional rescue therapies for refractory hypoxemia include recruitment maneuvers, proning, and ECMO. Proper diagnosis requires consideration of alternative conditions and use of diagnostic tools like echocardiogram, bronchoscopy, and chest CT scan.
Ards
This document defines acute respiratory distress syndrome (ARDS) and discusses its pathophysiology, risk factors, diagnosis, management, and ventilator strategies. ARDS is defined as acute onset bilateral pulmonary infiltrates, hypoxemia, and no heart failure. It was initially defined in 1971 and revised definitions in 1988 and 1994 established clearer criteria. Common causes are pneumonia, aspiration, and sepsis. Management involves treating the underlying cause, supportive ICU care, and lung protective ventilation with low tidal volumes (6 ml/kg) and moderate PEEP levels. Adjuncts like conservative fluid management, prone positioning, and recruitment maneuvers may provide benefits.
ARDS (acute respiratory distress syndrome) ppt SlideShare
Acute respiratory distress syndrome (ARDS) occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.
Ventilotry managemant of ards
The document discusses venting. In a few short sentences, it introduces the topic of venting without providing many details. The document does not have enough context or information to generate a multi-sentence summary while maintaining accuracy.
Recommended
Acute respiratory distress syndrome (ards)
The document provides information about Acute Respiratory Distress Syndrome (ARDS) including its definition, pathophysiology, diagnosis, management, and prognosis. ARDS is defined as rapid onset hypoxemia and diffuse pulmonary infiltrates leading to respiratory failure. It is caused by direct lung injury from conditions like pneumonia or indirect injury from sepsis or trauma. Diagnosis involves criteria of acute onset, hypoxemia with PaO2/FiO2 ≤200, and no heart failure. Management focuses on treating the underlying cause and providing ventilator support using low tidal volumes per the ARDSNet protocol to reduce ventilator-induced lung injury. Prognosis depends on risk factors and mortality ranges from 26-44%.
Hypoxemia for residents, 2 19-15
The document discusses the physiological causes of hypoxemia, including hypoventilation, ventilation-perfusion (V/Q) mismatching, and diffusion impairment. Hypoxemia can result from decreased alveolar ventilation leading to higher PaCO2 and lower PAO2, or from V/Q mismatching like shunts or dead space. Disease states like COPD, pulmonary edema, and fibrotic lung disease cause hypoxemia through various combinations of V/Q mismatching and diffusion impairment. Understanding the alveolar gas and ventilation equations is key to determining the root cause and response to hypoxemia in clinical practice.
Pulmonary edema & Management
Pulmonary Oedema is accumulation of fluid in lungs. It can be due to cardiogenic or non-cardiogenic causes. This presentation was a class presentation and discussed its management alongwith diagnosis.
Acute respiratory distress syndrome
This document provides information on Acute Respiratory Distress Syndrome (ARDS), including its history, definitions, pathophysiology, management, and related concepts like ventilator-induced lung injury. Some key points:
- ARDS was first described in 1967 and its definition has evolved, with the most widely used being the Berlin Definition from 2012.
- It is characterized by diffuse pulmonary edema and inflammation due to direct lung injury or indirect causes like sepsis.
- Management focuses on treating the underlying cause, protective lung ventilation with low tidal volumes, permissive hypercapnia, prone positioning, and recruitment maneuvers.
- Adjunctive techniques aim to prevent ventilator-induced lung injury from
ARDS
This document discusses ARDS (acute respiratory distress syndrome), including its history, definitions, pathophysiology, and evidence-based treatment strategies. ARDS is characterized by diffuse pulmonary inflammation and reduced lung compliance. Traditional ventilator strategies have been shown to cause ventilator-induced lung injury, so current recommendations focus on lung-protective ventilation with low tidal volumes and high PEEP. Additional rescue therapies for refractory hypoxemia include recruitment maneuvers, proning, and ECMO. Proper diagnosis requires consideration of alternative conditions and use of diagnostic tools like echocardiogram, bronchoscopy, and chest CT scan.
