# data[].attributes.body
The aim is to relieve hypoxaemia and obtain improvement in clinical signs and symptoms.

Clinical examination: Reduction in wheeze, accessory muscle use, respiratory rate, distress.

Gas exchange: Arterial blood gas levels and/or pulse oximetry levels should be monitored until the patient’s condition is stable (SpO2 88 to 92%).

Respiratory function testing: FEV1 should be recorded in all patients after recovery from an exacerbation.

Discharge planning: Discharge planning should be commenced within 24–48 hours of admission.

# data[].attributes.body
nausea, dizziness, constipation, vomiting, somnolence, and headache
respiratory depression, which may result in death

# data[].attributes.body
Global Initiative for Obstructive Lung Disease (GOLD)

# data[].attributes.body
Smoking. The risk increases with the length of time and the number of cigarettes smoked, even without emphysema.

Genetics. Certain types of pneumothorax appear to run in families.

Previous pneumothorax. Anyone who has had one pneumothorax is at increased risk of another.

# data[].attributes.body
- Yes
- but need to tailored to individual’s spesifik nerds and capabilities
- walking, cycling, swimming
- avoid over-exertion

# data[].attributes.body
Monitoring ABGs can be useful to:

Assess the effectiveness of pulmonary gas exchange;

Identify the presence of metabolic acidosis and alkalosis;

Identify critically unwell patients requiring urgent intervention;

Guide treatment and monitor response

Low pH means there is respiratory acidosis, which occurs due to failure of ventilation and accumulation of carbon dioxide. The primary disturbance is an elevated arterial partial pressure of carbon dioxide (pCO2) and a decreased ratio of arterial bicarbonate to arterial pCO2, which results in a decrease in the pH of the blood.

H2O + CO2 ↔ H2CO3 ↔ HCO3– + H+

This equation shows that carbon dioxide (CO2) in blood dissolves to form carbonic acid (H2CO3), which dissociates to form acidic H+ (which can then combine with physiological bicarbonate to push the equation back to the left). Blood pH depends on the balance of carbon dioxide and bicarbonate (HCO3–). A change in the amount of carbon dioxide will not lead to a change in pH if it is accompanied by a change in the amount of bicarbonate that preserves the balance.

One way that the body controls the pH of extracellular fluid is by increasing or decreasing the rate and depth of respiration and thereby the amount of carbon dioxide expelled.

Bicarbonate is the most important buffer in the blood and is the dominant buffer in the interstitial fluid.

Chemoreceptors located in the medulla sense pH changes in extracellular fluid and changes in arterial carbon dioxide, altering ventilation to maintain normal pH. In patients with chronically high PaCO2 (chronic hypercapnia); for example, owing to severe chronic obstructive pulmonary disease (COPD), chemoreceptors may become desensitised. The body then relies on PaO2 to detect inadequate ventilation (hypoxic drive)​. In chronic hypercapnia, supplemental oxygen in emergency settings should be given in a controlled manner with ABG monitoring to avoid respiratory depression.

Respiratory Acidosis:
- Hypoventilation (e.g. severe asthma exacerbation)
- Respiratory depression from drugs (e.g. opioids, benzodiazepines)
- Chronic obstructive pulmonary disease

Respiratory acidosis: patients who are acidotic with a high PaCO2. Because metabolic compensatory response takes longer to develop, acute respiratory acidosis is almost always uncompensated.

If pH indicates acidosis, High PaCO2 + high HCO3– = partially compensated respiratory acidosis.

# data[].attributes.body
For VK to have within a normal range of BMI, ie. 18.5-24.9, his height of 183 cm will need to tally with a weight of 61.95-83.39 kg.

