DO NOT USE FOR CLINICAL PRACTICE
Please use current guidelines available on the UHNM intranet for patient treatment
Please use current guidelines available on the UHNM intranet for patient treatment
RECOGNITION AND ASSESSMENT
- Respiratory failure is present when lungs are unable to maintain normal gas exchange at rest,
- PaO2 <8.0 kPa (type 1) and/or PaCO2 >6.0 kPa (type 2)
- Identify the underlying cause
Symptoms and signs
- Drowsiness
- Warm peripheries, bounding pulse, tachycardia
- Central cyanosis (difficult to detect in anaemic patients)
- In patients with rising PaCO2 flapping tremor and papilloedema
Investigations
- Arterial blood gases (ABG) while breathing air
- if clinical condition does not allow ABG when breathing air, record FiO2
- Chest X-ray
- FBC
- U&E
- ECG
IMMEDIATE TREATMENT
- Treat underlying cause
- Follow Treatment of hypoxaemia guideline
- Refer patients with neuromuscular disease or kyphoscoliosis presenting with type 2 respiratory failure to respiratory physician
DISCHARGE AND FOLLOW-UP
- Advice on life-style appropriate to underlying disease that precipitated admission
- Refer all patients with type 1 or type 2 respiratory failure for follow up with respiratory physician