Ards
This document defines acute respiratory distress syndrome (ARDS) and discusses its pathophysiology, risk factors, diagnosis, management, and ventilator strategies. ARDS is defined as acute onset bilateral pulmonary infiltrates, hypoxemia, and no heart failure. It was initially defined in 1971 and revised definitions in 1988 and 1994 established clearer criteria. Common causes are pneumonia, aspiration, and sepsis. Management involves treating the underlying cause, supportive ICU care, and lung protective ventilation with low tidal volumes (6 ml/kg) and moderate PEEP levels. Adjuncts like conservative fluid management, prone positioning, and recruitment maneuvers may provide benefits.
ARDS (acute respiratory distress syndrome) ppt SlideShare
Acute respiratory distress syndrome (ARDS) occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.
Ventilotry managemant of ards
The document discusses venting. In a few short sentences, it introduces the topic of venting without providing many details. The document does not have enough context or information to generate a multi-sentence summary while maintaining accuracy.
Respiratory failure
A basic overview of respiratory failure: the clinical presentation, workup Approach, treatment & Management, medication & guidelines
Non cardiogenic pulmonary oedema
Non-cardiogenic pulmonary edema (NPE) can have many causes that result in increased pulmonary capillary permeability and fluid leakage into the lungs. These include conditions like acute respiratory distress syndrome (ARDS), neurogenic pulmonary edema, renal failure, negative pressure pulmonary edema, high altitude pulmonary edema, drug overdoses, chemotherapy, and more. The pathogenesis usually involves elevated pulmonary vascular pressures or a direct injury to the lung tissues. Radiographically, NPE presents as diffuse bilateral infiltrates that resolve more quickly than cardiogenic pulmonary edema, lacking features like Kerley lines or enlarged heart size.
Acute Lung Injury & Ards
This document summarizes acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), including definitions, epidemiology, clinical presentation, predictors of poor outcome, mortality rates, and ventilator-based management strategies. It discusses the 1994 consensus definitions of ALI/ARDS, limitations of these definitions, updated recommendations, and stratification systems. It also describes mechanisms of ventilator-induced lung injury and the importance of limiting tidal volume and pressure to prevent further injury.
Acute Lung Injury & ARDS
The document provides an overview of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), including definitions, risk factors, pathogenesis, management approaches, and results from major clinical trials. It discusses how lower tidal volume ventilation as tested in the ARDS Network trial was the first intervention shown to improve survival for patients with ALI/ARDS.
Respiratory failure
1) Respiratory failure is a condition where the lungs cannot properly oxygenate the blood and remove carbon dioxide, classified as Type I (hypoxemic) or Type II (hypercapnic).
2) It can result from problems affecting gas exchange in the lungs, respiratory control centers in the brain, or the chest wall muscles.
3) Common causes of Type I respiratory failure include pneumonia, ARDS, and severe asthma, while Type II is often due to conditions that decrease breathing, such as COPD.
ARDS - Diagnosis and Management
This document provides an overview of the diagnosis and management of Acute Respiratory Distress Syndrome (ARDS). It begins with defining ARDS and discussing the Berlin definition. It then covers risk factors, etiology, clinical course, pathophysiology, differential diagnosis, and management approaches. The management section emphasizes the importance of lung-protective ventilation with low tidal volumes to prevent ventilator-induced lung injury in ARDS patients.
Acute Respiratory Distress Syndrome
This document provides an overview of acute respiratory distress syndrome (ARDS) including its definition, pathophysiology, clinical presentation, diagnosis, and management. Some key points:
- ARDS is characterized by acute hypoxemic respiratory failure due to widespread inflammation and fluid buildup in the lungs.
- Treatment involves supportive care with mechanical ventilation using low tidal volumes, maintaining adequate oxygen levels, treating the underlying cause, and considering rescue therapies for severe cases like prone positioning or extracorporeal membrane oxygenation.
- Mortality remains high at around 26-58% depending on severity, with the most common causes of death being complications of the initial insult or secondary infections like pneumonia. Ongoing research focuses on
12.Respiratory Failure
A 32-year-old male presented with fever, cough and sputum for 3 days. Chest X-ray showed pneumonia in the left lower lobe. Over the next few days, the patient developed acute shortness of breath and cyanosis. Blood gas analysis showed hypoxemia and acidosis, indicating acute respiratory distress syndrome (ARDS). The patient was intubated and received mechanical ventilation.
