1.Respiratory DistressSigns & SymptomsABGs

2. Identification LOOK at the patient 3. Identification Early Assessment Adequate Time of Implementation Avoidance of Advanced or InvasiveProcedures 4. Cardiopulmonary Symptoms Cough Sputum Production Hemoptysis Dyspnea Chest Pain Dizziness/Fainting Swelling of the Ankles Fever, Chills, Nights Sweats Headache, AMS, Personality changes GERD 5. Coughing Acute - allergies, Bronchitis Chronic - COPD, Asthma, TB Recurrent - Asthma, Allergies Dry - PE, Inhale irritants Dry then Productive - Pneumonia, asthma,smoking Chronic Productive- Chronic Bronchitis,Pneumonia Inadequate- Muscle weakness,Sedation,Emphysema 6. Coughing Paroxysmal- Aspiration, Asthma Barking - Croup, Epiglottitis Brassy/Hoarse - Laryngitis, Inspiratory Stridor Bronchitis- Obstruction, Croup, WheezyEpiglottitis- Asthma, Bronchitis,Bronchospasm Morning- Smoking, ChronicBronchitis 7. Coughing Afternoon or - Exposure toEveningirritants Associated withPosition Change- Bronchiectasis, Left Associated withHeart Failure,Eating or Drinking GERD - Aspiration, Neromuscular Diseases 8. Sputum Production Cause Mucus Glands (Most often) Characteristics Color (clear, green, yellow, blood tinged) Consistency (thin, thick, viscous,tenacious, frothy) Odor Quantity Time of day 9. Hemoptysis Coughing up blood streaked or bloodysputum Hemoptysis is not Hematemesis 10. Dyspnea Shortness of Breath (SOB) Respiratory and cardinal symptom ofCardiac Hematologic, metabolic, chemical,neurologic, psycogenic, mechanical 11. Dyspnea Work of Breathing (WOB) abnormallyhigh Ventilatory capacity is reduced Drive to breath is elevated 12. Signs of Difficulty Breathing Tripod Support arms on astationary object Accessory Muscles Intercostal Muscles Supraclavicular Subscapular 13. Signs of Difficulty Breathing Nasal Flaring 14. Signs of Difficulty Breathing Cyanosis Central Acrocyanosis 15. Chest Pain (Angina) Cardinal Symptom of Heart Disease Variation Classic symptoms: Left sided arm, jaw,shoulder, back pain or pressure Center of the chest Radiating to Back and Legs Nausea Vomiting Dizziness 16. Chest Pain: Pulmonary Causes Pleuritis Tachypnea, splinting affected side Sharp, stabbing Pulmonary Embolus/Infarction Stabbing, Sudden, Increased byInspiration Dyspnea, Tachypnea, Blood-tingedSputum 17. Chest Pain: Pulmonary Causes Pneumothorax Sharp, Tearing, Sudden, Localized Dyspnea, Tachypnea Tension Pneumothorax Mediastinal shift, Jugular Distention Pulmonary Hypertension Similar to Angina, also caused by stress Dyspnea, Tachypnea, anxiety, jugulardistention 18. Syncope Dizziness and Fainting Reduced Blood Flow Reduced Supply of Oxygen 19. Syncope Causes Obstruction of blood flow Thrombosis Embolism Hypovolemia Prolonged bouts of coughing Hypoxia Hypocapnia 20. Swelling of the Ankles Peripheral Edema Capillaries of the lungs narrow Pressures Build Fluid moves to other tissues 21. Fevers, Chills, Night Sweats Pulmonary Origins Infection most likely Abscess TB Pneumonia Chills Night Sweats 22. Headache and AlteredMental Status Inadequate Oxygen If hypercapnia continues Alertness Drowsiness Disorientation Stupor Coma 23. GERD Gastroesophageal Reflux Disease Abnormal Reflux of Gastric Contentsinto the Esophagus. Can cause or worsen symptoms ofasthma 24. Causes Asthma Wheezing, Prolonged Expiration Pneumothorax Acute, Sharp Pleuritic pain, Decreased orabsent breath sounds Tracheal shift Tension Pneumothorax Life Threatening/Minutes 25. Tension Pneumothorax 26. Tension Pneumothorax Diminished breath sounds Tachycardia, Hypertension Immediate Decompression of the Chest 18 gauge needle Over second rib on the anterior aspect ofchest Rush of air through the needle Remain in place until more conventionalchest tube is inserted Patient should become more stable quickly 27. Causes Foreign Body Aspiration Stridor, Wheeze, Retractions Pulmonary Emboli Chest Pain, Arrhythmias, Tachypnea,Wheezing Pulmonary Edema Dyspnea on exertion, Crackles at bases oflungs 28. Remember One of the most important thingsLOOK at your patient 29. References Wilkins, Robert L.; Stoller, James K.; Kacmarek, Robert M.2009. Fundamentals of Respiratory Care. Ninth Ed. MosbyElsevier