Lecture Notes: Respiratory Issues and Treatments

Active and Passive Breathing

• Active Inhalation: Uses accessory muscles to suck air in.
• Passive Exhalation: Relaxation; difficulty in forceful exhalation due to constriction (e.g., breathing through a straw).
• Asthma: Oxygen can be inhaled but CO2 is hard to expel, leading to wheezing on exhalation.
• Symptoms of Asthma Attack: Normal pulse ox, high CO2, red/flushed, warm due to vasodilation.

Asthma Management

• Initial Treatments: Use of Albuterol and Atrovent.
• Emergency Rescue: Sub-Q epinephrine if treatments fail (after ~20 minutes).
• Solumedrol: Not an emergency; effects take 15-30 minutes.
• Decision Factors: Transport to hospital and number of treatments needed.

Severe Asthma (Status Asthmaticus)

• Signs: Options exhausted after Albuterol and Atrovent; consider Sub-Q Epi.
• Magnesium: Last resort due to heart side effects (bradycardia, hypotension).

COPD Management

• Chronic Bronchitis (Blue Bloaters): Overweight, frequent bronchitis; similar treatment to asthma.
• Pulmonary Emphysema (Pink Puffers): Breathe based on O2 levels, trapped CO2 in alveoli.
• COPD Treatments: Albuterol, Sub-Q Epi with caution for cardiac issues; fluid bolus to thin secretions.

Hypoxic Drive & COPD

• Hypoxic Drive: Driven by O2 levels, not CO2 (in emphysema patients).
• Pulse Ox Management: Keep between 88-94%; adjust oxygen delivery carefully.
• Risks: Polycythemia, AFib, stroke.

Pneumonia Management

• Classic Pneumonia: Young, healthy; one lobe affected, yellow/green cough.
• Treatment: Fluids to thin mucus, Albuterol, antibiotics.
• Nursing Home Pneumonia: Differentiate from CHF; fever indicates pneumonia.

Foreign Body Aspiration

• Management: Humidified O2 if airway is irritated.
• Choking Protocol: Heimlich, chest compressions if unconscious.

Key Points

• Oxygen and CO2 Balance: Critical in treatment and management.
• Fluid Bolus: Can assist in thinning secretions across respiratory conditions.
• Asthma and COPD Management: Requires understanding of individual patient needs and responses to treatments.
• Monitoring: Vital to assess and adjust treatment strategies effectively.