hypoxemia in COPD
recommended FiO2 24-28%
or 1-2L nasal cannula
polycethemia
ususally with COPD
redness of extremities
measure cbc/wbc
chest tightness
refers to asthma
pulsus paradoxus
present in extreme cases of ventilatory difficulty
COPD PFT
low flows (FEV1, FEF25-75, PEFR)
increased FRC
normal/increased TLC
TX for COPD
- bronchodilators
- expectorants
- mucolytics
- antibiotics
- incentive spirometry
- deep breathing/coughing
- IPPB, PEP therapy
- CPT
tx for asthma
- bronchodilators
- expectorants
- corticosteroids
- iv methylprednisolone(solu-medrol)
- flovent, pulmicort, aerobid, advair, symbacort
- cromolyn sodium to prevent
foul smelling secreations
bronchiectasis
bronchiectasis xray
- cystic space
- signet ring
- tram tracks
symptoms of asthma
- chest tightness
- uncontrollable cough
- substernal retractions
theophylline
bronchodilator used for management of asthma/copd
can be toxic
15-20micrograms/ml
theophylline overdose
associated with
- seizures
- nausea
- vomiting
- headache
- arrythmias
elevated eosinophil levels
consistent with extrinsic asthma
normally measured w evidence of asthma
tx for status asthmaticus
1.subcutaneous epi 1ml of 1:1000 strength
up to 3 doses, 1 every 20 mins
weaning/assessing copd
check electrolytes!
weaning status asthmaticus
if bronchospasm is resolved, u can advance to flow by on vent
