Conditions & Treatment

What is the most common cause of upper airway obstruction?

The tongue

What are common causes of upper airway obstruction?

Tongue, foreign body, trauma, burns, allergic reaction, and infection

What should a conscious patient do if they can speak during a foreign body airway obstruction?

Encourage coughing

What should be done for a conscious patient unable to speak from airway obstruction?

Perform abdominal thrusts

What is the management of upper airway obstruction in an unconscious patient?

Open the airway, give two ventilations, and administer chest compressions

When should a finger sweep be performed?

Only when the foreign body is visualized

What tool can be used to visualize and remove an airway foreign body?

Laryngoscope and Magill forceps

What does COPD stand for?

Chronic Obstructive Pulmonary Disease

What conditions are included under COPD?

Chronic bronchitis and emphysema

What is chronic bronchitis commonly called?

Blue Bloater

What body habitus is commonly associated with chronic bronchitis?

Overweight

What type of cough is associated with chronic bronchitis?

Productive cough with sputum

What lung sound is associated with chronic bronchitis?

Coarse rhonchi

What skin finding is associated with chronic bronchitis?

Chronic cyanosis

What breathing complaint is associated with chronic bronchitis?

Mild chronic dyspnea

What airway resistance pattern is seen in chronic bronchitis?

Resistance on inspiration and expiration

What is emphysema commonly called?

Pink Puffer

What body habitus is commonly associated with emphysema?

Thin with barrel chest

What type of cough is associated with emphysema?

Nonproductive cough

What lung sounds are associated with emphysema?

Wheezing and rhonchi

What complexion is associated with emphysema?

Pink complexion

What breathing pattern is associated with emphysema?

Prolonged inspiration

What finger finding is associated with emphysema?

Clubbing

What is the management of COPD?

Oxygen, bronchodilators, steroids, and CPAP

What is the DuoNeb dose used in COPD?

Albuterol 2.5 mg in 3 mL and Ipratropium 0.5 mg

What steroid is considered in COPD?

Solu-Medrol (methylprednisolone) 125 mg

What are the two major problems in asthma?

Bronchoconstriction and inflammation

What is the primary bronchodilator used for asthma?

Albuterol

What medication reduces inflammation in asthma?

Steroids

What medications may be used in severe asthma?

Epinephrine and magnesium sulfate

What are common signs and symptoms of asthma?

Dyspnea, wheezing, retractions, decreased LOC, inability to speak in complete sentences, tachycardia, tachypnea, ETCO₂ >45 mmHg

Why is ETCO₂ elevated in asthma?

Air trapping

What is status asthmaticus?

Severe prolonged asthma attack unresponsive to repeated bronchodilators

Why are status asthmaticus patients often dehydrated?

Increased ventilatory effort

What should be anticipated in status asthmaticus?

Advanced airway management

What is the management of asthma?

Oxygen, bronchodilators, magnesium sulfate, steroids, IV fluids, epinephrine IM, and CPAP

What is the DuoNeb dose used in asthma?

Albuterol 2.5 mg in 3 mL and Ipratropium 0.5 mg

What is pneumonia?

Group of infections causing an acute inflammatory response

What types of pneumonia exist?

Bacterial, viral, fungal, and aspiration

What are common signs and symptoms of pneumonia?

Productive cough, pleuritic chest pain, tachypnea, wheezes, crackles, rhonchi, fever, and fatigue

What is the management of pneumonia?

Airway support, oxygen, fluids, and bronchodilators for wheezing

What does ARDS stand for?

Acute Respiratory Distress Syndrome

What type of respiratory failure is ARDS?

Hypoxemic respiratory failure

What type of pulmonary edema occurs in ARDS?

Non-cardiogenic pulmonary edema

What physiologic changes occur in ARDS?

Severe hypoxemia, intrapulmonary shunting, reduced lung compliance, and irreversible lung damage

What is the mortality rate of ARDS?

65%

What is a pulmonary embolism?

Rapid onset of dyspnea and chest pain due to pulmonary vascular obstruction

Which patients are at risk for pulmonary embolism?

Bedridden patients, post-surgical patients, long flights, DVT history, females on birth control, and smokers

What are signs and symptoms of pulmonary embolism?

Dyspnea, chest pain, cough, anxiety, hypertension, tachypnea, tachycardia, crackles, wheezes, and rhonchi

What is the primary treatment for pulmonary embolism?

Identification and rapid transport

What type of shock can pulmonary embolism cause?

Obstructive shock

What fluid bolus is recommended for obstructive shock from PE?

20 mL/kg repeated as needed

What EKG findings may be seen with pulmonary embolism?

Right axis deviation, sinus tachycardia, and S1Q3T3

What does S1Q3T3 mean?

S-wave in lead I, Q-wave in lead III, and inverted T-wave in lead III

What commonly causes hyperventilation syndrome?

Anxiety or panic attacks

What is the management of hyperventilation syndrome?

Calm environment, coaching slower breathing, oxygen if needed, and capnography monitoring

Why is capnography useful in hyperventilation syndrome?

Hyperventilation eliminates too much CO₂

What are signs and symptoms of hyperventilation syndrome?

Dyspnea, tachypnea, chest pain, and carpopedal spasms

What are carpopedal spasms?

Cramping of the fingers

What other conditions can mimic hyperventilation syndrome?

Hypoxia, cardiac disease, pulmonary disease, infection, pain, pregnancy, and drug use

What is a simple pneumothorax?

Air in the pleural space not necessarily causing major problems

What is a tension pneumothorax?

Accumulation of air in the pleural space causing tension and obstructive shock

What are signs and symptoms of tension pneumothorax?

Diminished breath sounds, dyspnea, restlessness, tachypnea, JVD, hyperresonance, subcutaneous emphysema, and hypotension

What is subcutaneous emphysema?

Rice Krispy feeling under the skin

Why does a tension pneumothorax cause hypotension?

Obstructive shock

What is acute mountain sickness?

Common high-altitude illness from rapid ascent above 5,000–7,000 feet

What are signs and symptoms of acute mountain sickness?

Headache, nausea, vomiting, weakness, dizziness, fatigue, difficulty sleeping, tachycardia or bradycardia, postural hypotension, and ataxia

What is ataxia at high altitude concerning for?

Progression to high altitude cerebral edema (HACE)

What is HAPE?

High Altitude Pulmonary Edema

What causes HAPE?

Increased pulmonary artery pressure

When do HAPE symptoms usually begin?

24–72 hours after exposure

Which altitude illness is most lethal?

HAPE

What are signs and symptoms of HAPE?

Progressive cough, hypoxia, tachypnea, weakness, crackles, wheezes, rhonchi, tachycardia, and cyanosis

What is the treatment for HAPE?

Oxygen administration and descent below 500 feet

What is the most common cause of upper airway obstruction in an unconscious patient?

Tongue

What COPD subtype is known as the Blue Bloater?

Chronic bronchitis

What COPD subtype is known as the Pink Puffer?

Emphysema

What asthma finding indicates air trapping?

ETCO₂ greater than 45 mmHg

What severe asthma condition is unresponsive to repeated bronchodilators?

Status asthmaticus

What respiratory condition produces non-cardiogenic pulmonary edema?

ARDS

What respiratory emergency commonly progresses to obstructive shock?

Pulmonary embolism

What EKG pattern is classically associated with pulmonary embolism?

S1Q3T3

What respiratory emergency presents with JVD, absent breath sounds, and hypotension?

Tension pneumothorax

What is the most lethal altitude illness?

High Altitude Pulmonary Edema (HAPE)