Respiratory Arrest
Respiratory Arrest is caused by airway obstruction, decreased respiratory drive, or respiratory muscle weakness.
Airway obstruction may be partial or complete; the most common cause in an unconscious or collapsed person is upper airway obstruction due to posterior tongue displacement into the oropharynx secondary to a loss of muscular tone. Other causes of upper airway obstruction include blood, mucus, vomit, or foreign body; spasm or oedema of the vocal cords, or trauma. Lower airway obstruction may occur after particulate aspiration of gastric contents, widespread severe bronchospasm, or extensive airspace-filling processes (e.g., pneumonia, pulmonary oedema, pulmonary haemorrhage).
If respiratory arrest is prolonged, cardiac arrest quickly follows because progressive hypoxia impairs cardiac function.
Respiratory Distress can be described as the mildest form of respiratory compromise. However the condition can gradually get worse as carbon dioxide in the blood rises and the patient becomes exhausted and rapidly develop into respiratory arrest.
Signs and Symptoms of Respiratory Distress
- Complaining of difficulty in breathing
- Tachypnoea
- Increased work while breathing
- Use of accessory muscles
- Abnormal Breath sounds (wheezing, rhonchi, rales, stridor)
- Cyanosis - this should reduce with use of supplemental oxygen
Signs and Symptoms of Respiratory Arrest
- Unresponsiveness
- Absence of spontaneous breathing
- No chest rise and fall
- Progressive colour change caused by lack of oxygen (cyanosis)
- Unable to feel air coming from mouth and nose
Ventilate
Providing ventilatory support by means of BVM for patients in respiratory arrest is critical. Further airway interventions maybe required such as suctioning, finger sweeps, inserting OP or NP airways to allow you to successfully ventilate your patient.
Failure to reverse the effects of respiratory arrest will mean the patient will go into full cardiorespiratory arrest. Early Paramedic backup is essential for the arrest patient.
Management
High concentration of O2, Assist ventilations if rate <10 or >30 breaths per minute or deemed to be inadequate, Place in recovery position, Reassurance. Always be aware that you may have to carry out BLS in a patient with respiratory distress
ASHICE (Consider)
Transport to Hospital
Professional Handover