Anesthesia in patient with respiratory disease
Patients with respiratory diseases pose challenges for anesthesiologists. Chronic obstructive pulmonary disease (COPD) is a major cause of death worldwide. Preoperative evaluations assess pulmonary function and risk factors. Techniques like regional anesthesia, careful airway management, and lung expansion methods can help reduce postoperative complications. Smoking cessation, bronchodilators, steroids, antibiotics and chest physiotherapy may optimize patients before surgery. During procedures, ventilator settings and humidified gases aim to prevent air trapping while monitoring oxygen levels.
Bronchial asthma anesthesia
Bronchial asthma and COPD are chronic respiratory conditions characterized by airway inflammation and obstruction. Bronchial asthma involves reversible airflow limitation due to bronchospasm while COPD involves irreversible airflow limitation from lung damage. Key differences are that asthma typically presents earlier in life and has a family history, while COPD is mainly caused by smoking. Preoperative treatment aims to prevent bronchospasm during anesthesia and surgery by optimizing lung function and suppressing airway reflexes.
Updates on Acute respiratory distress syndrome
The document provides an overview of acute respiratory distress syndrome (ARDS). It begins with a case presentation of a patient exhibiting symptoms of ARDS and then outlines the learning objectives which include understanding the definition, pathology, ventilation strategies, and adjunct therapies for ARDS. It reviews the history and evolving definitions of ARDS from 1967 to the current Berlin Definition from 2012. Key aspects of the Berlin Definition are described. The document discusses the incidence, outcomes, risk factors, pathophysiology involving different phases, clinical features, investigations, management goals and therapies for ARDS. Images are included showing histology, chest x-rays and CT scans of ARDS patients.
Lung protective strategies grooms
The document discusses two types of acute respiratory distress syndrome (ARDS) - pulmonary (direct) ARDS and extrapulmonary (indirect) ARDS. It notes key differences in characteristics and responses to mechanical ventilation strategies between the two types. Specifically, extrapulmonary ARDS patients tend to have better responses to higher levels of positive end-expiratory pressure (PEEP) compared to pulmonary ARDS patients. The document also reviews various mechanical ventilation strategies and studies regarding lung-protective ventilation in ARDS.
Acute respiratory failure ppt
Acute respiratory failure occurs when the respiratory system fails to maintain adequate gas exchange. There are two main types: hypoxemic respiratory failure, characterized by low oxygen levels, and acute ventilatory failure, characterized by high carbon dioxide levels. Hypoxemic failure is most common and can result from conditions that impair gas exchange like pneumonia or pulmonary edema. Ventilatory failure involves impaired breathing and can be caused by conditions that increase breathing workload like COPD. Diagnosis involves blood gas analysis and imaging. Treatment focuses on supporting oxygenation and ventilation through oxygen supplementation, ventilation support, and treating underlying causes.
Neurogenic Pulmonary Edema
Neurogenic pulmonary edema (NPE) is a clinical syndrome characterized by the acute onset of pulmonary edema following a significant central nervous system (CNS) insult. The etiology is thought to be a surge of catecholamines that results in cardiopulmonary dysfunction. A myriad of CNS events, including spinal cord injury, subarachnoid hemorrhage (SAH), traumatic brain injury (TBI), intracranial hemorrhage, status epilepticus, meningitis, and subdural hemorrhage, have been associated with this syndrome.
Copd
1. The document discusses the evaluation and treatment of COPD exacerbations in the emergency department. Common causes of exacerbation include viral and bacterial infections.
2. Initial treatment involves bronchodilators, steroids, oxygen supplementation, and antibiotics if pneumonia is present. Ventilation may be considered for severe exacerbations.
3. Upon discharge, the focus shifts to optimizing inhaler therapy and assessing eligibility for pulmonary rehabilitation to reduce readmissions.
Acute Lung Injury & ARDS
This document summarizes acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), including definitions, epidemiology, clinical presentation, predictors of outcome, mortality rates, and ventilator-based management strategies. Key points include:
- The 1994 consensus definitions of ALI and ARDS focus on timing, radiographic findings, and impaired oxygenation.
