Respiratory System

Fun fact: According to the Asthma & Allergy Foundation of America, Atlanta is the #1 WORST place to live if you suffer from asthma and allergies!

Common Respiratory Problems Asthma Emphysema Bronchitis Anaphylaxis Anxiety

Trivia Why do you get a runny nose when you cry?

Nasolacrimal ducts Canals that allow tears to drain from the eyes to the nasal cavity. These are why people get runny noses when they cry. Avoid touching your eyes: viruses on fingers can be transported from the eye via the nasolacrimal duct to the nose and throat.

Asthma Affects nearly 10 million Americans. 4,000-5,000 deaths per year.

What is Asthma? Reversible airflow obstruction caused by bronchial smooth muscle contraction.

What is Asthma? Excess mucus secretion results in bronchial plugging. Inflammatory changes occur in the bronchial walls.

Signs and Symptoms of Asthma Known history of asthma. Obvious respiratory distress.

Signs and Symptoms of Asthma Rapid breathing (>30). Cough, tightness in chest. Inability to speak full sentences. Labored breathing.

Signs and Symptoms of Asthma Diaphoresis (sweating). Pale or cyanotic nails/skin/lips. “Tripod position.” Audible wheezing. Prolonged expiratory phase.

Treatment of Asthma Call 911! Allow patient to stay in most comfortable position. Have patient use own inhalers if possible.

Note on Inhalers Why should people NOT share inhalers? Try to think of at least three reasons. May have different medicine. May have incorrect dose for individual. Sharing germs. Inhaler may not be ready for original individual if needed.

Treatment of Asthma Take vital signs and write them down. Remind patient to keep breathing!

Bronchitis: Acute & Chronic

Bronchitis Inflammation of the bronchi and bronchial tubes.

Acute Bronchitis Caused by infection. Most often caused by one of a number of viruses that can infect the respiratory tract and attack the bronchial tubes. Infection by certain bacteria can also cause acute bronchitis.

Acute Bronchitis Signs and symptoms include productive cough, dyspnea, chest pain, fever.

Treatment of Acute Bronchitis Antibiotics and expectorants to remove excess mucous.

Chronic Bronchitis Chronic inflammation. Damaged cilia. Enlarged mucous glands.

Causes of Chronic Bronchitis Frequent attacks of acute bronchitis. Smoking.

Causes of Chronic Bronchitis Long term exposure to pollutants or second hand smoke.

What makes it chronic? Chronic bronchitis can be mild to severe and is longer lasting — from several months to years. With chronic bronchitis, the bronchial tubes continue to be inflamed (red and swollen), irritated, and produce excessive mucus over time. Don’t SMOKE

Asthma AND Bronchitis?? In people with asthma, bouts of bronchitis may come on suddenly and trigger episodes in which they have chest tightness, shortness of breath, wheezing, and difficulty exhaling (breathing out). In a severe episode of asthmatic bronchitis, the airways can become so narrowed and clogged that breathing is very difficult.

Signs and Symptoms of Chronic Bronchitis Excess mucous. Productive cough. Wheezing. Dyspnea. Prolonged expiratory phase.

Chronic Bronchitis Signs and symptoms include dyspnea and a prolonged expiratory phase.

Chronic Bronchitis In advanced cases patients may exhibit cyanosis and edema. “Blue Bloater.”

Chronic Bronchitis Treatment: antibiotics, bronchodilators, respiratory therapy. NO CURE.

Emphysema Walls of the alveoli deteriorate and lose their elasticity. CO2 is trapped in alveoli. Poor air exchange.

Lung w/ Emphysema

Causes of Emphysema Smoking. Prolonged exposure to pollutants.

Emphysema Signs and symptoms include dyspnea, feeling of suffocation, pain, barrel chest, chronic cough.

Emphysema Cyanosis, rapid respiratory rate, prolonged expiratory phase.

Emphysema Eventual respiratory failure and death. “Pink puffer.”

Pink Puffer

Treatment of Emphysema Bronchodilators, treatment of infections, oxygen therapy, respiratory therapy.

Anaphylaxis

Severe allergic reaction. Causes deaths each year.

Signs and Symptoms of Anaphylaxis Patient may know they are having allergic reaction. Obvious respiratory distress.

Signs and Symptoms of Anaphylaxis Tightness in throat and chest. Audible wheezing on inhale AND exhale.

Signs and Symptoms of Anaphylaxis Runny nose Tearing Hives Flushed, red skin Swelling May have low blood pressure due to shock.

Treatment of Anaphylaxis Have patient use inhalers or epipen if possible.

Anxiety Attacks

Be Careful! One study in The Annals of Emergency Medicine described three cases in which people having heart attacks thought wrongly that they were hyperventilating. These patients died after losing oxygen while breathing into bags.

THE BOTTOM LINE Most studies advise against paper bags to treat hyperventilation.

Hyperventilation Often called an “anxiety attack” or “panic attack.” No related deaths (due to actual anxiety attack).

Anxiety Attack This patient is very upset, terrified of dying, and has the feeling that it is…..

Anxiety Attack … impossible to get enough air into the chest, even though there is really…..

Anxiety Attack …more air than usual being exchanged. This person has TOO much oxygen!

Signs of an Anxiety Attack Rapid, deep breathing or gasping for air. Flushed, red appearance. Diaphoresis.

Signs and Symptoms of an Anxiety Attack Dizziness Rapid heart beat Normal or high BP

Symptom of an Anxiety Attack Classic clue: this person will complain of numbness and tingling to fingers and toes.

Treatment of Hyperventilation Be careful to take a complete history and not miss something more serious.

Treatment of Hyperventilation Calm the patient. Have them breathe slowly. Instruct them to breathe in through nose and out through mouth (“blowing out birthday candles.”)

Pleurisy The double-layered pleura protects and lubricates the surface of the lungs as they inflate and deflate within the rib cage. Normally, a thin, fluid-filled gap -- the pleural space -- allows the two layers of the pleural membrane to slide gently past each other. When these layers become inflamed, with every breath, sneeze, or cough their roughened surfaces rub painfully together like two pieces of sandpaper.

Airway Adjuncts Size from mouth to curve of jaw OR earlobe Oropharyngeal Airway (OPA)

Nasopharyngeal Airway (NPA)

Laryngoscopes & Handle

Laryngoscopic view of vocal cords

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