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.