Diagnose Respiratory Distress and Respiratory Failure

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PALS Respiratory Distress 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

Take Note

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
Retropharangeal abscess Pulmonary edema
Anaphylaxis

Table 12

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