Respond to Respiratory Distress/Failure

INITIAL MANAGEMENT OF RESPIRATORY DISTRESS/FAILURE
AIRWAYOpen and support the airwaySuctionConsider advanced airway
BREATHINGMonitor O2 satsSupplemental O2Nebulizers
CIRCULATIONMonitor vitalsEstablish vascular access
Table 13

As an example, croup management depends on the severity of the disease.

Dexamethasone, a corticosteroid, can cause hypertension and reduce activation of lymphocytes.

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

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 (Heliox)
  • Nebulizers (albuterol and ipratropium bromide)
  • Corticosteroids
  • Magnesium sulfate
  • Epinephrine SQ
  • Support breathing
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
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.