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RESPIRATORY DISTRESS/FAILURE

RESPOND


INITIAL MANAGEMENT OF RESPIRTORY 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  


  • As an example, croup management depends on the severity of the disease.
  • Dexamethasone, a corticosteroid, can cause hypertension and reduced 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 endotracheal intubation. The provider must continually assess the patient's current needs and adjust care accordingly.

Croup Management



UPPER AIRWAY LOWER AIRWAY LUNG TISSUE DISEASE CNS ISSUES
Cause Treatment Cause Treatment Cause Treatment Cause Treatment
CROUP Dexamethasone
Oxygen (Heliox)
Nebulizer (epinephrine)
Intubate
Tracheostomy
BRONCHIOLITIS Suctioning
Nebulizers
PNEUMONIA Antibiotics
Nebulizers
Support breathing
OVERDOSE Naloxone (opioid reversal)
Antidotes
Support breathing
FOREIGN BODY Back slap, abdominal thrusts (Heimlich)
Suction
Expert consultation
Tracheostomy as needed
ASTHMA Oxygen
Nebulizers (albuterol and ipratropium bromide)
Corticosteroids
Magnesium sulfate
Epinephrine SQ
Support breathing
Iteliox
PNEUMONITIS Antibiotics (bacterial)
Nebulizers
Support breathing
TRAUMA Neurosurgery
Reduce intracranial
pressure
Support breathing
ANAPHYLAXIS Epinephrine IM
Nebulizer
Diphenhydramine
Methylprednisolone
Other H2 Blockers
    PULMONARY EDEMA Diuretics
Inotrope
Support breathing
   


  • In general, providers commonly work from the least invasive intervention to the most invasive (top to bottom).
  • If the patient 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.