Respiratory Failure: Prevention and Causes (Nursing)

00:00 So, what things have to happen so a patient doesn't go into respiratory failure? Well these are the different areas that you'll assess and this is what needs to be working well so the patient doesn't end up in respiratory failure.

00:13 First of all, there has to be adequate oxygen present in the air the patient is breathing either it's room air or were giving them supplemental oxygen but it's got to be adequate in the air they're breathing.

00:26 Now the airways have to be clear enough to deliver the oxygen air to the alveoli and carry CO2 back out through the airways.

00:35 So if the airways are clamped down if they're gunked up, if something like that is going on, then they're not clear and they're not able to do that gas exchange.

00:44 Now the alveoli need to be intact and clear for that gas exchange so they can't be filled with fluid like we talked about it in pulmonary edema, or a gunk like in pneumonia.

00:55 So you've got to have adequate oxygen in the air the patient's breathing, the airways have to be clear enough to deliver the oxygen and the alveoli have to be intact and clear for the CO2-O2 gas exchange Lastly, the bloodstream has to adequately circulate blood to the lungs and carry it back to the body.

01:15 So one more time if any one of these four areas isn't working efficiently, your patient's headed towards respiratory failure.

01:23 So they've got adequate oxygenation, either room air or the supplemental oxygen we give them, their airways have to be clear so they can get that oxygen down to the alveoli and get CO2 to back out of the body, the alveoli have to be intact and clear so no pneumonia or pulmonary edema and in the bloodstream has to be running by those alveoli so we can pick up oxygen and dump off carbon dioxide.

01:50 Any one of those four areas isn't working, we're heading towards respiratory failure.

01:56 So any condition that affects the lungs directly or the muscles, like your diaphragm your intercostals, your abdominals, the nerves, bones or tissues that support breathing can cause respiratory failure.

02:09 So keep in mind either the lungs are damaged or all the structures around the lungs that also support respiratory function are damaged, that could also cause respiratory failure.

02:21 So let's break that down and look at some very specific causes of respiratory failure.

02:26 So anything that affects the blood flow into the lungs, that might be a pulmonary embolus could block the blood flow that's gonna cause some real problems with delivering that O2 and CO2 to the rest of the body.

02:40 Also lung damage.

02:42 So I've got problems with lung damage, I can also have problems with circulation or perfusion in the lungs.

02:48 What about conditions that affect the nerves and muscles that control breathing? Exactly, we just talked about some of those but let me give you some specific examples: muscular dystrophy, ALS or spinal cord injuries - those play a significant role in impairing the nerves and muscles that control breathing.

03:11 Also conditions that affect areas of the brain that control breathing of patient has a stroke that may significantly impact their ability to breathe.

03:18 Now we're gonna throw drug and alcohol overdose in here too but we'll even talk about that a little more later.

03:25 Also conditions that affect the flow of air like COPD (chronic obstructive pulmonary disease), asthma, cystic fibrosis where you end up with really gunked up airways.

03:38 So we've talked about the flow of blood the nerves and muscles, the brain, and the flow of air Lastly, we're gonna look at things that really affect the gas exchange.

03:50 ARDS stands for acute respiratory distress syndrome, this is really severe and some patients don't survive ARDS.

04:00 And lastly, a pneumonia, right? Those airways fill with fluid and with pus and it makes it difficult for those alveoli to function.

04:09 So you're looking at the slide, woah! That is busy.

04:14 Hey look at the five categories: flow of blood, nerves and muscles that control breathing, the brain, flow of air and gas exchange.

04:26 Make sure you're rock solid on those five areas then go back in and lay down examples of what some of those are and I'll help you have a pretty good snapshot of the major causes of respiratory failure.

04:40 Knowing if your patient has any of these problems, that's where you're headed so we're on guard with sharp assessment skills and then intervene early.

04:48 Now I'm gonna show some other causes with you but I want to make sure you are rock solid on those ones we just talked about.

04:53 So any problem with the spine like scoliosis, have that weird kind of curve in their spine, that abnormal curve that can affect bones and muscles to their use for breathing.

05:03 We don't see that a whole lot but I want you to be aware of it Now if you have damage to the tissues in the ribs around the lungs well if someone's kind of cracked their rib, it hurts for them to breathe because remember those intercostal muscles kinda lift that ribcage up and spread it out every time they breathe, so it hurts to breathe and you'll see them breathe really shallow because of the pain.

05:26 An injury to the chest can also cause damage.

05:29 Inhalation injury - so if you inhale smoke from a fire or harmful fumes.

05:34 So a lot of times, someone who suffers a really serious injury from the fire, they may not be burned externally but the inhalation injuries can be very severe and up with airway oedema and all kinds of problems from the toxins that are inhaled.

05:50 Now lastly, I told you we'll bring that up again, is a drug or alcohol overdose.

05:56 So a lot of times a patient who has too much of a drug or drink too much alcohol that's really gonna suppress their respirations and can also end up with a fatal ending.