Session+5

Course Information

  • Course: ANT 210 L Session 5 - Advanced Airway and Respiratory Management

  • Instructor: Muhammad K. Muhammad, Mrs. of Anesthesia Technology

  • Institution: College of Healthcare Technologies

  • Contact Email: Muhammad.karim@auib.edu.iq

  • Meeting Date and Time: Thursday, 27.02.25, 2 PM - 4:30 PM

Session Outline

  • Common respiratory problems

  • Adults' airway management

  • Multiple case scenarios

  • Respiratory disorders/distress syndrome

  • Chest tube insertion

  • Top airway illnesses and diseases

Common Respiratory Disorders

  • Categories:

    • Asthma

    • Cystic Fibrosis

    • Emphysema

    • Lung Cancer

    • Mesothelioma

    • Pulmonary Hypertension

    • Tuberculosis

  • Consequences: Untreated lung disease can lead to significant health complications, distressing symptoms, and potential life-threatening situations.

Diagnostic and Treatment Approaches

  • Initial Assessment: Determining the cause and source of pulmonary conditions is crucial for treatment planning.

  • Role of Pulmonologist: After a thorough evaluation, a pulmonologist devises the best treatment plan based on the patient's condition and preferences.

  • Testing and Procedures: Various diagnostic and surgical tests are utilized, including:

    • Overviews of procedures

    • Rationale for procedures

    • Potential risks

    • Pre-procedure instructions

    • What to expect during and post-procedure

  • Patient Role: Patients are encouraged to understand risk factors and adopt preventative measures for lung disease.

Respiratory Emergencies

  • Definition: A respiratory emergency occurs when the body cannot adequately oxygenate the blood or eliminate carbon dioxide, often termed acute hypoxemic respiratory failure (AHRF).

  • Causes: Potential reasons for respiratory emergencies include:

    • Chest/spinal cord/brain injuries

    • Substance abuse (drugs and alcohol)

    • Lung diseases (e.g., COPD, pulmonary embolism)

    • Blockages, scarring, or fluid in the lungs

    • Exposure to irritants (smoking, pollution, etc.)

Case Scenario 1: Respiratory Assessment

  • Patient Profile:

    • 60-year-old male

    • Symptoms: Persistent right-sided chest pain and productive cough (yellow sputum), no hemoptysis.

    • Past smoking history: 1 pack daily for 50 years.

    • Family exposure to tuberculosis.

  • Physical Exam Findings:

    • Appearance: Cachectic, dyspneic

    • Vital Signs: BP 125/71 mmHg, Heart rate 122/min, Temperature 100°F, Respiratory rate 33/min, Sat 77% on room air (92% on 40% venti-mask).

    • Lung Auscultation: Diminished breath sounds on the right upper zone.

Diagnostic Imaging

  • Chest Radiograph: Two figures provided depicting the patient's condition upon initial presentation and transfer to ICU.

Clinical Question

  • As the patient's condition worsens, what is the appropriate means of providing ventilatory support? Options include:

    • A. Pressure support ventilation

    • B. Volume assist-control ventilation with tidal volumes of 6 ml/kg

    • C. Volume assist-control ventilation with tidal volumes of 12 ml/kg

    • D. Noninvasive positive pressure ventilation

Acute Respiratory Distress Syndrome (ARDS)

  • Symptoms: Difficulty breathing is the primary symptom. Additional symptoms may develop based on the underlying cause, including blood clots, infections, and organ failure.

ARDS Warning Signs

  • Common Indicators:

    • Shortness of breath

    • Rapid shallow breathing

    • Increased heart rate

    • Cough producing phlegm

    • Cyanosis (blue lips, skin)

    • Extreme fatigue

    • Crackling lung sounds

    • Chest pain with deep breaths

    • Low blood pressure

    • Confusion

Case Scenario 2: Pediatric Patient

  • Patient Profile: 6-year-old male with a 2-day history of cough and fever diagnosed with pneumonia. Poor inhaler response.

  • Assessment Steps: ABC assessment, oxygen application, initiation of nebulizer treatment, and escalation to intubation as necessary.

Case Scenario 3: Chest Tube Insertion

  • Patient Profile: 45-year-old male involved in a motor vehicle accident with severe left-sided chest pain and trouble breathing. Vital signs indicate respiratory distress with arterial hypoxemia (SpO₂ 88%).

Airway Diseases Overview

  • Types: Asthma, COPD, bronchiectasis, cystic fibrosis, reactive airway disease.

  • Symptomatology: Include breathing difficulty, persistent cough, wheezing, frequent infections, chest tightness, and fatigue.

Treatment Approaches for Airway Diseases

  • Primary Treatment: Cessation of smoking.

  • Medications: Bronchodilators, inhaled steroids, oral steroids, phosphodiesterase-4 inhibitors, antibiotics.

  • Therapies: Oxygen therapy and pulmonary rehabilitation.

  • Devices: BiPAP and home ventilation.

  • Surgery Options: Lung volume reduction, bullectomy, lung transplant (in severe cases).

Airway Management Definition

  • Purpose: Airway management involves assessment, planning, and medical procedures to maintain or restore breathing, ensuring air flows correctly from the nose and mouth into the lungs.

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