The document discusses various respiratory emergencies conditions including asthma, ARDS, pleural effusion, pulmonary embolism, and COPD. It describes asthma as an airway inflammation causing wheezing and dyspnea, managed with bronchodilators, steroids, and education. ARDS involves widespread lung inflammation reducing gas exchange, requiring intensive care and ventilator support to deliver oxygen and pressure to damaged lungs.

1.  PRESENTED BY
 Abhilasha Chaudhary

2.  An emergency is defined as a serious
situation or occurrence that happens
unexpectedly and demands immediate action.

3.  Respiratory emergencies are medical
emergencies characterized by difficulty
breathing or an inability to breathe at all.

4.  Few of the respiratory emergencies condition
are :
 Asthma
 ARDS (acute respiratory distress syndrome )
 Pleural effusion
 Pulmonary embolism
 Chronic obstructive pulmonary disease(COPD)

5.  Asthma is characterized by chronic airway
inflammation and increased airway hyper
responsiveness leading to symptoms of
wheeze, cough,chest tightness and dyspnoea.

6.  It is characterized functionally by the
presence of airflow obstruction which is
variable over short periods of time or is
reversible with treatment.

8.  The goals of asthma management
 Control symptoms
 Prevent asthma exacerbation
 Maintain pulmonary function as close to
normal as possible

10.  Short acting beta 2 adrenergic agonists-
albuterol, levalbuterol,pirbuterol.(relief of
acute symptoms and prevention of exercise
Induced asthma,relax smooth muscles).

11.  Steroids- (effective in alleviating symptoms ,
improving airway function)
 Methylxanthines-theophylline(mild to
moderate bronchodilator)
 Anticholinergic – ipratropium bromide(inhibit
muscarinic cholinergic receptors and reduce
intrinsic vagal tone of the airway.

12. Management of exacerbation
 Avoidance of aggravating factors
 Early treatment and education
 Oxygen supplementation
 Antibiotics

13.  It is life-threatening medical condition
characterized by widespread inflammation in
the lungs.
 ARDS is a disease of the microscopic air sacs
of the lungs (alveoli) that leads to decreased
exchange of oxygen and carbon dioxide (gas
exchange).

15.  ARDS often needs to be treated in an
intensive care unit (ICU).
 The goal of treatment is to provide breathing
support and treat the cause of ARDS.
 This may involve medicines to treat
infections, reduce inflammation, and remove
fluid from the lungs but there is no specific
pharmacological treatment for ARDS except
supportive care.

16.  Ventilator
 A ventilator is used to deliver high doses of
oxygen and continued pressure (positive
end-expiratory pressure, or PEEP) to the
damaged lungs.

17.  Pleural effusion is defined as abnormal
accumulation of fluid in the pleural space,
i.e., the space between parietal and visceral
pleura.It contains 5 to 15 ml, which acts as a
lubricant.

18.  Fever and chills
 Dyspnea in lying flat
 Coughing

19. Pleuritic chest pain
Shortness of breath

20.  Goal of the treatment is to discover the
underlying cause of the pleural effusion
 To prevent reaccumulation of fluid.
 To relieve discomfort,Dyspnea and
respiratory compromise.

21.  Thoracocentesis

23.  Pleurodesis
 Surgical pleurectomy

24.  Pulmonary embolism
refers to the
obstruction of the
pulmonary artery or
one of its branches by
a thrombus that
originates somewhere
in the venous system
or in the right side of
the heart.

25.  Dyspnea
 Chest pain
 Anxiety,fever ,
 Tachycardia
 Tachypnea
 Cough
 Hemoptysis
 Syncope

27.  General measures to improve respiratory and
vascular status.
 Anticoagulation therapy
 Thrombolytic therapy
 Surgical intervention

28.  Oxygen therapy
 Elevating the leg (above the level of the heart)
also increases venous flow.

29.  Using elastic compression stockings or
intermittent pneumatic leg compression
devices reduces venous stasis.

30.  Anticoagulant therapy (heparin, warfarin
sodium)
 Thrombolytic therapy (urokinase, strepto-
kinase, alteplase)


31.  Pulmonary embolectomy
 Transvenous catheter embolectomy

32.  COPD is a disease characterised by persistent
air flow limitation that is usually progressive
and associated with an enhanced chronic
inflammatory response in the airway and the
lung to noxious particles or gases. COPD is
often a mix of two diseases:chronic
bronchitis and emphysema.

35. Clubbing
Barrel chest

36.  SIGN AND SYMPTOMS
 Cough with or without mucous
 Fatigue
 Frequent respiratory infections
 Shortness of breath
 Wheezing

37.  The goal of treatment are:
 Relieve symptoms
 Improve daily function
 Decrease exacerbations
 Improve quality of life.

38.  Bronchodilator
(Methylxanthinestheophylline.(mild to
moderate bronchodilator)
 Anticholinergic (ipratropium bromide)
 Corticosteroids

39.  Oxygen therapy
 Cessation of smoking
 Prevention of pollution

40.  Bullectomy(surgical option for select patients
with bullous emphysema.

41.  Lung volume reduction surgery(removal of
the portion of the diseased lung parenchyma.
 Lung transplantation

42.  Activity intolerance related to fatigue,
hypoxemia, and ineffective breathing
pattern.
 Ineffective breathing pattern related
to:increased rate and decreased depth of
respirations associated with fear and
anxiety.

