![]() An asthma attack that doesn’t reverse is known as “status asthmaticus” and may be lethal. The carbon dioxide (CO2) value will increase reflecting trapped CO2. ![]() The pulse oximetry will drop, and the waveform seen on capnography will lengthen with an upward slope at the end. This is an attempt to keep the alveoli and bronchioles open. They may exhale through pursed lips to help maintain pressure in the lungs. The patient’s expiratory phase lengthens in an attempt to force the trapped air out of their lungs. As the bronchioles narrow, air becomes trapped in the alveoli. The patient may speak in short sentences, and there will be wheezing in all lung fields. This position helps maximize the size of the chest, and it allows the patient to utilize the accessory muscles in the chest, neck and abdomen. This is referred to as the ‘tri-pod’ position. The patient will assume an upright position, commonly leaning forward on outstretched arms. As the airway narrows, breathing becomes labored. AsthmaĪsthma is a reactive airway disease resulting in the sudden constriction of the bronchial tree in reaction to such stimulus as dust, stress or exercise. So, what then causes narrowed airway passages? Commonly when a patient complains of shortness of breath and the assessment of lung sounds reveals wheezing, the cause is asthma. Wheezing is usually heard by auscultation of lung sounds with a stethoscope, although in some cases it can be heard by the naked ear. The narrower the passageways, the higher pitched and softer the wheezing. As the air moves though these narrowed passageways, it creates a whistling sound. Wheezing is caused by air moving through narrowed airway passages. You and your partner begin to administer a common bronchodilator albuterol when you remember - all that wheezes is not asthma. Upon auscultation of his chest, you note wheezing throughout his lung fields. ![]() As you approach, you place him on oxygen with no relief. You note circumoral cyanosis and obvious respiratory distress as he attempts to speak. As you enter the house your patient looks at you anxiously. ![]()
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