Emergency Medicine Book

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Primary Survey Breathing EvaluationAka: Emergency Breathing Management, Rescue Breathing

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  1. Assess
    1. Breathing
    2. Ventilation
    3. Oxygenation
  2. Manage
    1. Awake with spontaneous breathing
      1. Supplemental 100% Oxygen Delivery
        1. Infants under 1 year old: Oxygen Hood
        2. Children/Adults: Nonrebreather mask with reservoir
    2. Conscious with respiratory failure
      1. Bag Valve Mask with 100% Oxygen
      2. Ventilation rate
        1. Adult: 12 breaths per minute
        2. Child: 15 breaths per minute
        3. Infant: 20 breaths per minute
      3. Consider Hyperventilating
        1. Corrects acidosis and lowers Intracranial Pressure
        2. Maintain:
          1. PaCO2 22-29 or
          2. Respiratory Rate twice normal
    3. Unresponsive or respiratory failure
      1. Orotracheal intubation
  3. Trauma Pitfalls
    1. Tension Pneumothorax
    2. Rib Fractures
      1. High risk injury if Fractured ribs 1 through 3
        1. Associated with significant cardiopulmonary injury
      2. Flail chest
      3. Pulmonary Contusion
    3. Open Pneumothorax
    4. Massive hemothorax

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