Podcast
Questions and Answers
What is the primary purpose of obtaining a pulse oximetry reading during the assessment of a patient with a respiratory emergency?
What is the primary purpose of obtaining a pulse oximetry reading during the assessment of a patient with a respiratory emergency?
Which of the following is NOT a general treatment for patients with respiratory distress?
Which of the following is NOT a general treatment for patients with respiratory distress?
What type of capnography reading should be obtained during the assessment of a patient with a respiratory emergency?
What type of capnography reading should be obtained during the assessment of a patient with a respiratory emergency?
What is the primary goal of airway management protocol in patients with respiratory distress?
What is the primary goal of airway management protocol in patients with respiratory distress?
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Which of the following is a common presentation of a patient in respiratory distress?
Which of the following is a common presentation of a patient in respiratory distress?
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What is the significance of obtaining a waveform capnography reading in patients with respiratory emergencies?
What is the significance of obtaining a waveform capnography reading in patients with respiratory emergencies?
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What is included in the universal initial adult patient assessment for patients with respiratory distress?
What is included in the universal initial adult patient assessment for patients with respiratory distress?
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What is the primary focus of the airway management protocol in patients with respiratory distress?
What is the primary focus of the airway management protocol in patients with respiratory distress?
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What is the significance of repeated vital signs assessment in patients with respiratory distress?
What is the significance of repeated vital signs assessment in patients with respiratory distress?
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What is the purpose of initiating ventilation in patients with respiratory distress?
What is the purpose of initiating ventilation in patients with respiratory distress?
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What is the most useful assessment tool in determining whether a patient's respiratory distress with rales and/or rhonchi is due to primarily cardiac or pulmonary causes?
What is the most useful assessment tool in determining whether a patient's respiratory distress with rales and/or rhonchi is due to primarily cardiac or pulmonary causes?
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Which of the following is a characteristic of congestive heart failure (CHF)?
Which of the following is a characteristic of congestive heart failure (CHF)?
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What is the initial treatment for a patient with cardiac pulmonary edema?
What is the initial treatment for a patient with cardiac pulmonary edema?
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What is the dose of nitroglycerin to administer if the systolic BP is between 90 mmHg and 160 mmHg?
What is the dose of nitroglycerin to administer if the systolic BP is between 90 mmHg and 160 mmHg?
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Why should nitroglycerin be avoided in certain patients?
Why should nitroglycerin be avoided in certain patients?
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What is the emphasis of treatment in cardiac pulmonary edema?
What is the emphasis of treatment in cardiac pulmonary edema?
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What is a characteristic of pulmonary edema?
What is a characteristic of pulmonary edema?
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What is the purpose of administering nitroglycerin in cardiac pulmonary edema?
What is the purpose of administering nitroglycerin in cardiac pulmonary edema?
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What is a common finding in patients with chronic congestive heart failure?
What is a common finding in patients with chronic congestive heart failure?
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When can nitroglycerin be administered to a patient with cardiac pulmonary edema?
When can nitroglycerin be administered to a patient with cardiac pulmonary edema?
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What is the primary focus of treatment in cardiac pulmonary edema?
What is the primary focus of treatment in cardiac pulmonary edema?
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What is a characteristic of acute pulmonary edema?
What is a characteristic of acute pulmonary edema?
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Why should nitroglycerin be avoided in certain patients?
Why should nitroglycerin be avoided in certain patients?
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What is the dose of nitroglycerin to administer if the systolic BP is between 90 mmHg and 160 mmHg?
What is the dose of nitroglycerin to administer if the systolic BP is between 90 mmHg and 160 mmHg?
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What is a characteristic of congestive heart failure?
What is a characteristic of congestive heart failure?
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What is the initial treatment for a patient with cardiac pulmonary edema?
What is the initial treatment for a patient with cardiac pulmonary edema?
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Study Notes
Medical Respiratory Emergencies
- Obtain and document pulse oximetry reading and waveform capnography reading during assessment and after treatment for all patients with respiratory emergencies.
- Treat any problems as per protocol(s) to address respiratory distress.
Common Presentations of Respiratory Distress
- Rales/Rhonchi
- Wheezing
- Unilateral absence of breath sounds
General Treatment for Respiratory Distress
- Perform Universal Initial Adult Patient Assessment / Care
- Implement Airway Management Protocol
- Initiate ventilation, oxygen, vascular access, and monitoring
- Monitor ECG rhythm, pulse oximetry, waveform capnography, and repeated vital signs assessment.