Normal SpO2 level: 95-100 %
Normal respiratory rate: 12-16 breaths per minute
Normal heart rate: 60-100 beats per minute
Normal blood pressure: Systolic <120 mmHg; Diastolic <80 mmHg
Normal body temperature: 36.1-37.2 degree Celsius

# data[].attributes.body
Source: https://www.nhlbi.nih.gov/health/respiratory-failure/treatment#:~:text=Treatments%20for%20respiratory%20failure%20may,a%20long%2Dterm%20care%20center.

# data[].attributes.attachment_link.description
You may get emergency oxygen therapy or medicines at the hospital for acute respiratory failure. You may need care at a long-term facility for chronic respiratory failure.

# data[].attributes.body
https://copdx.org.au/copd-x-plan/x-manage-exacerbations/x3-refer-appropriately-to-prevent-further-deterioration-p/x37-discharge-planning/#:~:text=Suggested%20criteria%20for%20a%20patient's,unless%20home%20oxygen%20is%20indicated)

# data[].attributes.headline
Celeste: Complications of subcutaneous emphysema 

# data[].attributes.subject
Celeste: Complications of subcutaneous emphysema 

# data[].attributes.body
1. compartment syndrome

Compartment syndrome is an increase in pressure inside a muscle, which restricts blood flow and causes pain

2. prevention of thoracic wall expansion

3. tracheal compression

4. tissue necrosis

# data[].attributes.body
- used with specific precaution in chronic respiratory insufficiency
- if insist on using diazepam, maybe can start with the lowest possible dose? (2mg)
- Adverse reaction: paradoxical reactions (e.g. restlessness, agitation, irritability, aggressiveness, delusion, rages, nightmares, psychoses)

# data[].attributes.body
Drug interaction between tramadol and diazepam - CNS depressant effect
-unresponsive
-Respiratory function compromised

# data[].attributes.body
Tramadol

# data[].attributes.attachment_caption
Avoid use of opioid in COPD pts (BNF82 P471)

# data[].attributes.attachment_caption
ABG analysis is used for evaluation of respiratory failure

# data[].attributes.body
1. Vital Signs
- Body Temperature (37°C)
- Blood Pressure (120/80mmHg)
- Heart Rate (60-100 bpm)
- Respiratory Rate ( 12-15 breaths per min)
- Oxygen ( 95-100%)

# data[].attributes.body
1. Lung Infections
2.Pneumothorax
3. Poor Gas Exchange
4. Heart Problems
5. Osteoporosis
6. Depression and Anxiety
7. Lung Cancer

# data[].attributes.body
Some people with chronic conditions need supplemental oxygen for life, while others need it temporarily until they recover from an acute (short-term) illness. You should follow your healthcare provider’s instructions. Depending on your specific health needs, you may need oxygen therapy 24 hours a day. Or you might need extra oxygen only when you sleep or exercise.

# data[].attributes.attachment_link.readable_text
What is oxygen therapy?

Oxygen therapy helps people with lung diseases or breathing problems get the oxygen their bodies need to function. This oxygen is supplemental (additional) to what you breathe in from the air. You may also hear the term supplemental oxygen.

Who needs oxygen therapy?

You may need oxygen therapy if you have:

People who live in or visit high-altitude areas may also need supplemental oxygen, including mountain climbers. Oxygen levels in the air are lower in high-altitude locations, which can lead to altitude sickness.

What does oxygen therapy do?

Oxygen therapy gives your body the oxygen it's not getting when you breathe in air. You might think of it as a respiratory system aid.

When you breathe through your mouth or nose, your body takes in air. Air contains 80% nitrogen and 20% oxygen. Your lungs filter oxygen from this air. They then send oxygen through blood vessels to your organs, tissues and cells.

When you have lung problems, not enough oxygen reaches your cells to keep your body and organs working as they should. You develop low blood oxygen levels ( hypoxemia). Over time, hypoxemia can lead to organ damage and organ failure. Lack of oxygen can be life-threatening.

What are healthy oxygen levels?

A healthy oxygen level (also called oxygen saturation) is 95% or higher. Healthcare providers prescribe oxygen therapy when oxygen levels drop below 88%.

