In our time, respiratory failure is usually defined as a state of the body in which the maintenance of normal blood gas composition is not ensured or is not achieved due to more intensive breathing and increased stress on the heart, which leads to a decrease in the functional capacity of the body. It should be borne in mind that the function of the respiratory apparatus is closely related to the function of the circulatory system: if the external respiration is insufficient, the intensified work of the heart is one of the important elements of its compensation.
Clinical signs of acute failure of external respiration, first of all, is a violation of the frequency, rhythm and depth of breathing:
A complete stop of respiration (apnea) after 4-5 minutes results in
to death from hypoxia, which leads to a sudden stop of blood circulation, electric injury, poisoning, brain trauma, etc.
Stenotic breathing is a violent inspiratory (choking breath), during which all the auxiliary muscles that entail the sudden occurrence of an obstruction of the airways at the level of the larynx are included in the process of breathing.
Bronchial asthma - allergic disease, accompanied by periodic attacks of suffocation (gr. asthma - choking), which involves bronchospasm, hypersecretion and edema of the bronchial mucosa. These seizures, as a rule, are of the same type, arise suddenly, gradually increase and last from several minutes to several days. The attack, which is delayed and does not respond to conventional treatment, is called asthmatic status.
During an attack, the patient is forced to sit in a sitting position, leaning on something with his hands and fixing thus the shoulder belt to activate the auxiliary muscles. Breathing with difficulty exhaling, wheezing, loud whistling, mouth open, nostrils inflating. At the beginning of the attack, numerous melodious, high-pitched rales are heard on inhalation and especially on exhalation. Cough is possible, but phlegm in the beginning and at the height of the attack is meager, it stands out hard, thick, viscous. When you exhale, the neck veins swell.
First aid in cases of suffocation
For emergency treatment of asthma, bronchospasmolytic and glucocorticoid hormones are used.
The pronounced cyanosis is (cyanosis) of the mucous membranes and skin is a late sign of respiratory failure. May be absent from anemia. Assessment of the degree of cyanosis is highly subjective, difficult with artificial lighting, skin pigmentation and mucous membranes.
In case of violations of the ventilation of the lungs, both hypoxemia (low oxygen in the blood) and hypercapnia (high content of carbonic acid in the blood) are broken.
Clinical signs of hypoxemia are: increased blood pressure and tachycardia, later with a drop in blood pressure with a preserved tachycardia, the skin of the extremities is cold, cyanotic. Euphoria and anxiety at the onset of the development of brain hypoxia are altered by suppression of consciousness and the development of hypoxic coma.
Clinical manifestations of hypercapnia: increased blood pressure, peripheral veins overflow, increased secretion of mucous membranes (sweating, bronchorrhea). The skin is moist, warm. Drowsiness and depression of consciousness grows.
First aid for respiratory failure. Support airway patency. Unbend the patient's head with a closed mouth. In this position, the root of the tongue moves away from the back wall of the pharynx and releases the entrance to the larynx for air to enter through the nose, with closed nasal passages slightly opening the mouth, without changing the position of the head. A similar effect is achieved by pulling the lower jaw forward, pulling the jaw of the chin. The passage of the airways improves the position on the side - "safe" for patients without consciousness. Foreign bodies, clots of mucus, blood are removed from the mouth and throat with a finger, wrapped in a handkerchief or gauze. Foreign bodies in the larynx try to remove, moving with the fingers of the root of the tongue, and dislocate them, tapping between the shoulder blades.
The victim provides peace, access to fresh air, give antispasmodics. If necessary, carry out artificial ventilation. Mandatory urgent hospitalization.