- Common causes are direct lung injury from aspiration/pneumonia or indirect injury from sepsis/shock.
- Mortality ranges from 31-74% depending on study. Non-respiratory organ failure is a major cause of death.
- A landmark 2000 trial showed that a "lung-protective strategy" using lower tidal volumes
HEMOPTYSIS
This document discusses pulmonary bleeding (hemoptysis). It defines hemoptysis as coughing up blood from the lungs or respiratory tract. The document outlines various causes of hemoptysis including infections like tuberculosis, lung cancers, vascular abnormalities and coagulation disorders. It also describes how to differentiate true hemoptysis from false, evaluates severity, provides clues from history and examination to suggest potential diagnoses, and lists relevant diagnostic tests and treatments.
Acute eosinophilic pneumonia
This document summarizes a case of acute eosinophilic pneumonia. A 19-year-old male presented with shortness of breath, sore throat, and fever after returning from Mecca. Exams found respiratory distress and hypoxemia. Tests showed elevated white blood cells and eosinophils in the lungs. Acute eosinophilic pneumonia was diagnosed based on lung biopsy findings and exclusion of other causes. The patient was treated with corticosteroids and supportive care and had an improvement in symptoms. Acute eosinophilic pneumonia is a rare lung disease characterized by lung tissue eosinophilia and often associated with smoking or other inhalational exposures.
Mitral regurgitation
Mitral regurgitation occurs when blood flows backward from the left ventricle to the left atrium due to problems with the mitral valve. It can be caused by conditions like endocarditis or myocardial infarction. Hemodynamically, it decreases cardiac output and overloads the left atrium and lungs. Clinically, patients experience dyspnea, fatigue, edema and signs of pulmonary congestion. The severity is classified by the regurgitant volume and fraction. Treatment involves diuretics, vasodilators, and sometimes surgery. The anesthetic goals are to maintain forward flow by keeping heart rate and contractility normal while decreasing afterload and preload to limit regurgitant fraction. Induction and maintenance of
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This document discusses different types of traction used in medical treatment, including skin traction methods like Buck's extension, Russell's traction, and Bryant's traction that use belts and harnesses on the body. It also covers skeletal traction techniques such as overhead arm traction, balanced suspension traction, skeletal tongs, and halo traction that apply traction directly to the bones. Halo traction, in particular, uses a ring placed around the head to immobilize the skull and neck.
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Non cardiogenic pulmonary oedema
Non-cardiogenic pulmonary edema (NPE) can have many causes that result in increased pulmonary capillary permeability and fluid leakage into the lungs. These include conditions like acute respiratory distress syndrome (ARDS), neurogenic pulmonary edema, renal failure, negative pressure pulmonary edema, high altitude pulmonary edema, drug overdoses, chemotherapy, and more. The pathogenesis usually involves elevated pulmonary vascular pressures or a direct injury to the lung tissues. Radiographically, NPE presents as diffuse bilateral infiltrates that resolve more quickly than cardiogenic pulmonary edema, lacking features like Kerley lines or enlarged heart size.
Acute Lung Injury & Ards
This document summarizes acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), including definitions, epidemiology, clinical presentation, predictors of poor outcome, mortality rates, and ventilator-based management strategies. It discusses the 1994 consensus definitions of ALI/ARDS, limitations of these definitions, updated recommendations, and stratification systems. It also describes mechanisms of ventilator-induced lung injury and the importance of limiting tidal volume and pressure to prevent further injury.
Acute Lung Injury & ARDS
The document provides an overview of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), including definitions, risk factors, pathogenesis, management approaches, and results from major clinical trials. It discusses how lower tidal volume ventilation as tested in the ARDS Network trial was the first intervention shown to improve survival for patients with ALI/ARDS.
Respiratory failure
1) Respiratory failure is a condition where the lungs cannot properly oxygenate the blood and remove carbon dioxide, classified as Type I (hypoxemic) or Type II (hypercapnic).
2) It can result from problems affecting gas exchange in the lungs, respiratory control centers in the brain, or the chest wall muscles.
3) Common causes of Type I respiratory failure include pneumonia, ARDS, and severe asthma, while Type II is often due to conditions that decrease breathing, such as COPD.