Providers use these tests to measure oxygen levels:

Pulse oximeter: This small device painlessly clips onto your finger, toe or earlobe. Sensors in the device send light beams through your skin to measure oxygen levels in capillaries (tiny blood vessels). Many providers routinely perform this test at each appointment. You can also buy a pulse oximeter (pulse ox) at drugstores to use at home.

Arterial blood gas test: This test uses a blood sample from an artery to measure oxygen and carbon dioxide levels in your blood. This test is the most accurate method for determining lung function.

Lung function tests: Pulmonary function tests like spirometry measure how well you inhale and exhale air. Some tests also measure your lungs' ability to send oxygen into your cells.

What are signs of low oxygen levels (hypoxia)?

You can't always tell when your oxygen levels are low. When symptoms occur, you may experience:

# data[].attributes.attachment_link.title
Supplemental Oxygen Therapy: Types, Benefits & Complications

# data[].attributes.attachment_link.description
Supplemental oxygen therapy helps people with breathing problems get the oxygen their bodies need to function. There are different types of oxygen therapy.

# data[].attributes.body
Oxygen therapy gives your body the oxygen it’s not getting when you breathe in air. You might think of it as a respiratory system aid.

When you have lung problems, not enough oxygen reaches your cells to keep your body and organs working as they should. You develop low blood oxygen levels (hypoxemia). Over time, hypoxemia can lead to organ damage and organ failure. Lack of oxygen can be life-threatening.

# data[].attributes.body
https://myhealth.alberta.ca/Alberta/Pages/deep-breathing-coughing-after-surgery.aspx

# data[].attributes.body
Providing information of aftercare for pneumothorax is important!

-Hold a pillow against the chest when you cough or take deep breaths. This will support the chest and decrease your pain.

-may need analgesics to relieve pain
-antibiotics to prevent any bacterial infection (follow the schedule and take the full course)

Some precautions that VK needs to know!
-do not dive underwater and climb high altitude
-do not fly (travel with airplane)

# data[].attributes.attachment_caption
The Glasgow Coma Scale (GCS) is used to objectively describe the extent of impaired consciousness in all types of acute medical and trauma patients. 

# data[].attributes.body
Non-pharmacological treatment for anxiety

1. Music therapy
2. Aromatherapy

# data[].attributes.attachment_link.readable_text
THE PASSION

The Lung Foundation of Malaysia (LFM)(200601006249/72599-P) is a non-profit Foundation established in 2006 to gather funds to contribute towards the improvement of standard of care and treatment of patients with lung diseases.

Chronic lung diseases such as broncho-pulmonary dysplasia in children, chronic obstructive pulmonary disease in adults and asthma in both children and adults are among lung diseases that commonly inflict people and lead to prolonged suffering and disability. Care for these people can also be difficult and expensive especially if it involves the usage of life support devices.

In LFM, we offer support for patients afflicted with lung diseases so that they can lead a better quality of life with minimal suffering. We also seek to achieve paradigm shift by increasing the awareness and knowledge among the public on lung diseases and fund scientific researches related to improvement of treatment of the diseases.

THE MISSION

Established by a group of medical professionals and corporate citizens fuelled with the determination to enable patients with lung diseases to get the best care and treatment and to live as healthily as possible, LFM aims to achieve the following:

i) To receive and administer funds for education, research and charitable purposes in relation to respiratory diseases for the public's welfare,

ii) To contribute towards scientific research, teaching, training and publication for the purpose of improving the knowledge, skills and care for patients in Malaysia,

iii) To organise and support schemes for the improvement of the standard of care of patients with lung diseases in this country, and

iv) To assist in the giving of relief to patients with chronic lung diseases.

Board of Trustees

Meet the Team

COVID-19

Coronavirus disease 2019, also known as COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), a member of a virus family of Coronaviridae. The disease was first detected in December 2019 in Wuhan, the capital of Hubei province in China. Since then the disease has spread to more than 200 countries resulting in pandemic, infecting more than 1.4 million people (as of 8 April 2020), resulting in more than 83,000 deaths.

