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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 depression may be due to impairment at multiple levels of the respiratory system, including CNS (e.g., drug overdose, vascular lesions, intracranial hypertension due to mass lesions or craniocerebral trauma); upper and lower airways (e.g., near drowning, tumour, haemorrhage, strangulation, asphyxiation, aspiration); alveolar spaces or chest wall, with impairment of the normal physiologic mechanisms of ventilation (e.g., pulmonary oedema, extensive lung infectious processes, pneumothorax, flail chest); or blood and circulatory system (e.g., carbon monoxide or cyanide poisoning, profound anaemia, cardio circulatory derangements).

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

Signs and Symptoms of Respiratory Arrest

Absence of spontaneous breathing No chest rise and fall Progressive colour change caused by lack of oxygen Unable to feel air coming from mouth and nose

Management

GO DR SHAVPU ACBC High concentration of O2, Place in recovery position, Reassurance Secondary Survey ASHICE (Consider) Transport to Hospital

Professional Handover

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