Pediatric emergency medicine trisk 2757 2757

Impending respiratory failure must be promptly recognized and managed Effective early intervention can limit progression, morbidity, and mortality A systematic approach to prioritizing assessment and support of airway, breathing, and circulation should be employed Emergency management of acute respiratory failure often involves both diagnostic testing and lifesaving therapeutic maneuvers After stabilization, attention must be given to treating the underlying condition Current Evidence While many cases of respiratory distress are benign and self-limited, requiring minimal or no intervention, pulmonary diseases contribute to significant morbidity and mortality in pediatrics, including 3% to 5% of deaths; some of these deaths may be preventable Importantly, respiratory failure often precedes cardiopulmonary arrest in children; unlike adults for whom primary cardiac disease is often responsible Therefore, careful assessment of cardiopulmonary status and anticipation of and preparation for deterioration are important aspects of care Prompt recognition and treatment of impending respiratory failure can be lifesaving and may reduce morbidity and mortality By definition, there are two components to respiratory failure—inability of the respiratory system to (1) provide sufficient oxygen for metabolic needs (hypoxic respiratory failure) and (2) excrete the carbon dioxide (CO2 ) produced by the body (hypercapnic or ventilatory respiratory failure) Both are often present simultaneously, but to varying degrees