Management of Respiratory Distress and Respiratory Failure

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INITIAL MANAGEMENT OF RESPIRATORY DISTRESS/FAILURE
AirwayOpen and support the airwaySuctionConsider advanced airway
BreathingMonitor O2 statsSupplemental O2Nebulizers
CirculationMonitor vitalsEstablish 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

Figure 12

Upper AirwayLower Airway
CauseTreatmentCauseTreatment
CROUP
  • Dexamethasone
  • Oxygen (Heliox)
  • Nebulizer (epinephrine)
  • Intubate
  • Tracheostomy
BRONCHIOLITIS
  • Suctioning
  • Nebulizers
FOREIGN BODY
  • Dexamethasone
  • Oxygen (Heliox)
  • Nebulizer (epinephrine)
  • Intubate
  • Tracheostomy
ASTHMA
  • Oxygen
  • Nebulizers (albuterol and ipratropium bromide)
  • Corticosteroids
  • Magnesium sulfate
  • Epinephrine SQ
  • Support breathing
  • Heliox
ANAPHYLAXIS
  • Epinephrine IM
  • Nebulizer
  • Diphenhydramine
 
Lung Tissue DiseaseCNS Issues
CauseTreatmentCauseTreatment
PNEUMONIA
  • Dexamethasone
  • Oxygen (Heliox)
  • Nebulizer (epinephrine)
  • Intubate
  • Tracheostomy
OVERDOSE
  • Naloxone (opioid reversal)
  • Antidotes
  • Support breathing
PNEUMONITIS
  • Antibiotics (bacterial)
  • Nebulizers
  • Support breathing
TRAUMA
  • Neurosurgery
  • Reduce intracranial pressure
  • Support breathing
PULMONARY EDEMA
  • Diuretics
  • Inotrope
  • Support breathing
OVERDOSE

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.

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