Recognising and Responding to the Seriously Ill Patient

Part 3 : Life Threatening Respiratory Distress

Respiratory distress is a common presenting symptom in acute care and may range from a mild decrease in exercise tolerance and a feeling of increased respiratory effort at rest to severe respiratory distress associated with life threatening hypoxia and altered conscious state. In life threatening respiratory distress, the patient is at risk for severe hypoxia due to failure of the lungs to adequately oxygenate the blood. Treatment is focused on ensuring a clear airway, administering high flow oxygen, supporting ventilation and treating the underlying cause.

In this topic we explore the clinical features that may be used to assess the degree of respiratory distress and identify the patient with life threatening respiratory distress. While the Primary Survey provides an initial starting point for responding to the patient with severe respiratory distress it is essential to move rapidly beyond the Primary Survey and make a "best guess" at the likely diagnosis and begin treatment. In many cases a delay to commencing treatment of the underlying cause may result in the patient continuing to deteriorate into respiratory and then cardiac arrest.

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