EME 106 Quiz 5 Review: Respiratory Emergencies

What are the 4 main lung sounds?

Wheezing, Ronchi, Stridor, Rales

What is wheezing?

A high-pitched, musical, whistling sound primarily heard on exhalation

What causes wheezing?

Narrowed airways

Where are patients are you most likely to see wheezing in?

Asthma, COPD, bronchitis

What is Ronchi?

Low-pitched, snoring/rattling-like sounds

What causes ronchi?

mucous secretions in the airway

What patients are you most likely to see ronchi in?

pneumonia, COPD, bronchitis, cystic fibrosis

What is stridor?

A harsh, high-pitched, loud sound heard primarily on inhalation

What causes stridor?

obstruction of the airway

What patients are you most likely to see stridor in?

Croup, anaphylaxis, and foreign airway obstructions

What is rales/crackles?

Discontinuous clicking, rattling, or bubbling sounds. Can be high or low pitched

What causes rales/crackles?

fluid buildup in the alveoli

What patients are you most likely to see rales in?

heart failure, pneumonia, COPD

What are the three tiers of respiratory disturbances?

Respiratory Distress, Respiratory Failure, Respiratory Arrest

What is the definition of respiratory distress?

Adequate tidal volume and respiratory rate. Adequate minute and alveolar ventilation.

What are the s/s of respiratory distress?

1. rapid/shallow breathing

2. wheezing, grunting, and or nasal flaring,

3. skin that is cool, clammy, or pale

What is the definition of respiratory arrest?

Inadequate tidal volume or inadequate tidal rate, or both.

What are the s/s of respiratory arrest?

1. changes in RR (tachypnea, apnea, bradypnea)

2. shallow chest rise

3. altered mental status

4. cyanosis

What is the definition of respiratory failure?

No tidal volume and no respiratory rate. The patient may have agonal respirations.

What are the s/s of respiratory failure

1. changes in RR (tachypnea, apnea, bradypnea)

2. altered mental status/unconscious

3. cyanosis

What does COPD stand for?

Chronic Obstructive Pulmonary Disease

What are the main components of COPD?

chronic bronchitis and emphysema

What is the nickname for emphysema?

pink puffer

What is the nickname for chronic bronchitis?

blue bloater

What is the main cause of emphysema and chronic bronchitis?

long-term smoking

What happens to patients with emphysema?

The alveoli are irreversibly destroyed, leading to reduced surface area for gas exchange

What happens to patients with chronic bronchitis?

Long-term inflammation of the bronchial tubes, leading to excessive mucus production

What are the s/s of emphysema?

-Barrel-chested patient

-Cyanotic

-Fatigue and Tiredness

-Wheezing and Ronchi

-Persistent, unproductive cough

What are the s/s of chronic bronchitis?

-Overweight

-Cyanotic

-Persistent, productive cough

-Coarse Ronchi

-JVD

-Pedal edema

-Hepatic congestion

-Patients are also very prone to respiratory infections

How do you treat patients with COPD?

-Fowler's position

-High flow O2

-Assist with a metered dose inhaler for wheezing

-Rapid transport

Is it true that high concentrations of O2 can slow down or stop someone with COPD from breathing?

Yes, however his takes hours and is not of real concern to us

What is the definition of Asthma?

chronic inflammatory disorder of the airways

What are the three different types of asthma?

Extrinsic Asthma, Intrinsic Asthma, Status Asthmaticus

What are the signs and symptoms of asthma?

Wheezing, shortness of breath, chest tightness, and coughing.

What triggers allergic asthma?

Outside irritants or pollutants

What triggers intrinsic asthma?

Exercise, emotional stress, or infection

What is status asthmaticus?

Life-threatening episode of airway obstruction that is unresponsive to common treatment

How do you treat asthma?

Oxygen

Prescribed metered-dose inhaler

Ventilation, in severe cases

What is pneumonia?

Acute infectious disease caused by bacteria or a virus

What's a major sign of pneumonia in a patient?

A fever

What's a pulmonary embolism?

blockage in a lung artery

What are the different ways a lung artery can be blocked in a PE?

A blood clot

Air bubble

Fat particle

What are the s/s of a pulmonary embolism?

Dyspnea

Respiratory distress

Stabbing chest pain

Cough (may cough up blood)

What is an acute pulmonary edema?

sudden buildup of fluid in the lungs' air sacs

What are the different types of acute pulmonary edema?

Cardiogenic and noncardiogenic

What are the s/s of acute pulmonary edema?

extreme shortness of breath, a feeling of drowning, and coughing up pink, frothy sputum

What's a spontaneous pneumothorax?

A sudden rupture of the visceral lining, leading to a change in pressure that causes the lung to collapse

Who is more likely to suffer from a spontaneous pneumothorax?

tall, thin males

What are the s/s of a spontaneous pneumothorax?

Tachypnea

Diaphoresis

Shortness of breath

Chest pain or shoulder pain

What should you consider when someone has a spontaneous pneumothorax?

Be prepared to support ventilations

Monitor for signs of a tension pneumothorax

What's hyperventilation syndrome?

Patient feels anxious and unable to catch breath

What are the s/s of hyperventilation syndrome?

Nervous/anxious, upset, syncope, tachypnea, tachycardia, carpal/pedal spasms

What are some special considerations for hyperventilation syndrome?

-Patient "blows off" excessive amounts of CO2, causing their signs and symptoms to worsen

-They may be SOB, but not hypoxic

Symptoms that require ventilation

Extreme fatigue or exhaustion

Inability to speak

Quiet or absent breath sounds

SpO2 < 90 percent with the patient on oxygen

General treatment for respiratory distress

-Always place the patient in a position of comfort (high fowlers)

-O2/PPV

-Try to find the cause

-Consider ALS backup if needed

-May assist with MDI for patients with bronchospasm

A medication commonly prescribed for the patient with a history of breathing problems is called?

Bronchodilator

What are the early signs of breathing difficulty in infants and children?

Retractions, nasal flaring, anxiety

What are medications commonly used for respiratory problems?

Tornalate, Serevent, Alupent

The total number of MDI doses that an EMT can deliver to a patient is?

determined by medical direction