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1、Diagnostic Testing,Pulse Oximetry Peak Expiratory Flow Testing Pulmonary Function Testing End-Tidal CO2 Monitoring Laboratory Testing of Blood Arterial Venous,Causes of Hypoxemia,Environment lower partial pressure of atmospheric O2 Transport inadequate hemoglobin level in blood hemoglobin bound by o
2、ther gas Medical pulm alveolar membrane distance pneumonia, pulmonary edema, COPD,Causes of Hypoxemia,Traumatic Reduced surface area for gas exchange pneumothorax, hemothorax, atelectasis Decreased mechanical effort pain, traumatic asphyxiation, hypoventilation sucking chest wound, obstruction,Patho
3、logic Causes of Airway and/or Ventilatory Compromise,Obstruction of the Airway Tongue most common snoring reposition airway Foreign Body partial or complete choking, gagging, stridor, aphonia, dysphonia,Pathologic Causes of Airway and/or Ventilatory Compromise,Laryngeal Spasm or Edema Spasmotic clos
4、ure of vocal cords stimulation with intact gag reflex edema results in narrowed airway epiglottitis, anaphylaxis Treatment calming ventilation muscle relaxants,Pathologic Causes of Airway and/or Ventilatory Compromise,Fractured Larynx decreased airway size laryngeal edema increased ventilatory effor
5、t Aspiration increased mortality destroys bronchiolar tissue increased risk of infection increases pulm alveolar membrane distance,Assessment & Recognition of Airway & Ventilatory Compromise,Respiratory Difficulty & Distress Upper or lower obstruction Inadequate ventilation rate or depth Impaired ve
6、ntilatory muscles Impaired ventilatory stimulation system,Assessment & Recognition of Airway & Ventilatory Compromise,Dyspnea (rate, regularity or effort) May be result of or result in hypoxia hypoxia lack of oxygen available lack of oxygen to tissues anoxia = total absence,Assessment & Recognition
7、of Airway & Ventilatory Compromise,Visual Assessment Position tripod orthopnea Rise & Fall of chest Audible gasping, stridor, or wheezes Obvious pulm edema (fulminant),Visual Assessment Skin color Flaring of nares Pursed lips Retractions Accessory Muscle Use Altered Mental Status Inadequate Rate or
8、depth of ventilations,Assessment & Recognition of Airway & Ventilatory Compromise,Auscultation Air movement at mouth and nose Tracheal sounds Vesicular lung sounds Palpation Air movement at mouth and nose chest wall paradoxical motion retractions,Assessment & Recognition of Airway & Ventilatory Compromise,Mechanical Ventilation increased resistance or changing compliance with ventilations Pulsus Paradoxus Systolic BP drops 10 mm Hg w/inspiration may detect change in pulse quality common in COPD, asthma, pericardial tamponade,