Respiratory Disorders

Obstructive Airway Disease

Alternate Names: Obstructive Airway Disease, Chronic Obstructive Lung Disease, COPD

Definition

A group of lung diseases characterized by limited airflow with varying degrees of air sack enlargement and lung tissue destruction. Emphysema, Chronic Bronchitis and Asthma are by far the commonest of the obstructive pulmonary diseases.

Emphysema

Emphysema is a lung disease that involves damage to the air sacs (alveoli). The air sacs are unable to completely deflate (hyperinflation) and are therefore unable to fill with fresh air to ensure adequate oxygen supply to the body.

Cigarette smoking is the most common cause of emphysema. Tobacco smoke and other pollutants are thought to cause the release of chemicals from within the lungs that damage the walls of the air sacs. This damage becomes worse over time, affecting the exchange of oxygen and carbon dioxide in the lungs.

Signs and Symptoms

Bronchitis

Chronic bronchitis is an inflammation of the bronchi, the main air passages in the lungs, which persists for a long period or repeatedly recurs.

The condition is characterized by excessive bronchial mucus and a productive cough that produces sputum for three months or more in at least two consecutive years, without any other disease that could account for this symptom.

Signs and Symptoms

Asthma

Asthma is an inflammatory disorder of the airways, characterized by periodic attacks of wheezing, shortness of breath, chest tightness, and coughing.

Asthma is a disease in which inflammation of the airways causes airflow into and out of the lungs to be restricted. When an asthma attack occurs, the muscles of the bronchial tree become tight and the lining of the air passages swells, reducing airflow and producing the characteristic wheezing sound. Mucus production is increased.

In sensitive individuals, asthma symptoms can be triggered by inhaled allergens (allergy triggers), such as pet hair, dust mites, moulds, or pollens. Asthma symptoms can also be triggered by respiratory infections, exercise, cold air, tobacco smoke and other pollutants, stress, food, or drug allergies. Aspirin and other non-steroidal anti-inflammatory medications (NSAIDS) provoke asthma in some patients.

Signs and Symptoms

Emergency symptoms:

Further  Respiratory Conditions

Pneumonia

Pneumonia is an inflammation of the lungs caused by an infection. Many different organisms can cause it, including bacteria, viruses, and fungi.

Pneumonia is a common illness that affects millions of people each year

Pneumonia can range from very mild to very severe, even fatal. The severity depends on the type of organism causing pneumonia as well as your age and underlying health.

Signs and Symptoms

Pulmonary Embolism

Pulmonary emboli are caused by clots from the venous circulation, from the right side of the heart. Most are caused from clots originating in the lower extremities called deep vein thrombosis (DVT). The risk factors include prolonged bed rest or inactivity, oral contraceptive use, surgery and fractures of the hips or femur.

Signs and Symptoms

*The signs and symptoms above are very similar to a patient who is having an acute myocardial infarct (AMI) but getting a good patient history will enable you to diagnose a possible PE. But definitive diagnosis will require hospital tests i.e. chest X-Rays. 

General Management Techniques:

GO DR SHAVPU ACBC

Administer O2 as per British Thoracic Guidelines; Assisted ventilations if needed, Patient positioning (Usually the PT will want to sit upright) Administer Salbutamol if indicated, In the case of Asthma consider the use of adrenaline in the case of failing respirations, Position in an Upright or semi-recumbent or whichever is comfortable for the patient, Be prepared to carry out BLS or assisted ventilations. As with all patients who suffer with COPD you must always be aware of Hypoxic Drive while administering O2

Secondary survey  

Continually monitor patient condition 

Consider an  ASHICE  

Smooth and rapid journey to hospital 

Professional handover to hospital staff

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True or False

  • Oxygen enters the blood by diffusion

Transporting the patient:

  • Patients who are experiencing respiratory difficulty usually prefer to be sitting upright or in a semi recumbent position as this takes the 'weight' off their chest and makes breathing easier.

Important!

  • Keep an eye on the patients vital signs at all times, as they may go into respiratory or cardiac arrest. Be prepared to carry out BLS.