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respiratory emergency

Respiratory system emergency map, detailed content, combined with textbooks and summary, dyspnea refers to the patient's subjective feeling of lack of air or difficulty breathing, objectively manifested as labored breathing movements, in severe cases, mouth breathing, nasal flaring, orthopnea and even cyanosis may occur , auxiliary respiratory muscles participate in respiratory movements, and have changes in respiratory frequency, depth, and rhythm.

Edited at 2023-10-29 13:40:34

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Outline

respiratory emergency

Dyspnea refers to the patient's subjective feeling of lack of air or difficulty breathing, which is objectively manifested as labored breathing movements. In severe cases, mouth breathing, nose flaring, orthopnea, or even cyanosis may occur, auxiliary respiratory muscles are involved in breathing movements, and respiratory frequency and depth are affected. , rhythm changes

Cause and pathogenesis

acute pulmonary embolism

Including pulmonary thromboembolism, fat embolism, amniotic fluid embolism, and air embolism. Pulmonary thromboembolism is the most common

Massive pulmonary embolism or severe pulmonary hypertension can lead to transient cerebral ischemia and syncope, which can be the first symptom of pulmonary infarction.

Bronchial Asthma

Airway inflammation is the essence of asthma, and airway hyperresponsiveness is an important feature of asthma

acute respiratory distress syndrome

It is caused by various internal and external factors in the lungs that cause acute diffuse lung injury and the subsequent development of acute respiratory failure.

chronic obstructive pulmonary disease

It is a group of lung diseases characterized by airflow limitation that develops progressively.

pneumothorax

Have hemodynamic changes

Condition assessment and judgment

health history

Ask about health history

Onset and time

Predisposing factors

clinical manifestations

Changes in breathing patterns

Respiratory rate

Increased respiratory rate, common in respiratory diseases, cardiovascular disease, anemia and fever

Slowed respiratory rate, more common in acute sedative-hypnotic poisoning and carbon monoxide poisoning

Breathing depth

breathing rhythm

Main symptoms and accompanying symptoms

physical signs

Patients with pulmonary embolism may have jugular vein filling, and local moist rales and wheezing may be heard in the lungs.

During an acute attack of bronchial asthma, the chest is hyperinflated, the inspiratory triple concavity sign is heard, and widespread expiratory wheeze can be heard in both lungs.

Shallow and fast breathing, barrel-shaped chest, excessive voicelessness on percussion, auxiliary respiratory muscles participating in respiratory movements and even contradictory movements of the chest and abdomen, common in copd

If the thorax on the affected side is full, there is a drum sound on percussion, and the breath sounds on auscultation are weakened or disappear, pneumothorax should be considered.

Auxiliary inspection

Blood oxygen saturation monitoring

arterial blood gas analysis

Chest x-ray or CT scan

electrocardiogram

Blood routine

special inspection

Assessment and judgment of illness severity

way of speaking

body position

Life-threatening signs of pneumothorax

Patients with pneumothorax can have life-threatening signs if any of the following signs occur: tension pneumothorax, acute dyspnea, hypotension, tachycardia, tracheal displacement

Acute pulmonary thromboembolism risk level

Grading of severity of asthma attacks

Diagnostic criteria for ARDS

Key points in identifying cardiogenic pulmonary edema and ARDS

Treatment and care

Treatment principles

Keep the respiratory tract open, correct hypoxia and/or carbon dioxide retention, correct acid-base balance imbalance, buy time for the treatment of underlying diseases and precipitating factors, and ultimately improve dyspnea, depending on the treatment of the cause.

Nursing measures

Immediate care measures

In case of dyspnea caused by any reason, life-saving should be the first priority

Keep airway open

Oxygen therapy

Low-flow oxygen inhalation should be considered when COPD is accompanied by carbon dioxide retention and pulmonary embolism combined with ventilatory dysfunction.

Establish intravenous access to ensure timely administration

Accurately collect blood samples

Check blood gas analysis, D-dimer

Get into a comfortable position

Have first aid supplies ready

Take isolation measures

Medication care

control infection

Antispasmodic and antiasthmatic drugs

maintain breathing

Apply respiratory stimulants

maintain blood pressure

Pain relief

correct acidosis

Condition observation

Monitor vital signs and respiratory function

Observe the effect of oxygen therapy