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.