RECOGNITION AND ASSESSMENT
- Respiratory failure is present when lungs are unable to maintain normal gas exchange at rest,
- PaO2 <8.0 kPa and/or PaCO2 >6.0 kPa.
- 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
- 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
© 2022 The Bedside Clinical Guidelines Partnership.
Created by University Hospital North Midlands and Keele University School of Computing and Mathematics.
Research and development team: James Mitchell, Ed de Quincey, Charles Pantin, Naveed Mustfa