Acute respiratory failure and emergency

In medical practice, it is important to provide emergency care in such critical conditions as acute respiratory failure, circulatory insufficiency, stopping breathing and working the heart.

Etiology

Acute respiratory failure is a consequence of injuries to the respiratory system and chest, which are accompanied by fractures of the ribs and the development of pneumothorax and hemothorax, with tumors and brain diseases, which result in a violation of the central respiratory mechanism. The disease develops with obstruction of the respiratory tract, with severe inflammatory lesions, pulmonary edema, thromboembolism, circulatory disturbance in a small circle.

Symptoms

Acute respiratory failure is characterized by severe shortness of breath at rest, cyanotic skin, rapid heartbeat (tachycardia), psychomotor agitation, which is followed by a retardation and confusion. The skin is pale, moist, and auxiliary muscles are involved in breathing. The initial period of the disease is characterized by high blood pressure, which is subsequently replaced by hypotension, cardiac arrhythmia, arrhythmia, and cardiac arrest may occur.
With acute respiratory failure, it is very important to provide medical care in the early period, since at the terminal stage, resuscitation activities often prove ineffective.

Diagnostic measures

The main thing in diagnosing the disease is to find the cause that led to the occurrence of a breathing disorder, so you need to carefully examine the patient and, if possible, interview him. It is necessary to make an x-ray picture of the chest, in order to detect pneumo- or hydrothorax, fracture of the ribs, pneumonia, etc. A blood test for oxygen content should be performed. Contraindicated in the introduction of sedative and narcotic drugs before the cause of the disease. With the testimony, bronchoscopy is possible.

Acute respiratory failure, emergency care

Therapy of the disease depends on the cause. It is necessary to examine the airways for obstruction by means of a laryngoscope. For inspection of the larynx and bronchi, bronchoscopy is suspected if obstruction is suspected. When foreign bodies are detected, they are removed endoscopically under the control of vision. When obturation of the respiratory tract with dense phlegm in pneumonia, endoscopically it is possible to perform lavage (washing) and administration of antibiotics.
With pneumo- and hydrothorax, the pleural cavity must be evacuated. With a large accumulation of blood or transudate, they are removed using a puncture needle. With severe pain during breathing, caused by a fracture of the ribs, a novocaine blockade is performed. In severe condition and the impossibility of independent breathing, the patient is transferred to auxiliary (artificial) ventilation of the lungs (IVL). The ventilator is carried out with the help of artificial respiration apparatus, outside medical facilities, with the help of an Ambu bag or a portable portable device. With prolonged ventilation, the patency of the pathways is maintained by performing intubation of the trachea.

Acute respiratory failure due to swelling of the lungs (toxic or infectious etiology), hypotension, is cured by the infusion of glucocorticosteroids in large doses. Assign diuretics, bronchodilators, oxygen therapy.

Acute respiratory failure in children mainly occurs when foreign bodies enter the larynx and bronchi, with acute inflammatory diseases, allergic reaction. Principles of treatment of breathing disorders are the same as for adults, taking into account the individual dosage of the drug.