Common symptoms are fever, cough and shortness of breath. Other symptoms are sore throat, running nose, fatigue, muscle ache, diarrhoea and loss of smell. The majority of cases are mild but a small percentage will progress to pneumonia which can be severe and fatal.

The virus is mainly spread by droplets produced when those infected cough, sneeze or talk. This normally takes place during close contact. The droplets may also be produced during breathing but will not travel far. The infection can also be contacted when people touch contaminated surface of various objects and then touch their face. The diagnosis is confirmed by real-time reverse transcription polymerase chain reaction (rRT-PCR) from nasopharyngeal swab.

Asthma

Asthma is a common lung disease affecting about 300 million people worldwide. In Malaysia it is estimated about 1.5 million people of all ages suffer from asthma. As many as 50% children with asthma missed school and about a third of adults missed work because of asthma and many of these patients had to be hospitalized and experienced symptoms of uncontrolled disease. Suboptimal treatment and inadequate knowledge about the illness are factors contributed to poor control of asthma.

Chronic ventilatory failure

Asthma is a common lung disease affecting about 300 million people worldwide. In Malaysia it is estimated about 1.5 million people of all ages suffer from asthma. As many as 50% children with asthma missed school and about a third of adults missed work because of asthma and many of these patients had to be hospitalized and experienced symptoms of uncontrolled disease. Suboptimal treatment and inadequate knowledge about the illness are factors contributed to poor control of asthma.

Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease disease affects almost exclusively adult smokers. Initial symptoms include cough with sputum production and difficulty in breathing initially on severe exertion but later on may be so debilitating that even walking a few steps can be a real struggle. In the terminal stage of the illness many patients would require continuous oxygen supplement to alleviate their breathlessness.

Bronchopulmonary dysplasia

Bronchopulmonary dysplasia is a lung disease that occurs in premature neonates who needed oxygen therapy or mechanical ventilation during their early lives. The lung damage can be severe that long term oxygen may be required for many of these infants for a considerable period of time.

News & Activities

Donation Drive to supply Oxygen Concentrator to ministry of health COVID-19 Treatment centers is now CLOSED!

The Lung Foundation of Malaysia would like to thank all donors who have generously contributed towards the donation drive to supply Oxygen Concentrators to the Ministry of Health Quarantine and Treatment Centres. As of 27th July 2021, we have contributed 64 Oxygen Concentrators with consumables to MAEPS Quarantine and Treatment Centre in Selangor. Another 10 oxygen concentrators were donated to the Kota Bharu Quarantine and Treatment Centre in Kelantan. In addition, a total of 30 oxygen concentrators, 86 Oxygen twinhead flowmeters, 6 units of palm pulse oximeters and 110 units of fingertip oximeters have been donated to 9 Ministry of Health Hospitals in Johor (2 hospitals), Selangor (2 hospitals), Perak, Kelantan, Kedah, Sarawak, Melaka, Penang and Labuan. Another 2 oxygen concentrators are earmarked for donation to Kuching Hospital in Sarawak

List of Donors Donation Drive

List of donors

Your contribution, no matter how small it is will make a big difference to someone with breathing difficulty - to them. every breath matters

In any moment of decision, the best thing you can do is the right thing, the next best thing is the wrong thing, and the worst thing you can do is nothing. Theodore Roosevelt

# data[].attributes.attachment_link.description
THE PASSION The Lung Foundation of Malaysia (LFM)(200601006249/72599-P) is a non-profit Foundation established in 2006 to gather funds to contribute towards the improvement of standard of care and treatment of patients with lung diseases.

# data[].attributes.body
If you have been diagnosed with COPD as a result of conditions in your workplace, you could be eligible to make a claim. If your occupation exposes you to harmful dust or fumes, your employer has a responsibility to look after your welfare, for example by providing protective equipment.

