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1、Diagnostic TestingPulse OximetryPeak Expiratory Flow TestingPulmonary Function TestingEnd-Tidal CO2 MonitoringLaboratory Testing of BloodArterialVenousCauses of HypoxemiaEnvironmentlower partial pressure of atmospheric O2Transportinadequate hemoglobin level in bloodhemoglobin bound by other gasMedic
2、al pulm alveolar membrane distancepneumonia, pulmonary edema, COPDCauses of HypoxemiaTraumaticReduced surface area for gas exchangepneumothorax, hemothorax, atelectasisDecreased mechanical effortpain, traumatic asphyxiation, hypoventilationsucking chest wound, obstructionPathologic Causes of Airway
3、and/or Ventilatory CompromiseObstruction of the AirwayTonguemost commonsnoringreposition airwayForeign Bodypartial or completechoking, gagging, stridor, aphonia, dysphoniaPathologic Causes of Airway and/or Ventilatory CompromiseLaryngeal Spasm or EdemaSpasmotic closure of vocal cordsstimulation with
4、 intact gag reflexedema results in narrowed airwayepiglottitis, anaphylaxisTreatmentcalmingventilationmuscle relaxantsPathologic Causes of Airway and/or Ventilatory CompromiseFractured Larynxdecreased airway sizelaryngeal edemaincreased ventilatory effortAspirationincreased mortalitydestroys bronchi
5、olar tissueincreased risk of infectionincreases pulm alveolar membrane distanceAssessment & Recognition of Airway & Ventilatory CompromiseRespiratory Difficulty & DistressUpper or lower obstructionInadequate ventilation rate or depthImpaired ventilatory musclesImpaired ventilatory stimulation system
6、Assessment & Recognition of Airway & Ventilatory CompromiseDyspnea (rate, regularity or effort)May be result of or result in hypoxiahypoxialack of oxygen availablelack of oxygen to tissuesanoxia = total absenceAssessment & Recognition of Airway & Ventilatory CompromiseVisual AssessmentPositiontripod
7、orthopneaRise & Fall of chestAudible gasping, stridor, or wheezes Obvious pulm edema (fulminant)Visual AssessmentSkin colorFlaring of naresPursed lipsRetractionsAccessory Muscle UseAltered Mental StatusInadequate Rate or depth of ventilationsAssessment & Recognition of Airway & Ventilatory Compromis
8、eAuscultationAir movement at mouth and noseTracheal soundsVesicular lung soundsPalpationAir movement at mouth and nosechest wallparadoxical motionretractionsAssessment & Recognition of Airway & Ventilatory CompromiseMechanical Ventilationincreased resistance or changing compliance with ventilationsPulsus ParadoxusSystolic BP drops 10 mm Hg w/inspirationmay detect change in pulse qualitycommon in COPD, asthma, pericardial tamponade