43.  Ineffective airway clearance related to
increased airway resistance associated with
edema of the bronchial mucosa and
pressure on the airways .
 Impaired gas exchange related to:impaired
diffusion of gases associated with
accumulation of fluid in the pulmonary tree
and alveoli.

44.  Obstetrical emergencies are life
threatening medical conditions that occur in
pregnancy or during or after labor and
delivery.

45.  Few of the obstetric emergencies are:
 Prolapse Of The Cord And Cord
Presentation
 Amniotic Fluid Embolism
 Rupture Of The Uterus
 Postpartum Haemorrhage (PPH)

48.  Cord presentation
 This occurs when the umbilical cord lies in
front of the presenting part with the
membranes still intact

49.  Cord prolapse(overt prolapsed cord)
 In this case the cord lies in front of the
presenting part and the membranes are
ruptured.

50.  Occult cord prolapse:
 The cord lies along side but not in front of
the presenting part.

52.  Umbilical cord visible at,or external
to the vaginal opening
 Evidence of membranes having
ruptured
 A non reassuring fetal status:

53.  Change in fetal movement pattern
 Meconium in the amniotic fluid (vaginal
discharge may be stained green)
 Fetal tachycardia
 Fetal bradycardia(more common)

54.  The treatment depends up on the;
 degree of cervical dilatation
 the live of the fetus
 the type of presentation

55.  Insert a gloved hand in to the vagina and
push the presenting part up to decrease
pressure on the cord and dislodge the
presenting part from the pelvis
 Relieve pressure
 Raise end of bed
 Put mother knee chest position
 if fetal heart rate non reassuring go for
cesarean delivery.

57.  Most common obstetric emergencies. It is
defined as:
 Bleeding from the genital tract during the
third stage of labor or any time following the
baby’s birth up to 6 weeks after delivery:
 to the amount of 500ml or more following
vaginal birth or
 to the amount of 1000 ml or more following
cesarean section.

59.  Primary PPH. This is called when bleeding
occurs within 24 hours of delivery.
 Secondary PPH This is called when bleeding
occurs from the genital tract more than 24
hours after delivery of the placenta and may
occur up to 6 weeks later.

60.  CALL FOR HELP
 Rapid assessment
◦ ABC
◦ Vital signs -
◦ High flow oxygen
◦ Large bore IV access and fluid resuscitation
◦ Catheterise

61. ◦ Investigations
 Cross match
 Clotting studies
◦ Identify cause
◦ Treat
◦ Genital tract trauma > repair tears
◦ Retained placenta > manual removal of placenta

62.  Uterine atony > uterine massage, drugs,
bimanual compression, surgery

63.  Uterine rupture is a event occuring
during childbirth by which the integrity of
the myometrial wall is breached.
 It is often fatal for the fetus and may also be
responsible for the death of the mother.

64.  Complete rupture:- When the overlying
peritoneal coat is torn and bleeding and fetus
is under abdominal skin.
 Incompletes:- When the peritoneum remains
intact and bleeding tracks under the
peritoneal cavity.

65.  History of obstructed
labour
 Bandl’s ring is seen
before rupture
 No Fetal heart rate
 Uterine contraction
stop or slow down.
 Haemorrhagic shock
may be present.

66.  IN THE HOSPITAL
 Lie patient flat
 Blood group and cross match
 Put Intravenous drip
 Get patient to sign consent form
 Give pre medication
 Carry out doctor’s order

67. Repair of the uterus Hysterectomy

68.  This condition when amniotic fluid containing
meconium, vernix and fetal cells enter the
maternal circulation under pressure between
the placental and the uterine wall and
forming an embolus which obstructs one of
the pulmonary arterioles or alveolar
capillaries.

69.  Sudden onset of maternal respiratory distress
such as severe dyspnea and cyanosis.
 Cardio vascular collapse
 Tachycardia
 Hypotension
 Cardiac arrest
 Convulsions
 Hemorrhage

70.  Anyone of the above symptoms is indicative
of an acute emergency.
 Oxygen administered by face mask .
 Resuscitation equipment should be at hand
 Fetal heart rate should be monitored
continuously.
 Treat hemorrhage.
 Transfer to referral center.

71.  Fluid volume deficit related to vaginal
bleeding.
 Ineffective tissue perfusion related to vaginal
bleeding.
 Anxiety/ Fear related to changes in
circumstances or the threat of death.
 Risk for infection related to bleeding.

72.  Risk for fetal injury related to reduced
placental perfusion secondary to vasospasm.
 Risk for infection related to presence of
favourable condition for infection

74.  Smeltzer Suzanne C, Barebrenda G, Hinkle Janice L,
Cheever Kerry H. Textbook of medical surgical
nursing, 12th ed. Newdelhi: Lippincot wolter’s kluwer;
p.113-114(vol-1)
 Lewis Sharan mantik, Heitkemper Margaret Mclean,
Shannon Ruff Dirksen,Obrien Patrical, Giddens Jean
Foret, Bucher Linda. Medical surgical nursing. 6th
ed.Mosby; p.874-78
 Dutta D.C , Textbook of obstetrics.5th ed. Newdelhi:
New central book agency.p.340-346.
 Rao A Kamini, Handbook of obstetric Emergencies.1st
ed.Newdelhi:Jaypee Brothers Medical
publisher(P)Ltd.p.134,154,163.


75.  what are the different respiratory
emergencies conditions?describe any 2 with
its management.