Since he is an employed scuba diving coach, he can try to claim compensation from his company because they may be responsible for his COPD.

# data[].attributes.attachment_link.readable_text
If you're suffering from chronic obstructive pulmonary disease (COPD), the impact on your life can be devastating. It can affect your ability to work or even do the things you love in your free time. And, if your condition is severe, it could mean your close friends and family have to make sacrifices in order to care for you.

We understand how distressing it can be to deal with such a life-changing disease. If your occupation brings you into regular close contact with dust or fumes, your employer has a responsibility to protect your health and wellbeing. If they have failed in that duty and you have been diagnosed with COPD, you could be eligible to make a claim.

Whether you've only recently been diagnosed or have been dealing with the symptoms for some time, we can put you on the path towards claiming for COPD compensation . Call us on or fill in our call back form and one of our friendly personal injury advisors will call you back.

# data[].attributes.attachment_link.title
COPD Compensation Claims Solicitors | Industrial COPD | National Accident Helpline

# data[].attributes.attachment_link.description
If you're suffering from chronic obstructive pulmonary disease (COPD), the impact on your life can be devastating. It can affect your ability to work or even do the things you love in your free time. And, if your condition is severe, it could mean your close friends and family have to make sacrifices in order to care for you.

# data[].attributes.body
Non-pharmacological treatment for respiratory depression

1. Quit smoking
- halting the progress of lung function decline

2. Pulmonary rehabilitation
- maintaining physical activity and muscle strength
- reversing systemic manifestation of the disease

# data[].attributes.body
The patient is restless and agitated as he feels uncomfortable and in pain due to the chest tube insertion.
The tube lies on the ribs and moves slightly with each breath.

# data[].attributes.body
DI between tramadol and diazepam
- Tramadol may induce respiratory depression, seizures and serotonin syndrome, possibly worsened when in combination with benzodiazepines.

- Only use Diazepam and Tramadol together under a doctor's supervision, as it can be hazardous.
This combination can heighten the risk of severe side effects like respiratory depression, confusion, and sedation. It can also increase the possibility of an overdose.

# data[].attributes.body
Suggest patient to lay down in prone position while sleeping

# data[].attributes.body
Treatments differences between COPD and asthma
1. Asthma
- bronchodilator
- Systemic steroids
- Magnesium
- Antibiotics
- Ventilatory support

2. COPD
- Bronchodilator
- Systemic steroids
- Antibiotics
- Ventilatory Support

# data[].attributes.body
Differences between COPD and asthma

# data[].attributes.body
COPD stages

Stage 1: Low risk, fewer symptoms
-  You may have no symptoms. You might be short of breath when walking fast on level ground or climbing a slight hill.

Stage 2: Low risk, more symptoms
- If you’re walking on level ground, you might have to stop every few minutes to catch your breath.

Stage 3: High risk, fewer symptoms
- You may be too short of breath to leave the house. You might get breathless doing something as simple as dressing and undressing.

Stage 4: High risk, more symptoms
-  You might have lung or heart failure. This can make it hard to catch your breath even when you’re resting. You might hear this called end-stage COPD.

# data[].attributes.body
- Respiratory rate less than 25 breaths/min
- Tidal volume greater than 5ml/kg
- vital capacity less than 30ml/kg

# data[].attributes.body
1. crepitusa (popping, clicking or crackling sound in a joint: may mean that air is moving in the joint, which is usually harmless) on palpation (Palpation is a method of feeling with the fingers or hands during a physical examination)

2. Distention or bloating may be present in the abdomen, chest, neck, and face.

3. Palpebral (The palpebral are the upper and lower eyelids, which make up the shape of the eye) closure resulting in visual distortion

4. phonation(Phonation is the production of speech sounds) changes from vocal cord compression

# data[].attributes.attachment_caption
Subcutaneous emphysema: air underneath the dermal layers of skin

# data[].attributes.body
How does subcutaneous emphysema occur pneumothorax?

Subcutaneous emphysema is thought to arise in spontaneous pneumothorax through the 'Macklin Effect'. The rupture of alveoli in a spontaneous pneumothorax is followed by an air leak into the loose connective tissue surrounding the pulmonary vasculature.

