CASE STUDY INFO SHEET: Acute Respiratory Failure (with Tracheostomy)

By: Sotheavy Moeung

What is
Acute
Respiratory
Failure?

Diagnosis

Incidence &
Prevalence

Treatment
Options

A condition that occurs when fluid builds up in the air sacs in your lungs. When that
happens, your lungs cant release oxygen (air) into your blood. In turn, your organs cant
get enough oxygen-rich blood to function. You can also develop acute respiratory failure if
your lungs cant remove carbon dioxide from your blood.
Respiratory failure happens when the capillaries in your air sacs cannot properly
exchange carbon dioxide for oxygen. The condition can be acute or chronic. In the case of
acute respiratory failure, you will experience immediate symptoms from not having
enough oxygen in your body. In most cases, this failure may lead to death if not quickly
treated.
Acute respiratory failure requires immediate medical attention. You may be given oxygen
to help you breath and to prevent tissue death in your organs and brain.
After your doctor stabilizes you, he may perform or order specific tests to correctly
diagnose your condition. Possible tests include the following:
a physical exam
inquiries about your family or personal health history
checking your bodys oxygen levels with a pulse oximetry device or arterial blood gas test
(both measure oxygen and carbon dioxide in the blood)
using a chest X-ray to locate abnormal issues in your lungs
In the US, the number of hospitalizations owing to acute respiratory failure increased
from 1,007,549 in 2001 to 1,917,910 in 2009.
Mortality associated with acute respiratory failure is often related to a persons overall
health and the potential development of systemic organ dysfunction that can occur with
acute illness.
Acute respiratory failure is often associated with pulmonary infections, the most common
being pneumonia.
There is no gender variation in the occurrence of chronic respiratory disease that leads to
respiratory failure.
Treatment usually addresses any underlying conditions you may have. Then, your doctor will treat your
respiratory failure with these possible options.
Medications: Pain medications may be prescribed.
Surgeries: For severe cases, a tracheostomy (artificial airway in the windpipe) may be performed.
Alternative Therapies: You may be given oxygen to help you breathe better. This comes in the form of an
oxygen tank or ventilator machine. Portable air tanks may be taken home if your condition requires them.

Precautions
&
Contraindica
tions

The following are some tips to prevent problems and complications with your tracheostomy:
It is very important to provide humidification to keep secretions thin and to avoid mucus plugs
Avoid dust, smoke and powders such as face powder, hair spray, spray deodorant, etc.
Use a stoma cover at all times to prevent foreign particles from entering you airway and lungs
Never put anything into your trach tube that doesn't belong there (no smoking through trach tube)
Protect your stoma from too much sun
Beware of over-the-counter medicines that may thicken secretions
Use a shower guard when you bathe, shower or shave and aim the nozzle below your stoma
Carry your obturator with you at all times in case your tube comes out and you have to reinsert it
Do not leave the inner cannula out for more than ten minutes at a time
Sit down and rest for a few moments if you feel upset or begin to gag. Breathe slowly and deeply. If this is a
problem for you, tell your doctor. He or she can help you learn to relax.
Standard Respiratory Etiquette Strategy:
Implement the use of surgical masks by healthcare personnel, during the evaluation of patients with respiratory
symptoms.
Provide surgical masks to all patients with symptoms of a respiratory illness. Provide instructions on the proper
use and disposal of masks.
For patients who cannot wear a surgical mask in addition to any medical treatment being provided, provide
tissues and instructions on when to use them (i.e., when coughing, sneezing, or controlling nasal secretions),
how and where to dispose of them, and the importance of hand hygiene after handling this material.
Continue to use droplet precautions to manage patients with respiratory symptoms until it is determined that the
cause of symptoms is not an infectious agent that requires precautions beyond standard precautions.

Prognosis

If your underlying problem is treated appropriately, you will see improvement in your lung function. You may
also require pulmonary rehab, which includes exercise therapy, education and counseling.
Acute respiratory failure can become a long-term condition without the right treatment. Its important to know
when to seek emergency medical care.

References:
1.
2.
3.

http://www.healthline.com/health/acute-respiratory-failure#Overview1
http://www.ncbi.nlm.nih.gov/pubmed/23335231
https://www.health.ny.gov/professionals/ems/policy/03-11.htm
4. http://trachs.com/precautions-with-a-tracheostomy/