Medical Respiratory Emergencies
- Obtain and document pulse oximetry reading and waveform capnography reading during assessment and after treatment for all patients with respiratory emergencies.
- Treat any problems as per protocol(s) to address respiratory distress.
Common Presentations of Respiratory Distress
- Rales/Rhonchi
- Wheezing
- Unilateral absence of breath sounds
General Treatment for Respiratory Distress
- Perform Universal Initial Adult Patient Assessment / Care
- Implement Airway Management Protocol
- Initiate ventilation, oxygen, vascular access, and monitoring
- Monitor ECG rhythm, pulse oximetry, waveform capnography, and repeated vital signs assessment.
Respiratory Distress with Rales and/or Rhonchi
- A patient's history is the most useful assessment tool in determining whether respiratory distress with rales and/or rhonchi is due to primarily cardiac or pulmonary causes.
Congestive Heart Failure (CHF)
- Usually a chronic illness with acute exacerbations.
- Patients typically experience SOB for days rather than hours.
- May present with swelling of both lower extremities.
- May be taking diuretics and cardiac medications.
- Patients are frequently more comfortable sitting up.
Cardiac Pulmonary Edema
- Acute pulmonary edema may develop within minutes.
- Patients may have watery, frothy sputum.
- Lung sounds will be progressively absent starting from the bases up as Pulmonary Edema develops.
Treatment for CHF and Cardiac Pulmonary Edema
- Place the patient on CPAP mask device as soon as possible, if available and if the patient is cooperative.
- Administer nitroglycerin:
- 0.4 mg SL if systolic BP is between 90 mmHg and 160 mmHg, repeat every 3 to 5 minutes if needed as long as the systolic BP remains greater than 90 mmHg or until relief of signs or symptoms.
- 0.8 mg SL (two tabs) if systolic BP is greater than 160 mmHg, repeat every 3 to 5 minutes if needed as long as the systolic BP remains greater than 160 mmHg or until relief of signs or symptoms.
- Do not administer nitroglycerin if the patient is known or suspected to have taken sexually enhancing drugs and/or drugs prescribed for pulmonary hypertension within the specified time frames (e.g., Viagra/Revatio, Levitra, Cialis/Adcirca).
- Administer furosemide (Lasix) if the patient remains symptomatic after initial interventions and the systolic BP remains above 90 mmHg.
- Administer normal saline, 500 mL IV bolus if the systolic BP is less than 90 mmHg.
- Administer premix dopamine, 400 mg in 250 mL D5W IV/IO, if systolic BP is still below 90 mmHg.
Respiratory Distress with Rales and/or Rhonchi
- A patient's history is the most useful assessment tool in determining whether respiratory distress with rales and/or rhonchi is due to primarily cardiac or pulmonary causes.
Congestive Heart Failure (CHF)
- Usually a chronic illness with acute exacerbations.
- Patients typically experience SOB for days rather than hours.
- May present with swelling of both lower extremities.
- May be taking diuretics and cardiac medications.
- Patients are frequently more comfortable sitting up.
Cardiac Pulmonary Edema
- Acute pulmonary edema may develop within minutes.
- Patients may have watery, frothy sputum.
- Lung sounds will be progressively absent starting from the bases up as Pulmonary Edema develops.
Treatment for CHF and Cardiac Pulmonary Edema
- Place the patient on CPAP mask device as soon as possible, if available and if the patient is cooperative.
- Administer nitroglycerin:
- 0.4 mg SL if systolic BP is between 90 mmHg and 160 mmHg, repeat every 3 to 5 minutes if needed as long as the systolic BP remains greater than 90 mmHg or until relief of signs or symptoms.
- 0.8 mg SL (two tabs) if systolic BP is greater than 160 mmHg, repeat every 3 to 5 minutes if needed as long as the systolic BP remains greater than 160 mmHg or until relief of signs or symptoms.
- Do not administer nitroglycerin if the patient is known or suspected to have taken sexually enhancing drugs and/or drugs prescribed for pulmonary hypertension within the specified time frames (e.g., Viagra/Revatio, Levitra, Cialis/Adcirca).
- Administer furosemide (Lasix) if the patient remains symptomatic after initial interventions and the systolic BP remains above 90 mmHg.
- Administer normal saline, 500 mL IV bolus if the systolic BP is less than 90 mmHg.
- Administer premix dopamine, 400 mg in 250 mL D5W IV/IO, if systolic BP is still below 90 mmHg.
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Description
This quiz assesses the responder's knowledge of respiratory distress emergencies, including initial assessment, treatment protocols, and common presentations of respiratory distress.