The Macklin effect is a phenomenon whereby a large pressure gradient between the alveoli and the lung interstitium induces alveolar rupture, leading to the subsequent accumulation of free air that course towards the mediastinum along the sheath of the bronchi or pulmonary vessels.

# data[].attributes.body
- Pleural space always maintains a negative pressure. During inspiration, its volume expands, and the intrapleural pressure drops. This pressure drop decreases the intrapulmonary pressure as well, expanding the lungs and pulling more air into them.
- During expiration, this process reverses.

# data[].attributes.body
1. Assist with smoking cessation through counseling and recommending nicotine replacement therapy (NRT)

2. Counsel the patient with alternative options to manage his stress & anxiety (Yoga, meditation, listening to relaxing music)

# data[].attributes.body
-Acute or chronic severe respiratory insufficiency
-respiratory depression,
-myasthenia gravis
-sleep apnoea,
- severe hepatic insufficiency
-acute narrow-angle glaucoma,
-phobic or obsessional states, chronic psychosis,
-Avoid alcohol.
- Infants <6 months.

# data[].attributes.body
-Acute intoxication with centrally acting analgesics, hypnotics, psychotropic drugs, alcohol, or other opioids
-uncontrolled epilepsy, significant respiratory depression, acute or severe bronchial asthma (in unmonitored setting or lack of resuscitative equipment)
-known or suspected gastrointestinal obstruction (including paralytic ileus)
-Children <12 years and in children <18 years who have undergone tonsillectomy and/or adenoidectomy.
-Concomitant use or within 14 days after MAOI therapy

# data[].attributes.body
Diazepam is used to treat anxiety, alcohol withdrawal, and seizures. It is also used to relieve muscle spasms and to provide sedation before medical procedures. This medication works by calming the brain and nerves. Diazepam belongs to a class of drugs known as benzodiazepines.

# data[].attributes.body
Tramadol is a strong pain medication used to treat moderate to severe pain that is not being relieved by other types of pain medicines. Tramadol is a synthetic opioid and acts in the brain and spine (central nervous system) to reduce the amount of pain you feel.

# data[].attributes.body
-    Many of the harmful and volatile chemicals in tobacco smoke are also present in marijuana smoke.
-      It may worsen the symptoms by damaging the small blood vessels in the airways thus this leads to worsening in cough & increased mucusproduction

-      Smoking marijuana also causes microscopic injury to the large airways, which may make symptoms of chronic bronchitis worse.

# data[].attributes.body
Marijuana is a green, brown, or grey mix of dried, crumbled parts from the marijuana plant. The plant contains chemicals which act on your brain and can change your mood or consciousness

# data[].attributes.body
Rolling it up and smoking it like a cigarette or cigar

Smoking it in a pipe

Mixing it in food and eating it

Brewing it as a tea

Smoking oils from the plant ("dabbing")

Using electronic vaporizers ("vaping")

# data[].attributes.body
Blood-thinning medicine: to reduce events of blood clots, especially in patients with shock

IV Fluids: to improve blood flow and maintain hydration

Nutritional support: to supply nutrition, protein, and energy for patients with ventilator

Physical Therapy: maintain muscle strength and shorten recovery time

Positioning of the body with face facing down: to get more oxygen into the lungs

# data[].attributes.body
Antibiotics: to treat lung infections caused by bacteria (e.g.: pneumonia)

Bronchodilators: to dilate the airways

Corticosteroids: to treat inflammation of airway

# data[].attributes.body
Noninvasive positive pressure ventilation (NPPV): delivery of oxygen into the lungs via positive pressure without the need for endotracheal intubation

