Respiratory Failure

Abstract

Respiratory failure (RF) may be defined as the failure of normal breathing, ventilation and gas exchange in the lungs leading to low oxygen levels in the cells of the body. Respiratory failure may occur acutely or chronically. The chronic forms are usually managed in hospital or in the home. Acute RF and acute exacerbations of the chronic form are likely to be encountered by emergency responders. Respiratory failure may be classified as type 1, where there is failure of carriage of oxygen from the alveoli to the pulmonary capillaries and type 2 where there is a failure of ventilation of the alveoli leading to the build-up of carbon dioxide. An understanding of these two forms is important for the decision to ventilate.

Early diagnosis of RF is particularly important in acute failure. It may be established by both primary and secondary assessments of the airway, breathing, circulation and conscious level. The clinical assessment of RF can be assisted by the use of pulse oximetry, capnography and basic blood gas measurement.