1
Q
Kussumal Respirations
A
Deep, rapid, “air hunger”, typical with acidosis or following strenuous exercise
2
Q
URTI
A
- Common cold, caused by a viral infection of the URT
- Spread through droplets, either directly inhaled or spread through touch
Signs and Symptoms: - Red mucous membranes of the nose and pharynx
- Copious watery discharge
- Mouth breathing, change in tone and voice
- Cough may develop from irritation of discharge
Treatment: - Acetaminophen for fever and headache
- Decongestants to reduce congestion
- Humidifiers- keep secretions liquid to aid in removal
- Antibiotics DO NOT cure viral infections
3
Q
Sinusitis
A
- Bacterial infection secondary to a cold or an allergy that has obstructed drainage of one or more of the paranasal sinsuses
- Causes build-up of the exudate which leads to severe pain in the face
- Decongestants and analgesics are recommended until sinsuses are draining well
- Antibiotics are often required to eradicate the infection
4
Q
Croup
A
- Common viral infection in children between 1 and 2
- Begins with nasal congestion and cough
- The larynx and subglottic area become inflamed with swelling and exudate- leads to characteristics “barking cough”, hoarse voice, and inspiratory stridor
- Worse at night
- Treatment- cool, moisturized air from a humidifier or shower
5
Q
Epiglottitis
A
- Acute infection from a bacterial organism
- Most common in children aged 3-7
- Infection caused by swelling of the larynx, supraglottic area and epiglottis
- Onset is rapid, fever and sore throat that develop, and child refuses to swallow
- They will be anxious, mouth open, struggling to breathe
- Treatment involved O2 and airway management
6
Q
Tuberculosis
A
- Infection that affects the lungs primarily, but may also invade other organs
- Transmitted by oral droplets released from a person with active infection inhaled into the lungs
Signs and Symptoms: - Primary- asymptomatic
- Secondary- initially vague manifestions such as malaise, fatigue and weight loss, low grade fevers, cough is prolonged and gets increasingly severe, often contains blood
7
Q
Cystic Fibrosis
A
- Genetic disorder affecting the 7th chromosome that results in a thick, sticky mucus secretion in the lungs
- Mucus obstructs airflow in the bronchioles causing air trapping and permanent damage to alveoli
8
Q
Signs and Symptoms of Cystic Fibrosis
A
- Chronic cough and frequent respiratory infections
- Hypoxia, fatigue and exercise intolerance develop
- Chest may appear over inflated due to air trapping
- Audible rhonchi
- Failure to meet the normal growth milestones due to chronic respiratory problems
- Dyspnea, tachypnea, accessory muscle use, cyanosis, diminished breath sounds
9
Q
Aspiration
A
- Passage of food or fluid, vomit or drugs, or any other foreign material into the trachea or lungs
- Normally a cough removes the material
10
Q
Signs and Symptoms of Aspiration
A
- Coughing with dyspnea
- Stridor and hoarseness
- Wheezes with aspiration of liquids into the lungs
- Tachycardia and tacypnea as a response to SOB
- Complete obstruction- no sound
11
Q
COPD
A
- Group of chronic respiratory that are characterized by progessive tissue degeneration and obstruction of the airways
- Causes irreversible damage to the lungs
- Examples are emphysema, bronchitis, and asthma
12
Q
Asthma
A
- Disease that involves periodic episodes of severe but reversible bronchial obstruction in persons with hypersensitivity/hyper responsive airways
- May be acute or chronic
- The bronchi and bronchioles respond to stimuli in 3 ways:
- Inflammation of the mucosa with edema
- Constriction of smooth muscle (bronchoconstriction)
- Increased secretions of thick mucus in the passages
- Partial obstruction of the bronchioles results in air trapping and hyperinflation of the lungs
- Air passes through the areas distal to the obstruction and is only partially expired
- Air builds up and the pt tries to force expiration which leads to collapse of the bronchial walls
13
Q
Signs and Symptoms of Asthma
A
- Cough, dyspnea, tightness in chest
- Agitation as obstruction increases
- Wheezes as air asses through the narrowed bronchioles