ARDS - Diagnosis and Management
This document provides an overview of the diagnosis and management of Acute Respiratory Distress Syndrome (ARDS). It begins with defining ARDS and discussing the Berlin definition. It then covers risk factors, etiology, clinical course, pathophysiology, differential diagnosis, and management approaches. The management section emphasizes the importance of lung-protective ventilation with low tidal volumes to prevent ventilator-induced lung injury in ARDS patients.
Acute Respiratory Distress Syndrome
This document provides an overview of acute respiratory distress syndrome (ARDS) including its definition, pathophysiology, clinical presentation, diagnosis, and management. Some key points:
- ARDS is characterized by acute hypoxemic respiratory failure due to widespread inflammation and fluid buildup in the lungs.
- Treatment involves supportive care with mechanical ventilation using low tidal volumes, maintaining adequate oxygen levels, treating the underlying cause, and considering rescue therapies for severe cases like prone positioning or extracorporeal membrane oxygenation.
- Mortality remains high at around 26-58% depending on severity, with the most common causes of death being complications of the initial insult or secondary infections like pneumonia. Ongoing research focuses on
12.Respiratory Failure
A 32-year-old male presented with fever, cough and sputum for 3 days. Chest X-ray showed pneumonia in the left lower lobe. Over the next few days, the patient developed acute shortness of breath and cyanosis. Blood gas analysis showed hypoxemia and acidosis, indicating acute respiratory distress syndrome (ARDS). The patient was intubated and received mechanical ventilation.
Anesthesia in patient with respiratory disease
Patients with respiratory diseases pose challenges for anesthesiologists. Chronic obstructive pulmonary disease (COPD) is a major cause of death worldwide. Preoperative evaluations assess pulmonary function and risk factors. Techniques like regional anesthesia, careful airway management, and lung expansion methods can help reduce postoperative complications. Smoking cessation, bronchodilators, steroids, antibiotics and chest physiotherapy may optimize patients before surgery. During procedures, ventilator settings and humidified gases aim to prevent air trapping while monitoring oxygen levels.
Bronchial asthma anesthesia
Bronchial asthma and COPD are chronic respiratory conditions characterized by airway inflammation and obstruction. Bronchial asthma involves reversible airflow limitation due to bronchospasm while COPD involves irreversible airflow limitation from lung damage. Key differences are that asthma typically presents earlier in life and has a family history, while COPD is mainly caused by smoking. Preoperative treatment aims to prevent bronchospasm during anesthesia and surgery by optimizing lung function and suppressing airway reflexes.
Updates on Acute respiratory distress syndrome
The document provides an overview of acute respiratory distress syndrome (ARDS). It begins with a case presentation of a patient exhibiting symptoms of ARDS and then outlines the learning objectives which include understanding the definition, pathology, ventilation strategies, and adjunct therapies for ARDS. It reviews the history and evolving definitions of ARDS from 1967 to the current Berlin Definition from 2012. Key aspects of the Berlin Definition are described. The document discusses the incidence, outcomes, risk factors, pathophysiology involving different phases, clinical features, investigations, management goals and therapies for ARDS. Images are included showing histology, chest x-rays and CT scans of ARDS patients.
Lung protective strategies grooms
The document discusses two types of acute respiratory distress syndrome (ARDS) - pulmonary (direct) ARDS and extrapulmonary (indirect) ARDS. It notes key differences in characteristics and responses to mechanical ventilation strategies between the two types. Specifically, extrapulmonary ARDS patients tend to have better responses to higher levels of positive end-expiratory pressure (PEEP) compared to pulmonary ARDS patients. The document also reviews various mechanical ventilation strategies and studies regarding lung-protective ventilation in ARDS.
Acute respiratory failure ppt
Acute respiratory failure occurs when the respiratory system fails to maintain adequate gas exchange. There are two main types: hypoxemic respiratory failure, characterized by low oxygen levels, and acute ventilatory failure, characterized by high carbon dioxide levels. Hypoxemic failure is most common and can result from conditions that impair gas exchange like pneumonia or pulmonary edema. Ventilatory failure involves impaired breathing and can be caused by conditions that increase breathing workload like COPD. Diagnosis involves blood gas analysis and imaging. Treatment focuses on supporting oxygenation and ventilation through oxygen supplementation, ventilation support, and treating underlying causes.