Bag mask ventilation: the mask is manually held tightly against the face, and squeezing the bag will ventilate the patient through the nose and mouth

Mechanical ventilator: machine to assist breathing partially or completely by applying positive pressure

Tracheostomy: surgical procedure to create an opening in the neck in order to place a tube into the trachea

Extracorporeal membrane oxygenation (ECMO): replaces the function of the heart and lungs by circulating blood through an artificial lung and returning the blood back into the bloodstream of patient

# data[].attributes.body
Sharp, stabbing chest pain that worsens when trying to breathe in

Shortness of breath

Bluish skin caused by a lack of oxygen

Fatigue

Rapid breathing and heartbeat

A dry, hacking cough:

consistent tone

absence of mucus

caused by irritation and inflammation of the airway

Source: https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumothorax/symptoms-diagnosis-treatment

# data[].attributes.attachment_caption
darker space indicates air in pleural cavity, lung is compressed to a very small size

# data[].attributes.body
https://youtube.com/shorts/Heh8ZfnCngs?feature=share

# data[].attributes.attachment_caption
left side of chest is darker which indicates air in pleural cavity and lung collapse

# data[].attributes.body
How to identify pneumothorax on a chest X-ray
https://youtu.be/J1n2mJ00xKs

# data[].attributes.body
Chest x-ray

Ultrasound

Computerized tomography (CT) scan: a type of x-ray which takes 360-degree image of internal organs

# data[].attributes.attachment_caption
barcode sign (no lung motion) indicates that the lung is not inflated completely during breathing

# data[].attributes.body
Respiratory failure

Cardiac arrest

Pyopneumothorax (pneumothorax that involves pus)

Empyema (pus in the pleural space)

Re-expansion pulmonary edema (a collapsed lung is able to expand suddenly)

Pneumopericardium (presence of air or gas in the pericardial sac, a double-walled sac that wraps around the heart)

Pneumoperitoneum (presence of air or gas in the abdominal (peritoneal) cavity)

Pneumo hemothorax (presence of air and blood in chest cavity)

Bronchopulmonary fistula (abnormal connecting tract between pleural space and bronchi)

Damage to the neurovascular bundle during tube thoracostomy (thoracostomy: insertion of tube into pleural space to drain fluid / air, and deliver medication to pleural space)

Pain and skin infection at the site of tube thoracostomy

Source:
https://www.ncbi.nlm.nih.gov/books/NBK441885/

# data[].attributes.body
Treatment for subcutaneous emphysema:
- It requires nothing more than bed rest, medication to control pain, and perhaps supplemental oxygen.
- It will resolve on its own in around 10 days once the underlying cause is treated.

# data[].attributes.body
Treatment for pneumothorax:
- Needle aspiration or chest tube insertion (inserting a needle or chest tube between the ribs to remove the excess air)
- Nonsurgical repair or surgery
- Supplemental oxygen therapy to speed air reabsorption and lung expansion if neccessary
- Medication, morphine is the drug of choice for analgesia

# data[].attributes.headline
[Moderate Drug interaction] Marijuana + Diazepam -> respiratory and CNS depression

# data[].attributes.subject
[Moderate Drug interaction] Marijuana + Diazepam -> respiratory and CNS depression

# data[].attributes.body
BNF85 p1582
Cannabidiol (a chemical substance in marijuana) increase the exposure to the active metabolite of BZD (diazepam), leading to:

Respiratory depression

Cardiovascular collapse

Bradycardia

Hypotension

Sedation

Fatigue

Confusion

Anterograde amnesia

At the same time, BZD (diazepam) increase the exposure to the active metabolite of cannabidiol -> CNS depression

https://www.ncbi.nlm.nih.gov/books/NBK537022/

# data[].attributes.body
occurs when there is lack of blood flow (hypoperfusion) to respiratory muscles in patients who are experiencing shock

shock:  condition of cellular and tissue hypoxia

the metabolic demands are too high for the respiratory system to compensate

patients are usually intubated at this stage

# data[].attributes.body
Functional residual capacity (FRC) falls below the closing volume

Functional residual capacity: the volume remaining in the lungs after a normal, passive exhalation

