Management of Respiratory Distress and Respiratory Failure

INITIAL MANAGEMENT OF RESPIRATORY DISTRESS/FAILURE
Airway	Open and support the airway	Suction	Consider advanced airway
Breathing	Monitor O₂ sats	Supplemental O₂	Nebulizers
Circulation	Monitor vitals	Establish vascular access

Table 13

Take Note

Croup management is dependent on the degree of the disease.
Dexamethasone, a type of corticosteroid, can cause hypertension and reduce activation of lymphocytes.

The degree of the condition controls the employment of PALS in cases of respiratory distress/failure. For example, bronchodilator inhalers are sufficient when treating mild asthma. However, ET intubation is required for treating severe asthma (status asthmaticus). The patient’s circumstances and situation must be taken into account for a more appropriate treatment.

Croup Management

PALS Croup Management

Figure 12

Upper Airway		Lower Airway
Cause	Treatment	Cause	Treatment
CROUP	Dexamethasone Oxygen (Heliox) Nebulizer (epinephrine) Intubate Tracheostomy	BRONCHIOLITIS	Suctioning Nebulizers
FOREIGN BODY	Dexamethasone Oxygen (Heliox) Nebulizer (epinephrine) Intubate Tracheostomy	ASTHMA	Oxygen (Heliox) Nebulizers (albuterol and ipratropium bromide) Corticosteroids Magnesium sulfate Epinephrine SQ Support breathing
ANAPHYLAXIS	Epinephrine IM Nebulizer Diphenhydramine

Lung Tissue Disease		CNS Issues
Cause	Treatment	Cause	Treatment
PNEUMONIA	Dexamethasone Oxygen (Heliox) Nebulizer (epinephrine) Intubate Tracheostomy Antibiotics (bacterial)	OVERDOSE	Naloxone (opioid reversal) Antidotes Support breathing
PNEUMONITIS	Nebulizers Support breathing	TRAUMA	Neurosurgery Reduce intracranial pressure Support breathing
PULMONARY EDEMA	Diuretics Inotrope Support breathing

Table 14

Take Note

Providers generally work their way up from the least invasive intervention to the most invasive one.
For evidently more severe cases, it is recommended to perform more aggressive treatment methods
To start bronchodilation, albuterol is commonly administered via nebulizer.
Mycoplasma pneumonia, Haemophilus influenza, Chlamydia pneumonia, and Streptococcus pneumonia are among the agents of acute community-acquired pneumonia.
Intense fever usually causes quiet tachypnea.