Chapter 17

Respiratory Syncytial Virus

cause

S&S

Ex

Extremely contagious viral infection affecting mostly newborns and toddlers

odd like symptoms and dehydration

Often causes bronchiolitis

how to know if child is dehydrated?

sunken fontanelles, dry mucous membrane, hypovolemic shock

Croup

cause

S&S

seen in what ages?

tx

inflammation and swelling of pharynx, larynx (voice box), and sometimes trachea and bronchi

hoarse voice, stridor, barking cough, accessory muscle use, retraction

children 6 months to 3 years

have mom and dad hold baby, hold NRB close to nose and mouth to not freak them out

what do you not do with a infant when giving treatment and what do you want to do

blood pressure, strapping on NRB

make them feel safe and calm

epiglottitis

causes

S&S

tx

bacterial infection in epiglottis

tripod, drooling, fever

medical emergency—>ventilate (BVM) and give treatment immediately

what happens if you think they are and switch to BVM but then they are swinging around

no need to switch to BVM

pertussis (whooping cough)

causes

S&S

tx

age group

violent coughing fits from bacterial infection —→ bacteria has toxins that inflame airway

fever and whoop after coughing fits, can’t catch breath

get vaccinated

under 6 years

influenza Type A

S&S

fever, cough, sore throat, muscle aches, headache, and fatigue

pneumonia

causes

S&S

infection of the lung, flu becomes pneumonia if severe

lung sounds (crackles)

tuberculosis (TB)

cause

risk factors

S&S

bacterial infection

living in close quarters, decreased immune system, geriatrics

night sweats, weight loss, coughing up blood, chest pain, fatigue, crackles, wheezing

what is ppe for tuberculosis

gloves, eye protection, N-95

air transmission

hemoptysis

coughing up blood

how to know when there is damage to pleura tissue and what does it indicate

increased pain when breathing

possible tuberculosis

chronic obstructive pulmonary disease (COPD) (2 types)

risk factors

tx

smoking destroys elasticity of lung tissue

inhaler

chronic bronchitis

inflammation of bronchi from smoke

produces mucous and swelling, rhonchi sounds (chronic productive cough)

emphysema

damage to walls of alveoli and loose elasticity

air isn’t pushed out and alveoli don’t fully retract

is inhaling and exhaling active or natural motion

inhale = active

exhale = natural

what do people with emphysema have to do more of?

breathe stronger with muscles to get air all out of alveoli

late stage emphysema

chronic CO2 retention, have to rely on peripheral levels rather than CO2 levels

lower oxygen being breathed in

brain stem function

receives signals from chemoreceptors to breathe, especially if it detects CO2

tx for emphysema

high flow O2

pink puffer

emphysema

blue bloater

bronchitis

clubbed fingers

lungs issues

asthma, hay fever, anaphylaxis

cause

allergic reaction to a substance inhaled, ingested, or injected

asthma

S&S

tx

acute spasm of smaller air passages in bronchioles

bronco constriction (wheezing)

inhaler

dose of inhaler

indication

contraindication

1-2 puffs

wheezing, trouble breathing

hypersensitivity, tachycardia, chest pain or cardiac origin

how to know if MDI worked

ask patient with their breathing, look at their breathing, osculate wheezing sounds to see if no more

hay fever (allergic rhinitis)

S&S

cold like symptoms like runny nose, sneezing, congestion, and sinus pressure

rhin- prefix

relating to nose and sinus

anaphylaxis

cause and S&S

definitive tx

severe allergic reaction causing bronchospasm and upper airway swelling, and vasodilation

hypotension, wheezing, stridor

epinephrine

epinephrine

vasoconstricts

spontaneous pnuemothorax

occurs without any apparent cause

simple pnuemothorax

relatively stable form that doesn’t cause severe symptoms

tension pneumothorax

increasing pressure causes the lung to cross mediastinum

who is at risk for pneumothorax?

smokers, vapers, genes, asthmatics, tall thin people

blebs

pocket of air between visceral pleura

weak spots on lungs that can cause spontaneous pneumothorax

pneumothorax

collapsed lung, air that leaks into space between lungs and chest wall

pleural effusion

causes

S&S

tidal volume increased or decreased

collection of fluid in the pleural space (outside of lung, in between pleura)

caused by infection, irritation, congestive heart failure, or cancer

dull sound when auscultated in lungs

decreased

will you hear crackles on outside of lung with fluid there in pleural cavity

no because oxygen isn’t there

difference between pulmonary edema and pleural effusion

edema: fluid on inside of lung

effusion: fluid in pleural cavity

hyperventilation

causes

S&S

getting rid of too much CO2

sometimes due to compensation or distress

is a problem when the blood becomes too alkaline

anxiety, dizziness, tingling of hands/feet

hypoventilation

retain CO2, acidity rises

opposite of hyperventilation

rapid deep breathing, burning in chest, heart pounding, has anxiety/panic attack hx

hyperventilation/panic attack

tx for hyperventilation

calming the patient down so they don’t worry

if S&S of anxiety, dizziness, tingling of hands/feet (hyperventilation), what do you do

try to fix it, not compensation for something

talk to the patient, auscultate lung sounds, have them take long deep breath

when do you use bvm for hyperventilation and how

when they feel like they are about to pass out

explain to them that you will use a BVM

environmental/industrial exposure

causes

S&S

carbon monoxide exposure produced by fuel burning appliances and smoke, binds to hemoglobin

flu like symptoms, headache, cherry red skin, weakness, normal spo2

cystic fibrosis

cause

S&S

tx

genetic disorder leading to thick mucus production and chronic lung infection

sinus congestion to wheezing, asthma like complaints and gastrointestinal complaints

suction and oxygenate

where does CO2 we have come from

biproduct of cellular metabolism

Co2 proves that cells are working bc we are exhaling Co2

capnography

monitoring concentration or partial pressure of Co2 in respiratory gasses

use and hook up for cardiac and respiratory arrest

higher level than EMT but can set it up

opioid overdose (narcotic overdose)

S&S

tx

bradycardia

bradypnea

altered level of consciousness

pinpoint pupils (constricted pupils)

nalaxone (consult medical control), DDICE, recovery position

Naloxone

dose

indication

contraindication

2mg, 1 per each nostril

opioid overdose, pinpoint pupils, respiratory depression

hypersensitivity

Naloxone side effects

nausea, vomiting, aggression (from withdrawal), seizure

how to make someone not hypoxic from naloxone

give them oxygen BVM

slow shallow breath use

BVM

why would someone have a seizure for opioid overdose

if they abuse drugs and can be a contraindication narcan

CPAP contraindications

hypotension, vomiting

late stage COPD

hypoxia drive, assist with oxygen