Module 5: Respiratory Emergencies

By the end of this module, you will be able to:

• Recognize the signs and symptoms of common respiratory emergencies.

• Understand the pathophysiology of respiratory conditions such as asthma, COPD, and pneumonia.

• Provide appropriate pre-hospital care for patients experiencing respiratory distress.

• Utilize oxygen delivery systems effectively.

Overview

• Primary Function: Gas exchange (oxygen in, carbon dioxide out).

• Structures:

  • Upper and lower airways.

  • Lungs: Right lung (3 lobes), left lung (2 lobes).

  • Diaphragm: Main muscle of respiration.

Physiological Processes

• Ventilation: Air movement into and out of the lungs.

• Respiration: Gas exchange at the alveolar level.

General Signs and Symptoms

• Shortness of breath (dyspnea)

• Increased respiratory rate and effort

• Use of accessory muscles

• Altered mental status

• Cyanosis (bluish skin)

• Abnormal breath sounds (wheezing, stridor, crackles)

Assessment

• Look, Listen, Feel: Observe chest rise, listen to breath sounds, feel for airflow.

• Position: Patients may prefer sitting upright (Tripod position).

1. Asthma

• 1. Pathophysiology: Bronchospasm, inflammation, and mucus production leading to airway narrowing.

  2. Symptoms: Wheezing, coughing, chest tightness.

  3. Triggers: Allergens, exercise, cold air.

2. Chronic Obstructive Pulmonary Disease (COPD)

• 4. Includes: Emphysema and chronic bronchitis.

  5. Causes: Long-term exposure to irritants (smoking).

  6. Symptoms: Chronic cough, sputum production, shortness of breath.

3. Pneumonia

• 7. Infection: Inflammation of the lung tissue.

  8. Symptoms: Fever, productive cough, pleuritic chest pain.

4. Pulmonary Embolism

• 9. Cause: Blood clot in the pulmonary artery.

  10. Symptoms: Sudden onset dyspnea, chest pain, tachycardia.

5. Anaphylaxis

• 11. Severe Allergic Reaction: Airway swelling, bronchoconstriction.

  12. Symptoms: Hives, swelling, hypotension.

General Care

• Ensure Patency of Airway

• Provide Oxygen Therapy

  • Nasal cannula for mild distress.

  • Non-rebreather mask for moderate to severe distress.

  • BVM for inadequate respirations.

• Positioning

  • Comfortably seated, often in high-Fowler's position.

• Assist with Medications

  • Metered-Dose Inhaler (MDI) : Contains bronchodilators like albuterol.

  • Nebulizer Treatments: For more severe cases.

Specific Interventions

• Asthma/COPD

  • Assist with prescribed inhalers.

  • Monitor for signs of fatigue and respiratory failure.

• Anaphylaxis

  • Administer epinephrine via auto-injector (EpiPen).

  • Rapid transport due to potential airway compromise.

Devices and Flow Rates

• Nasal Cannula

  • Flow rate: 1-6 L/min

  • Oxygen concentration: 24-44%

• Non-Rebreather Mask

  • Flow rate: 10-15 L/min

  • Oxygen concentration: Up to 90%

• Bag-Valve Mask (BVM)

  • Flow rate: 15 L/min

  • Oxygen concentration: Nearly 100% with reservoir attached

Safety Precautions

• Use oxygen appropriately to avoid complications like oxygen toxicity.

• Monitor for changes in patient condition.