Respond to Respiratory Distress/Failure
INITIAL MANAGEMENT OF RESPIRATORY DISTRESS/FAILURE | |||
---|---|---|---|
Airway | Open and support the airway | Suction | Consider advanced airway |
Breathing | Monitor O2 stats | Supplemental O2 | Nebulizers |
Circulation | Monitor vitals | Establish vascular access |
Table 13
If a person has a medication patch on their chest, remove it before applying the AED pads. Also, if there is a bulge under the skin of their chest, a pacemaker may be present. Avoid placing the AED pads over this device and adjust placement accordingly. If the AED malfunctions or does not work, continue performing CPR until additional help arrives.
PALS management of respiratory distress/failure is adjusted based on the severity of the current condition. For example, mild asthma is treated with bronchodilator inhalers, but severe asthma (status asthmaticus) may require ET intubation. The provider must continually assess the person’s current needs and adjust care accordingly.
Croup Management

Figure 12
Upper Airway | Lower Airway | ||
---|---|---|---|
Cause | Treatment | Cause | Treatment |
CROUP |
|
BRONCHIOLITIS |
|
FOREIGN BODY |
|
ASTHMA |
|
ANAPHYLAXIS |
|
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
Lung Tissue Disease | CNS Issues | ||
---|---|---|---|
Cause | Treatment | Cause | Treatment |
Table 14
- In general, providers commonly work from the least to the most
invasive intervention (top to bottom). - If the person presents with severe distress, proceed directly to maneuvers that are more aggressive.
- Albuterol is the most common medication used via nebulizer to cause bronchodilation.
- Common causes of acute community-acquired pneumonia include Streptococcus pneumonia, Mycoplasma pneumonia, Haemophilus influenza, and Chlamydia pneumonia.
- High fever is the most common cause of quiet tachypnea.