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The Big Wheeze. CHF vs. COPD. COPD Facts. COPD is the 4 th leading cause of death 122,486 (2007) Men – 58,263 Women – 64,223. CHF Facts. 56,565 deaths (2007) Males – 21,764 Females – 34,801. The Pink Puffer. Emphysema Barrel chest Thin Polycythemia Wheezes Tripod Cor Pulmonale.

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the big wheeze

The Big Wheeze

CHF vs. COPD

copd facts
COPD Facts
  • COPD is the 4th leading cause of death
  • 122,486 (2007)
  • Men – 58,263
  • Women – 64,223

Source; cdc.gov/nchs

chf facts
CHF Facts
  • 56,565 deaths (2007)
  • Males – 21,764
  • Females – 34,801

Source; cdc.gov/nchs

the pink puffer
The Pink Puffer
  • Emphysema
  • Barrel chest
  • Thin
  • Polycythemia
  • Wheezes
  • Tripod
  • Cor Pulmonale
the blue bloater
The Blue Bloater
  • Chronic Bronchitis
  • Cyanosis
  • Overweight
  • Productive cough
  • Wheezing
slide8
Mild
  • Chronic cough
  • May be productive
  • May use bronchodilator
  • May not seek medical attention
moderate
Moderate
  • Seek medical attention
  • S.O.B. with exertion
  • Bronchodilators
  • Pulmonary rehab
severe
Severe
  • Oxygen therapy
  • Increased S.O.B.
  • Episodes of severe dyspnea
  • May need antibiotics
  • May need surgical intervention
end stage
End stage
  • Increased symptoms
  • Frequent episodes of dyspnea
  • Irreversible
chronic bronchitis
Chronic bronchitis
  • Breakdown of cilia
  • Mucous buildup
  • Bronchiole constriction
signs and symptoms of copd
Signs and Symptoms of COPD
  • Dyspnea
  • Morning headaches
  • Weight loss or gain
  • Cyanosis
  • Pedal edema (cor pulmonale)
  • Barrel chest (emphysema)
  • Chronic cough
slide15
CHF
  • Systolic dysfunction
    • Decreased contractility
    • Decrease in stroke volume
    • Compensatory rise in preload
slide16
CHF
  • Diastolic dysfunction
    • 50% have diastolic dysfunction
    • Reduction in ventricular compliance
    • Hypertrophy
signs and symptoms of chf
Signs and Symptoms of CHF
  • Weakness
  • Dyspnea with exertion
  • Hypertension
  • PND
  • Orthopnea
  • Pedal edema
  • Pulmonary edema
assessment
Assessment
  • Signs
    • Time of day (PND)
    • Position (tripod)
    • Skin color (pink or blue)
    • Diaphoresis
    • Vitals signs
    • Surroundings (O2, inhaler)
assessment1
Assessment
  • Pertinent medical history
    • Onset (rest or exertion)
    • Time (acute or persistent)
    • Medications
    • Lung sounds
    • SpO2?
    • capnography
capnography
Capnography

It’s the smoke from the fire of metabolism

the air we breathe
The air we breathe
  • Inhalation
  • O2 = 20.94%
  • N2 = 79.01%
  • CO2 = 0.04%
  • Exhalation
  • O2 = 16.4%
  • N2 = 79.6%
  • CO2 = 4.0%
respiration
Respiration
  • Intact system
  • Adequate rate
  • Adequate quality
circulation
Circulation
  • Intact system
  • Effective pump
  • RBC’s
  • Hemoglobin
slide31

Alveoli

exhale

Inhale

slide35
COPD
  • Work the airway
  • Bronchodilators
  • Nebulizer
  • IV’s
  • Cardiac Monitor

Follow your protocol!

slide37
CHF
  • Nitroglycerin
    • Systolic >100
    • Rule out RVI
  • CPAP
  • IV’s
  • Cardiac Monitor

Follow your protocol

slide38

CHF

COPD

slide39

ASTHMA

COPD

DKA

TRAUMA

SEIZURES

GI BLEED

HEAD TRAUMA

slide40

QUESTIONS ?

COMMENTS ?

APPLAUSE ????????

thank you
THANK YOU!!

Julie Williams, NREMT-P, NCEE

Training Coordinator

Beaufort County EMS

[email protected]

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