Presentation can be as severe respiratory distress or frank respiratory arrest. This topic outlines an approach to the evaluation, diagnosis, and treatment of respiratory failure. Space constraints necessitate prior mastery of ACLS and ATLS protocols. In a less urgent setting, a full problem-oriented ROS is indicated.
Physical exam emphasizes the ABCs.
Note the rate, pattern, and character of breathing. Note the presence of stridor, wheezing, bilateral breath sounds, paradoxical chest wall movement, rales, rhonchi, accessory muscle use, and retractions. Initial BCLS, ACLS therapy should not be delayed by diagnostic tests. When the airway is established, then other testing should include a CXR, CBC with diff., ABG, and blood or urine toxicology screen. The CBC and diff.