Diagnose Respiratory Distress and Respiratory Failure
Figure 11
Explained simply, respiratory distress is a condition wherein pulmonary activity is deemed insufficient to regulate oxygen and extract carbon dioxide from the blood. It becomes harder to detect respiratory failures when the patient appears to be breathing, but is actually experiencing agonal breathing. The proper rate and depth of breathing are important factors to consider when evaluating the quality of the person’s breathing. Two main actions involved in breathing are ventilation and oxygenation. Signs and symptoms are listed below for easier diagnosis.
| Ventilation | ||
| Is the airway clear? | Are the muscles of the chest functioning? |
Is the rate of breathing sufficient? |
| Ex. An obstructed airway prevents gas flow |
Ex. Chest muscle fatigue can occur |
Ex. CNS depression can slow/stop breathing |
| Oxygenation | ||
| Is oxygen available? | Is lung blood flow adequate? |
Can gases cross the pulmonary vasculature? |
| Ex. High altitudes have low O2 |
Ex. Vascular shunts may not send blood to lungs |
Ex. Pulmonary edema or pneumonia |
Abnormal breath sounds
| STRIDOR | • Upper airway obstruction (foreign body) |
| GRUNTING | • Upper airway obstruction (Swollen airway) • Pneumonia (grunting to recruit alveoli) |
| WHEEZING | • Lower airway obstruction (Asthma) |
| CRACKLES | • Fluid in lungs (Wet), Atelectasis (Dry) |
| ABSENT/DECREASED BREATH SOUNDS |
• Collapsed lung (air, blood) • Lung tissue disease (pneumonia) |
Table 11
Sounds in breathing may provide information about the respiratory problem.
Causes of Respiratory Distress/Failure
Upper airway, lower airway, lung tissue disease, and central nervous systems (CNS) issues are the main categories of respiratory failure. The list provided in Table 12 is not comprehensive, with specialized conditions requiring extensive treatment, but these broad categories reflect the usual causes of respiratory distress or failure among children and infants.
| UPPER AIRWAY | LOWER AIRWAY | LUNG TISSUE DISEASE | CNS ISSUES |
| Croup (swelling) | Bronchiolitis | Pneumonia | Overdose |
| Foreign body | Asthma | Pneumonitis | Head trauma |
| Retropharyngeal abscess | Pulmonary edema | ||
| Anaphylaxis |
Table 12