Closing volume: the lung volume at which airway closure begins to occur

results from lung atelectasis that occurs during surgery (perioperative)

atelectasis: partial lung collapse

also known as Perioperative Respiratory Failure

other causes: GA, depressed cough reflex

# data[].attributes.body
- Yes, scuba diving is one of the risk factors as when diving the air pressure changes
- BMI does correlate with pneumothorax
- Most likely to occur in people between 20 and 40 years old, especially if the person is very tall and underweight yet a smoker.
- This is because it shows unbalanced physical development and underweight patients likely to have significantly poorer lung function.

# data[].attributes.body
Source:
https://www.ncbi.nlm.nih.gov/books/NBK526127/#:~:text=in%20respiratory%20failure.-,Type%201%20respiratory%20failure%20occurs%20when%20the%20respiratory%20system%20cannot,the%20body%2C%20leading%20to%20hypercapnia.

https://link.springer.com/chapter/10.1007/978-1-4471-4315-4_7

# data[].attributes.body
occurs when the respiratory system cannot sufficiently remove carbon dioxide from the body, leading to hypercapnia

hypercapnia - increase in partial pressure of carbon dioxide (PaCO 2)

an increase in arterial carbon dioxide (PaCO2) > 45 mmHg

with a pH < 7.35 due to respiratory pump failure and/or increased carbon dioxide production

# data[].attributes.body
Type 1

occurs when the respiratory system cannot adequately provide oxygen to the body, leading to hypoxemia

hypoxemia: lack of oxygen in the blood

partial pressure of oxygen (PaO2): < 60 mmHg

partial pressure of carbon dioxide (PaCO2): normal or decreased

# data[].attributes.body
chest drainage system

to restore proper air pressure to the lungs

to re-inflate a collapsed lung

to remove blood and other fluids

consist of vertical columns that have measurements in milliliters

single-chamber / two-chamber / three-chamber / four-chamber

More info (advantages and disadvantages of underwater seal with different number of chambers):

https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2044.1993.tb06859.x

https://derangedphysiology.com/main/required-reading/equipment-and-procedures/Chapter%20262/underwater-seal-chest-drain-system

# data[].attributes.body
Percussion

a type of lung assessment

to determine if the area under the percussed finger is -> filled with air (sound resonant like a drum), filled with fluid (a dull sound) or solid (a flat sound)

tapping the patient's chest wall with some degree of force

Hyper-resonance

high level of vibration

indicates that

the cavity around the lung (pleural cavity) is filled with air and is unable to expand completely during breathing

air is trapped in small airways and alveoli

Source:
https://www.ncbi.nlm.nih.gov/books/NBK368/

# data[].attributes.attachment_link.title
Percussion & Auscultation of the Lungs - OSCE Guide | Clip

# data[].attributes.body
air is accumulated outside the lung but within the pleural cavity

the accumulated air applies pressure on the lung, causing it to collapse

can be classified as

primary pneumothorax - no underlying lung disease (can be due to smoking)

secondary pneumothorax - happens in the presence of lung disease (COPD, asthma, TB)

# data[].attributes.body
- Hypoxemia
- Hypercapnia
- Patients in coma who need airway protection
- Patients undergoing general anesthesia during surgery

# data[].attributes.headline
Difference in COPD and asthma, and the difference in their treatments

# data[].attributes.subject
Difference in COPD and asthma, and the difference in their treatments

# data[].attributes.headline
What are the effects of it to the body and does it worsen COPD? 

# data[].attributes.subject
What are the effects of it to the body and does it worsen COPD? 