Respiratory Distress Syndrome

Respiratory Distress Syndrome

Definition/Etiology:

This is a form of noncardiogenic pulmonary edema. It is an inflammatory syndrome characterized by diffuse alveolar injury. It results in severe hypoxemia.

The cause can be traumatic or secondary to a disease process such as sepsis. Be sure to understand your ED’s sepsis protocol

Pathophysiology:

The inflammatory response causes increased permeability in the alveoli which causes fluid leakage into the lungs. Pulmonary edema results.

Clinical Presentation:

• Acute respiratory distress
• Tachypnea
• Tachycardia
• Cyanosis
• Anxiety, restlessness, agitation
• Accessory muscle use
• Possible fever or hypothermia

Know the underlying mechanism

Collaborative Management:

• Labs: CBC, CMP….ABG!! Early blood cultures.
  NEED A CHEST X-RAY – will show diffuse bilateral infiltrates, followed by complete “white out”. *X-ray may be negative early.
• Need constant monitoring, IV access, and proper positioning….ER basics
• Possible RSI and ICU admission. Pt needs PEEP and sedation.
• Identify and treat underlying cause

Evaluation | Patient Monitoring | Education:

• ABCs
• Vent management
• Be wary of fluids
• I&O – renal failure common
• Goal is to wean off vent
• Monitor repeat chest x-ray and ABGs

Linchpins: (Key Points)

• Early identification
• Treat underlying cause
• Provide ventilatory support