Airway and Pulmonary Embolism
The condition occurs when a thrombus dislodges, becoming an emboli.
Symptoms include:
Sudden shortness of breath (SOB)
Sharp chest pain
Bloody sputum (indicative of obstruction)
Tachycardia (elevated heart rate)
Risks for Pulmonary Embolism
Surgical procedures
Prolonged immobility (deep dive and long travel)
Pregnancy
Chronic obstructive pulmonary disease (COPD)
Obesity
Chronic Bronchitis
Defined as inflammation of the airways.
Commonly referred to as "blue bloaters."
Symptoms include:
Chronic cough
Wheezing
Shortness of breath (SOB)
Chest pain
Cyanosis, often due to pulmonary edema
Emphysema
Characterized by damage to the alveoli, impairing gas exchange.
Commonly referred to as "pink puffers."
Symptoms include:
Puckered lip breathing
Shortness of breath (SOB)
Increased respiratory rate
Thin, frail appearance due to increased effort to breathe
Minimal coughing
Treatment for Emphysema
Use of Continuous Positive Airway Pressure (CPAP) and Bag-Valve-Mask (BVM) ventilation
Any positive pressure is helpful in treatment.
Asthma
Condition where bronchioles constrict.
Symptoms include:
Wheezing
Cough
Chest tightness
Inability to speak well when experiencing an attack
Night cough that worsens
Treatment for Asthma
Medications such as albuterol
Positive pressure ventilation if needed.
Pneumonia
An infection in the lungs.
Symptoms include:
Cough
Fever
Chest pain (especially when coughing)
Chills
Fatigue
Notable risk factor: COPD patients are at higher risk of developing pneumonia.
Treatment for Pneumonia
Oxygen transport; ensuring patient receives sufficient oxygen
Tuberculosis
A bacterial respiratory infection.
Symptoms include:
Bloody cough
Shortness of breath (SOB)
Recommendations include wearing an N-95 or HEPA mask to prevent transmission.
Indications for Oxygen Supplementation
Hypoxia (low oxygen levels)
Altered Mental Status (AMS)
SpO2 less than 94%
Use Non-Rebreather Mask (NRB) if the patient can breathe.
Use Positive Pressure Ventilation (PPV) if the patient cannot breathe, characterized by ineffective breathing:
Apneic, short, or shallow breathing
Respiratory rate less than 8, greater than 28 initiates ventilation.
Use BVM on a conscious patient in cases of critical breathing issues.
Pediatric Respiratory Issues
Croup
Defined as an upper airway infection.
Characteristics:
Seal bark cough (specific sound)
Affects children age 5 and younger
Treatment:
Oxygen transport, utilize humidified oxygen.
Epiglottitis
An infection of the epiglottis.
Symptoms include:
Stridor (noisy breathing)
Drooling
Dysphagia (difficulty swallowing)
Dysphonia (difficulty speaking)
Respiratory distress
Administration of oxygen is critical.
Cardiogenic Shock
Known as acute coronary syndrome, representing cardiac compromise.
Mechanism involves reduced blood flow to the myocardium.
Symptoms include:
Angina (chest pain)
Stable Angina: Predictable, occurring with exertion or stress within 5 minutes.
Squeezing, pressure-like chest pain radiating to jaw, arm, and neck.
Unstable Angina: Severe chest pain occurring at rest, not relieved by nitroglycerin, indicating an oncoming Acute Myocardial Infarction (AMI).
Acute Myocardial Infarction (AMI - Heart Attack)
Result of blocked blood flow in coronary arteries.
Consequence: Cardiac tissue dies due to ischemia.
Symptoms include:
Severe chest pain
Pain radiating to jaw and neck
Vital signs may include normal blood pressure and heart rate
Signs of stress: Sweating, nausea, vomiting, and lowered SpO2 levels.
Oxygen is administered if SpO2 is under 90% using NRB;
Nitro can be given if SpO2 is over 90%.
Aspirin as secondary treatment: 4 tabs = 324 mg.
Aortic Aneurysm
A dilation (ballooning) of the aorta.
Can lead to rupture.
Symptoms include tearing chest pain, back pain, and pain in the upper shoulder blades and abdomen.
Physical examination may reveal a pulse in the navel region.
Treatment involves rapid transport to emergency.
Congestive Heart Failure (CHF) Notes
The heart is unable to pump sufficient blood to meet bodily needs.
Left-Sided Heart Failure
Leads to pulmonary complications:
Symptoms include:
Crackles
Pulmonary edema
Shortness of breath (SOB)
Pink, frothy sputum
Symptoms worsen when lying flat
Rapid respiratory rate
Right-Sided Heart Failure
Leads to systemic effects:
Symptoms include:
Jugular Venous Distension (JVD)
Edema in legs, ankles, sacral region, and arms
Weight gain
Reduced appetite
Treatments for CHF
CPAP or PPV for assistance in breathing.
Diuretics (Lasix, thiazides) to manage fluid overload.
Cardiac Tamponade
An accumulation of blood in the pericardial sac from trauma.
Symptoms include:
Beck's triad:
Hypotension
Jugular Venous Distension (JVD)
Muffled heart sounds
Basic Life Support (BLS) Notes
The only shockable rhythms are:
Ventricular Fibrillation (VF) and Ventricular Tachycardia (Vtach).
Conditions and Types of Shock
Weak pulse necessitates supporting ventilation.
Types of Shock:
Hypovolemic Shock: Due to loss of blood/fluid volume.
Hemorrhagic Shock: Due to significant blood loss.
Cardiogenic Shock: Due to pump failure of the heart.
Obstructive Shock: Due to obstruction/blockage preventing adequate perfusion.
Distributive Shock: Related to loss of vessel tone.
Types of Distributive Shock:
Neurogenic (spinal cord injury)
Psychogenic (related to severe emotional distress)
Septic (due to bacterial infections)
Anaphylactic (due to allergen exposure)
Compensation and Decompensation in Shock
Compensation Signs include:
Anxiety or restlessness
Pale, cool, clammy skin
Normal tachycardia
Narrow blood pressure (BP)
Systolic BP above 100
Reduced urine output
Decompensation Signs include:
Hypotension
Ashen, cyanotic skin
Weak pulse
Irregular breathing
Altered Mental Status (AMS)
No urine output.