ACLS- Respiratory Arrest Case Questions with Complete Solutions Graded to Pass

Average respiratory rate for adults 12-16 (20)/minute Below 6/min= requires assisted ventilation with bag-mask device or advanced airway with 100% oxygen Normal tidal volume 8-10 mL/kg -Maintains normal oxygenation and elimination of CO2 Respiratory distress Clinical state characterized by abnormal respiratory rate or effort --Increased effort= nasal flaring, accessory muscle use) --Decreased effort= hypoventilation, bradypnea S/S of respiratory distress Tachypnea Increased respiratory effort Inadequate respiratory effort Abnormal airway sounds (stridor, wheezing, grunting) Tachycardia Pale, cool skin (except sepsis- warm, red, diaphoretic) Changes in LOC/ agitation Use of abnormal muscles to breathe Apparent when pt tries to maintain adequate gas exchange, despite airway obstruction, reduced lung compliance, or lung tissue disease Respiratory failure Clinical state of inadequate oxygenation, ventilation, or both. Often the end stage of respiratory distress S/S of respiratory failure Marked tachypnea Bradypnea, apnea (late) Increased, decreased, or no respiratory effort Poor to absent distal air movement Tachycardia (early) Bradycardia (late) Cyanosis Stupor, coma (late) Results from upper or lower airway obstruction, lung tissue disease, and disordered control of breathing Can occur without signs of respiratory distress Can occur with a rise of arterial CO2 and/or a drop in blood oxygenation Respiratory Arrest The cessation of breathing Usually caused by an event (drowning, head injury) Treating respiratory arrest Providing tidal volume of ~500-600 mL (6-7 mL/kg) Pts with airway obstruction or poor lung compliance may need high pressures to be properly ventilated BLS assessment of respiratory arrest Pt has a pulse but not breathing Deliver ventilations once every 5-6 seconds with bag mask or any advanced airway device Recheck for pulse every 2 minutes Primary assessment of respiratory arrest Decide if need to insert an advanced airway device -Laryngeal mask airway -Laryngeal tube -Esophageal-tracheal tube -Endotracheal tube Ventilate once every 5-6 seconds --Each breath should take 1 second and achieve visible chest rise Management of respiratory arrest