- Rapid, laboured breathing with accessory muscle use
- Thick, tenacious mucus coughed up
- Tachycardia
- Respiratory failure- decreased LOC, cyanosis
14
Q
Emphysema
A
- Destruction of the alveolar walls which leads to large, permanently inflated alveolar air spaces
- Often called “pink puffers”
- Breakdown of alveolar walls result in:
- Loss of surface for gas exchange
- Loss of elastic fibers affecting lung recoil
- Decreased support for bronchial structures leading to obstruction of airflow in expiration
- Thickening of bronchial walls leads to narrowed airways
- Difficult expiration leads to air trapping and increased residual volumes and over inflation
- Fixation of ribs in inspiratory position (barrel chest)
- Hypercapnia
- Hypoxic drive as pt’s respiratory center adapts to high CO2 levels and fails to be the respiratory center adapts to high CO2 levels and fails to be the respiratory centers regulatory mechanism
- The large air spaces (blebs) can create the tissues and pleural membranes around the bleb to rupture, causing a pneumothorax
- Frequent infections as secretions are difficult to remove
- Pulmonary HTN and cor pulmonale develop as pulmonary blood vessels are destroyed causing increased pressure in pulmonary circuit
15
Q
Signs and Symptoms of Emphysema
A
- Dyspnea initially on exertion, then even at rest
- Hyperventilation with prolonged expiratory phases and accessory muscle use
- Barrel chest from hyperinflation
- Tripod positioning to facilitate breathing
- Fatigue contributes to weight loss- often these patients are extremely thin
- Clubbed fingers- vascular endothelial growth factor (VEGF)
- Your body produces more VEGF when it can’t get enough oxygen
- Polycythemia- increased red blood cells
16
Q
Chronic Bronchitis
A
- Mucosa is inflamed and swollen
- Hypertrophy of mucous glands and increased secretions are produced
- Chronic irritation and inflammation lead to thickening of bronchial walls and further obstruction
- Secretions pool and are difficult to remove
- Low O2 levels = cyanosis
- “Blue bloaters”
17
Q
Signs and Symptoms of Chronic Bronchitis
A
- Mucosa is inflamed and swollen
- Tachypnea
- SOB
- Frequent secretions that are thick
- Rhonchi- usually more prevalent in the morning as secretions have pooled
- Cyanosis and hypoxia
18
Q
Pulmonary Embolism
A
- Blood clot or mass of other material that obstructs the pulmonary artery or branch of it, blocking blood flow through the lung tissue
- Effects depend largely on size and location
19
Q
Signs and Symptoms of Pulmonary Embolism
A
- Transient chest pain that often increases with coughing or deep breathing
- Cough
- SOB
- Tachypnea
- Hypoxia stimulates sympathetic response- anxiety, restlessness, tachycardia
- Massive ones cause low BP, crushing chest pain, rapid weak pulse, loss of consciousness
20
Q
Fast acting bronchodilators
A
- Work on beta cells in the lungs
- Stimulate beta cells which relax smooth muscles in the airways
- Used to treat bronchoconstriction
- Ventolin is most common
21
Q
Long Acting Bronchodilators
A
- Long acting beta 2 agonist
- Often have some steroids in them or are used in conjunction with steroids
- Not to be used in emergent situations
- Used to provide control, not relief
- Advair and symbicort
22
Q
Anticholinergics
A
- Works to block the parasympathetic response
- Sympathetic- increases HR and causes bronchodilation
- Parasympathetic- decreases HR and causes bronchodilation
- Most common is Ipratropium (atrovent)
23
Q
Corticosteroids
A
- Used to reduce bronchial swelling
- Available through inhalation or IV
- Long term negative effects such as high BS, decreased immune system, generalized edema
- Common drugs: dexamethasone, prednisone, hydrocortisone, betamethasone
24
Q
Diuretics
A
- Used to help maintain BP and remove fluid from the body
- Beneficial in patients with pulmonary edema
- Negative side effects is lost potassium
- Most common used in emergent situations is lasix
25
Sympathomimetics
- Work to stimulate the beta 2 receptors
- Assist in bronchodilation
- Mostly given IM in emergent situations
- Epinepherine
26
Paramedic Flashcards
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