Orthopnea
Dyspnea relieved by a change in position, SLEEPING UPRIGHT with pillows, usually CHF pulmonary edema problem.
Apneustic
... [Show More] breathing
Characterized by prolonged inspirations unrelieved by attempts to exhale, which indicates trauma to the pons.
Definitive Care
Care that will improve, rather than simply stabilize, a patient's condition (surgery or other care provided in a hospital)
Pleural Decompression
- Used to treat Tension pneumothorax:
- Insert 14g needle through the 2nd/3rd intercostal space along the midclavicular line directly above the rib
- "Rush of air"?
- Remove needle, leave catheter, one-way flutter valve, secure catheter
Indications for removal of a dual lumen airway
-When gurgling is heard over the epigastrum
-Pt becomes conscious
-Pt is able to maintain airway
-On-line medical directs you to do so
Complications of ET tube placement (to name a few)
- Trauma to the mouth, teeth, and upper airway
- Over-inflation of the cuff may impede blood flow
- Over-inflation of the lungs may cause a pneumothorax (especially pt's with other diseases eg: COPD, emphysema)
- Too deep of placement may cause accidental endobronchial intubation
- Esophageal placement may result in gastric distention, vomiting, and aspiration
Complications of intubating a burn patient
-Airway edema obstruction
-Discolored or deformed landmarks
-Tape may not adhere to burned skin
-In peds, swelling occurs much faster
Complications of hyperventilation
- Lowered C02 can lead to respiratory acidosis
- Barotrauma results from rapid pressure changes in the lungs (especially with pt's who have underlying lung pathology)
- Pneumothorax or gastric distention which could lead to vomiting and aspiration
Characteristics of Cystic Fibrosis
- Genetic disease that affects mostly the lungs, but also the liver, pancreas, and kidneys
- Characterized by a change in the functioning chemistry of the glands that create thicker than normal secretions which usually lead to chronic infections (typically pulmonary)
- Presents similarly to COPD or pneumonia and is treated in the same way
- Kids with CF may have a salty "frosting" on their skin that looks like small crystals
Continuous Quantitative ETCO2 Waveforms
See diagram:
Oxygenation pathways
All the masks, cannulas, BVM's, tubes, etc...
Congestive heart failure (CHF)
The failure of the heart to pump efficiently, leading to excessive blood or fluids in the lungs, the body, or both.
- Left sided pump failure leads to pulmonary edema
- Right sided failure leads to pitting edema and JVD
Complications of Toxic Inhalation
Airway management
Treatment of chemical injuries revolves around the following basic steps: 1. Remove the exposed patient from the environment. 2. Secure the airway. 3. Provide supplemental oxygen. 4. Assist with ventilation
Pathophysiology of COPD
Catch all term for bronchitis, emphysema, and asthma that often occur in combination from long term tobacco use or inhaled toxins. 4th leading cause of death in US. Bronchitis - has lots of mucus and enlarged cells in lungs and airways. Lots of congestion. Someone that has a productive cough for 3 months for 2 consecutive years with no definable cause. Overweight, cor pulmonale (a type of right ventricular defect) or ventricular failure. Rhonchi or wheezing present. Emphysema - long term damage by tobacco or inhaled agents causes alveolar destruction/coalescence. These are permanent. Elasticity of alveoli is decreased, volume is retained because it's hard to exhale. Blebs, or weakened areas of the large alveoli, are often present and can cause a spontaneous pneumothorax. Polycythemia (increased blood cells) almost always occurs in an attempt to increase circulating O2. barrel chest often occurs from the increased volume. Pursed lips to create back pressure in the lungs when exhaling. Clubbing of the fingers, decreased breath sounds or hyperresonant chest. If it's a new onset, patients may attribute loss of energy to old age
Signs and Symptoms of a Tension Pneumothorax
Hyperinflation of the affected side, Poor bag compliance, Respiratory distress, Jugular vein distention (JVD), Decreased/absent lung sounds on affected side, Tympany (hyperresonance) to percussion on the affected side, Tachycardia, S&S of shock, and Cyanosis [Show Less]