Chapter 16: Respiratory Emergencies

Overview

• Focus on respiratory emergencies in infants, children, and adults.
• Topics covered:
  • Respiratory anatomy and physiology
  • Pathophysiology
  • Signs and symptoms of respiratory conditions
  • Assessment and management in pre-hospital settings

Key Terms

• Dyspnea: Difficulty breathing.
• Respiratory system anatomy: Diaphragm, chest wall muscles, accessory muscles, nerves from brain and spinal cord.

Anatomy of Respiratory System

• Upper Airway: Above vocal cords (nose, mouth, jaw, oral cavity, pharynx, larynx).
• Lower Airway: Includes trachea, bronchi, bronchioles, alveoli.
• Lungs' Function: Respiration, exchange of oxygen and carbon dioxide.
• Physiology of Respiration: Inspiration and expiration processes.

Pathophysiology

• Conditions hindering gas exchange due to abnormalities in airway anatomy, disease processes, trauma, or pulmonary vessel issues.
• Carbon Dioxide Retention: Can lead to hypoxic drive in COPD patients.
• Various causes of dyspnea: pulmonary edema, airway obstruction, carbon monoxide poisoning.

Respiratory Conditions

• Upper Airway Infections: Croup, epiglottitis, RSV.
• Lower Airway Infections: Bronchiolitis, pneumonia.
• Asthma, COPD, Pleural Effusion, Pneumothorax: Common diseases with distinct causes and symptoms.

Infectious Respiratory Diseases

• RSV: Common in children, leads to bronchitis and pneumonia.
• Pneumonia: Infection in the lungs, bacterial or viral.
• Pertussis (Whooping Cough): Highly contagious bacterial infection.
• Influenza Type A: Causes respiratory symptoms, can lead to pneumonia.
• Tuberculosis (TB): Drug-resistant bacterial infection affecting lungs.

Other Respiratory Conditions

• Pulmonary Edema: Fluid in alveoli, often linked to congestive heart failure.
• COPD: Chronic lung diseases like emphysema, bronchitis.
• Asthma: Acute bronchiole spasm, often allergic in nature.
• Anaphylaxis: Severe allergic reaction with airway involvement.
• Pneumothorax: Air in pleural space, often spontaneous.

Assessment and Management

• Scene Size-Up: Use PPE, identify potential airborne hazards.
• Primary Assessment: ABCs (Airway, Breathing, Circulation), lung sounds.
• History Taking: Use SAMPLE and OPQRST for patient history.
• Secondary Assessment: Monitor vital signs, perform chest auscultation.

Treatment Strategies

• Administer oxygen, provide ventilatory support if needed.
• Assist with inhalers or nebulizers when appropriate.
• Specific Treatments:
  • Upper/Lower Airway Infections: Humidified oxygen, avoid airway suctioning in epiglottitis.
  • Pulmonary Edema: 100% oxygen, CPAP, position comfortably.
  • COPD: Assist with inhaler, monitor for overuse.
  • Asthma/Anaphylaxis: Manage airway, provide epinephrine if needed.
  • Pneumothorax/Pleural Effusion: Provide oxygen, prompt transport.
  • Obstructions: Clear airway only in complete obstruction.

Review Questions

• Highlights include distinguishing between upper and lower airway obstructions, identifying drug-resistant diseases, and managing various acute respiratory conditions effectively.

Conclusion

• Understanding of respiratory emergencies and their management is crucial for effective EMT response. Regular review and practice are recommended.