![]() ![]() Pulmonary function tests taken & reveal normal FEV1/FVC & decreased FEV1. Lab studies: Hb = 12 g/dL Hct = 35% WBC = 12,000/mm^3 Neutrophils = 68% Bands = 3% Creatinine = 1.1 mg/dL Sodium = 136 mEq/L Potassium = 5 mEq/L Calcium = 9.6 mg/dL Amiodarone levels = 1.6 ug/mL (normal levels, 1-3 ug/mL) Chest radiograph shows patchy alveolar infiltrates. Cardiac exam shows apical impulse, & no murmurs or gallops are appreciated. Physical exam reveals lung with diffuse crackles, decreased air movement, & pleural rub. Vital signs are temp 37.6 C (99.6 F), BP 120/60 mmHg, pulse 98/min, & respirations 20/min. She mentions that she has lost weight, even though her appetite is good. She drinks 2 glasses of wine a day & smoked cigarettes for 20 years but quit 10 years ago. Med history positive for flu 1 week ago treated with amantadine, ventricular tachycardia treated with implantable cardioverter-defibrillator (ICD) & amiodarone, & OCP for last year since she began menopause. Most likely diagnosis?Ĥ7 yo African-American woman + SOB, chest pain w/ respirations, & nonproductive cough that has been going on last 3-4 months. ![]() ![]() If the breathing pattern or inspiratory volumes are inadequate to sustain life, rescue breathing will be required, and an advanced airway should be placed.47 yo African-American woman + SOB, chest pain w/ respirations, & nonproductive cough that has been going on last 3-4 months. Some possible changes are apnea (cessation of breathing), irregular breathing patterns, or poor inspiratory volumes. ![]() If trauma, hypoxia, stroke, or any other form of injury affects this area, changes in respiratory function may occur. 355 bullets, Lapua 260 Rem brass, or Starline/R-P 45-70 Govt brass. The breathing center that controls respirations is found within the pons and medulla of the brain stem. It offers readings in both Meters per Second (MPS) and 5 to 9,999 feet Feet per. If neither technique works, attempt an advanced airway using inline stabilization. If the jaw-thrust proves unsuccessful in opening the patient’s airway attempt an oropharangeal or nasopharangeal airway. If there is a reason to suspect a cervical spine injury, if the patient’s adverse event went unwitnessed, if trauma occured, or the patient suffered drowning the jaw-thrust maneuver should be used to open the airway. If the adverse event of the patient was witnessed and there is no reason to suspect a cercival spine injury, the provider should use the head tilt-chin lift maneuver to open the airway. If the provider evaluates the patient to have an obstructed airway, intervention should take place. If the airway is partially obstructed snoring or stridor may be heard. The provider will also not feel or hear the movement of air. Doctors order says: 2L of D5 1/2 Normal Saline with 50 meq Potassium Chloride to infuse over. If the patient is attempting spontaneous breaths without success, there may be noticeable effort of intercostal muscles, diaphram, or other accessory muscles without significant chest rise/expansion. Flow rates are measured in mL/hr (milliliters per hour). An awake patient will lose their ability to speak, while both a conscious or unconscious patient will not have breath sounds on evaluation. The provider may also be able to hear or feel the movement of air from the patient.Ī completely obstructed airway will be silent. If the airway is patent there should be noticeable chest rise/expansion with either spontaneous respirations or with rescue breaths. Second, is there possible injury or trauma that would change the providers method of treating an obstructed airway or inefficient breathing. First, is the airway patent or obstructed. There are two important principles when evaluating the airway and breathing. ![]()
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