Neurogenic Pulmonary Edema
Neurogenic pulmonary edema (NPE) is a clinical syndrome characterized by the acute onset of pulmonary edema following a significant central nervous system (CNS) insult. The etiology is thought to be a surge of catecholamines that results in cardiopulmonary dysfunction. A myriad of CNS events, including spinal cord injury, subarachnoid hemorrhage (SAH), traumatic brain injury (TBI), intracranial hemorrhage, status epilepticus, meningitis, and subdural hemorrhage, have been associated with this syndrome.
Copd
1. The document discusses the evaluation and treatment of COPD exacerbations in the emergency department. Common causes of exacerbation include viral and bacterial infections.
2. Initial treatment involves bronchodilators, steroids, oxygen supplementation, and antibiotics if pneumonia is present. Ventilation may be considered for severe exacerbations.
3. Upon discharge, the focus shifts to optimizing inhaler therapy and assessing eligibility for pulmonary rehabilitation to reduce readmissions.
Acute Lung Injury & ARDS
This document summarizes acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), including definitions, epidemiology, clinical presentation, predictors of outcome, mortality rates, and ventilator-based management strategies. Key points include:
- The 1994 consensus definitions of ALI and ARDS focus on timing, radiographic findings, and impaired oxygenation.
- Common causes are direct lung injury from aspiration/pneumonia or indirect injury from sepsis/shock.
- Mortality ranges from 31-74% depending on study. Non-respiratory organ failure is a major cause of death.
- A landmark 2000 trial showed that a "lung-protective strategy" using lower tidal volumes
HEMOPTYSIS
This document discusses pulmonary bleeding (hemoptysis). It defines hemoptysis as coughing up blood from the lungs or respiratory tract. The document outlines various causes of hemoptysis including infections like tuberculosis, lung cancers, vascular abnormalities and coagulation disorders. It also describes how to differentiate true hemoptysis from false, evaluates severity, provides clues from history and examination to suggest potential diagnoses, and lists relevant diagnostic tests and treatments.
Acute eosinophilic pneumonia
This document summarizes a case of acute eosinophilic pneumonia. A 19-year-old male presented with shortness of breath, sore throat, and fever after returning from Mecca. Exams found respiratory distress and hypoxemia. Tests showed elevated white blood cells and eosinophils in the lungs. Acute eosinophilic pneumonia was diagnosed based on lung biopsy findings and exclusion of other causes. The patient was treated with corticosteroids and supportive care and had an improvement in symptoms. Acute eosinophilic pneumonia is a rare lung disease characterized by lung tissue eosinophilia and often associated with smoking or other inhalational exposures.
Mitral regurgitation
Mitral regurgitation occurs when blood flows backward from the left ventricle to the left atrium due to problems with the mitral valve. It can be caused by conditions like endocarditis or myocardial infarction. Hemodynamically, it decreases cardiac output and overloads the left atrium and lungs. Clinically, patients experience dyspnea, fatigue, edema and signs of pulmonary congestion. The severity is classified by the regurgitant volume and fraction. Treatment involves diuretics, vasodilators, and sometimes surgery. The anesthetic goals are to maintain forward flow by keeping heart rate and contractility normal while decreasing afterload and preload to limit regurgitant fraction. Induction and maintenance of
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This document discusses various types of splints used for immobilizing fractures including straight splints, Thomas splints, Bohler Braun's splint, internal splinting using plates or nails, cervical collars, and plaster of Paris slabs which are used to immobilize broken bones and ensure proper healing.
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Myasthenia gravis new
Myasthenia gravis is an autoimmune disorder characterized by varying degrees of weakness of voluntary muscles. It is caused by antibodies against acetylcholine receptors at the neuromuscular junction, impairing transmission of nerve impulses to muscles. Symptoms include drooping eyelids, double vision, weakness of facial muscles and difficulty swallowing. It occurs most commonly in young adult women and older men. While its cause is unknown, treatment involves anticholinesterase drugs, immunosuppressants, plasmapheresis, IVIG, and sometimes thymectomy. Complications include myasthenic crisis with severe generalized weakness and respiratory failure.
