Respiratory arrest

• What is respiratory arrest?


  Cessation of breathing
• Pathophys of resp arrest


  Disrupt normal ventilation → hypoxia & hypercapnia → increased RR to compensate → underlying issue persists → persistent hypercapnia → resp acidosis (excessive CO2) → cells switch from aerobic to anaerobic metabolism → lactic acid production → more acidosis → high CO2 → cerebral vasodilation → increased ICP & acidosis depresses CNS function (inc resp centres in medulla & pons) → decreased stimulation for respiration → diminished effort for breathing or complete cessation (resp arrest)
• What happens if resp arrest isn't immediately treated?


  Severe hypoxia → cell death & tissue injury (particularly in high O2 demand organs (brain & heart)) → can lead to cardiac arrest secondary from resp arrest
• What are the signs & symptoms of respiratory arrest?


  Agonal breathing (Gasping, laboured breaths that occur infrequently & irregularly)

  Absent breathing

  Cyanosis

  Decreased consciousness

  Pulse changes (tachy = early, brady = worse)

  Dysphonia or aphonia (suggests upper airway obstruction)

  Absence of breath sounds

  Use of accessory muscles

  Nasal flaring
• What are the RFs of resp arrest?


  COPD

  Asthma

  Neurological disorders (stroke or head injury)

  Drug overdose/poisoning
• What is the treatment of resp arrest?


  Maintain O2 & ventilation (BLS, O2, airway adjuncts)

  Identify & treat underlying cause

  Post-arrest care

  • when stable, transfer to HDU or ICU for monitoring & management
  • consider referral to specialist services
  • implement measures to prevent recurrence