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Acute respiratory failure

Respiratory failure is a pathological condition in which the normal gas composition of the blood is not supported or its provision is achieved by enhancing external respiration. In 20-30% of cases, acute respiratory failure leads to death.

Pathophysiology

• Respiratory failure occurs due to a violation of the structure of the alveolar-capillary membrane.

• Changes in the membrane increase its permeability.

• Liquid trapped in the alveoli disrupts lung function.

Initial inspection

• Assess the patient's level of consciousness, its dynamics.

• Assess the presence or absence of shortness of breath, dry cough.

• Determine respiratory rate (BH), heart rate, and blood pressure.

• Check for fever.

First aid

• Provide extra oxygen access. If symptoms of hypoxemia persist, prepare the patient for endotracheal intubation, and if necessary, for mechanical ventilation.

• Carry out ECG monitoring.

• Take the patient’s blood to determine its gas composition.

• After the end of the intubation, administer sedatives to the patient (as directed by the doctor).

Hypocostemia is an important sign of respiratory failure.

Following actions

• Constantly check vital parameters.

• Install the patient with venous and arterial catheters.

• Prepare the patient for an x-ray of the chest.

Preventive measures

• Talk with patients about the dangers of smoking.

• Warn allergy sufferers that anaphylaxis may occur when exposed to allergens.

• Workers in “hazardous” enterprises must observe safety precautions.

The position of the patient with acute respiratory failure

A patient with acute respiratory failure must first be given the correct position.
If the patient lies on his back, his tongue sinks in, which closes the lumen of the larynx. At the same time, the epiglottis descends, further blocking the airways. Appears sonorous, audible from a distance breathing (snoring, wheezing). Such breathing difficulties can lead to a complete stop of it, which is especially common in patients unconscious.

To prevent the retraction of the tongue, the lower jaw should be pulled forward and at the same time, it should be extended in the occipital-cervical joint. A very simple technique that does not require any adaptations and ensures airway patency in patients who are unconscious is to give the patient a so-called stable lateral position (preferably on the right side).

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Acute respiratory failure

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