Respiratory assessment and monitoring

Abstract

This chapter focuses on assessment of respiratory function in the critical care patient, and the management of common respiratory disorders, including pneumonia, pleural effusion, pneumothorax, asthma, chronic obstructive pulmonary disease, pulmonary oedema, pulmonary embolism, tuberculosis, interstitial lung disease, and acute respiratory distress syndrome (ARDS). The physical assessment of the critical care patient’s respiratory function, including signs and symptoms identified on inspection, palpation, percussion, and auscultation, is described. Normal and abnormal findings of respiratory-focused assessment are compared. The principles and use of key respiratory monitoring techniques are described and their limitations are considered. Techniques covered include pulse oximetry, capnography, and the peak flow meter. Specific respiratory disorders are then described in detail, including their definition, causes, assessment findings, and management. The chapter also incorporates the most recent evidence relating to care of the patient with a chest drain, ventilator requirements, and management of severe asthma.