Meningitis
Meningitis is an infection of the meninges, the membranes covering the brain and spinal cord. It used to occur mainly in infants but a vaccine has reduced infant cases, so it now occurs primarily in adults. Viral meningitis is usually less severe and people typically recover fully, while bacterial meningitis can cause more serious complications like seizures, increased intracranial pressure, and residual neurological deficits if not treated promptly.
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4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
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Ards
- 1. Care of the Client with Acute Respiratory Distress Syndrome (ARDS) 1
- 2. Acute Respiratory Distress Syndrome _____________________________________ Is a sudden, progressive disorder characterized by: 1. Acute Lung Inflammation 2. Diffuse Alveolocapillary Injury 2
- 3. Cause Of ARDS ___________________________ A. Insult (Bacteria) B. Medical Condition (Multiple Trauma, CABG, Burns) C. Noxious Event ( Smoke Inhalation, Radiation) 3
- 4. Conditions Causing ARDS ___________________________ 1. Direct Pulmonary Trauma 2. Indirect Pulmonary Trauma 4
- 5. Early Signs & Symptoms of ARDS _____________________________________ Rapid, Shallow Breathing Air Hunger Cough Restlessness Respiratory Alkalosis Marked Dyspnea Hypoxemia Lung Sounds Clear to Fine Crackles 5
- 6. ARDS -Later Signs & Symptoms ___________________________ Decreased Lung Compliance Diffuse Bilateral Crackles & Rhonchi Diffuse Bilateral Infiltrates Metabolic or Respiratory Acidosis Intercostal & Suprasternal Retractions Tachycardia & AMS Low PaO2 & High PaCO2 Cyanosis & Pallor Extensive Interstial & Alveolar Infiltrates (White Lung) 6
- 7. Clinical Progression of ARDS ___________________________________ Hyperventilation | Respiratory Alkalosis | Dyspnea & Hypoxemia | Metabolic Acidosis | Respiratory Acidosis | Further Hypoxemia | Hypotension & Decreased Cardiac Output | Death 7
- 8. Treatment Goals for Clients with ARDS _____________________________ 1. Respiratory Support 2. Treat Cause 3. Prevent Complications 8
- 9. Treatment for the Client with ARDS _____________________________ 1. Mechanical Ventilation with PEEP 2. Sedation 3. Neuromuscular Blocking Agents a. Pavulon (Pancuronium) b. Vecuronium c. Atracuronium 9
- 10. Treatment for the Client with ARDS _____________________________ 4. Sedative/Anesthetic Agent a. Diprivan 1. Dose: 5-50 mcg per kg per minute 5. Treat Cause – Shock or Infection 6. Monitor for Complications 10
- 11. ARDS Complications ___________________________ Cardiac Dysrhythmias O2 Toxicity Renal Failure Thrombocytopenia GI Bleed Sepsis DIC 11
- 12. Mechanical Ventilation _____________________________ 1. Intubation a. Endotracheal Tube 1. Laryngoscope 2. E.T. Cuff b. Tracheostomy Tube 1. Keep at bedside: 2nd trach. tube, obturator, trach. dilator 2. Suctioning a. Wall pressure adult – 80 –120 mmHg b. Suctioning distance – 20 – 24 cm 12
- 13. Complications of Positive Pressure Ventilation ___________________________________ 1. Decreased Cardiac Output 2. Decreased Blood Flow to the Splanchnic Area a. Ischemic Gastric Mucosa b. Decreased Renal Blood Flow 3. Respiratory Alkalosis 4. Barotrauma 5. Volu-pressure Trauma 6. Alveolar Hypoventilation 7. Alveolar Hyperventilation 8. Ventilator Associated Pneumonia 13
- 14. Nursing Care of the Client on a Ventilator ________________________________ 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Respiratory Assessment Suctioning Oral Care ABG &/or continuous O2 sats. Supplementary Respiratory Treatments Providing for hydration Maintaining Nutrition ROM Exercises Rest & Sleep Anxiety Communication 14