critical care medicine
Overview of Respiratory Arrest
Symptoms and Signs of Respiratory Arrest
With respiratory arrest, patients are unconscious or about to become so. Patients with hypoxemia may be cyanotic, but cyanosis can be masked by anemia, Carbon Monoxide Poisoning , or Patients being treated with high-flow oxygen may not be hypoxemic and therefore may not exhibit cyanosis or desaturation until after respiration ceases for several minutes. Conversely, patients with chronic lung disease and polycythemia may exhibit cyanosis without respiratory arrest. If respiratory arrest remains uncorrected, cardiac arrest follows within minutes of onset of hypoxemia, hypercarbia, or both. Before complete respiratory arrest, patients with intact neurologic function may be agitated, confused, and struggling to breathe. Tachycardia and diaphoresis are present; there may be intercostal or sternoclavicular retractions. Patients with CNS impairment or respiratory muscle weakness have feeble, gasping, or irregular respirations and paradoxical breathing movements. Patients with a foreign body in the airway may choke and point to their necks, exhibit inspiratory stridor, or neither. Monitoring end-tidal carbon dioxide can alert practitioners to impending respiratory arrest in decompensating patients. Infants, especially if<3 months, may develop acute apnea without warning, secondary to overwhelming infection, metabolic disorders, or respiratory fatigue. Patients with Asthma or with other chronic lung diseases may become hypercarbic and fatigued after prolonged periods of respiratory distress and suddenly become obtunded and apneic with little warning, despite adequate oxygen saturation. 