Makindo Medical Notes

📖 Introduction

🫁 Respiratory arrest is defined as the complete cessation of breathing, leading to absent or inadequate gas exchange. It is a medical emergency that rapidly causes hypoxaemia, hypercapnia, and death unless immediate intervention occurs. Pathophysiology involves either airflow obstruction, central drive suppression, neuromuscular failure, or lung/circulatory compromise. 💡 Rapid recognition and management using an ABCDE approach is critical.

🧾 Approach to Diagnosis

• 👀 Recognition: Unresponsive patient, apnoea, absent chest rise, cyanosis.
• 🫀 Circulation check: Always assess for concurrent cardiac arrest → pulse, ECG.
• 🎧 Airway & Breathing: Look for obstruction, listen for breath sounds, feel for chest movement, measure SpO₂ and end-tidal CO₂ if available.
• 🧪 Investigations: Tailored once airway and ventilation are secured (ABG, CXR, ECG, metabolic bloods, cultures).

📊 Causes, Diagnosis and Management of Respiratory Arrest

💡 Commentary & Teaching Pearls

• 🔑 Always check for cardiac arrest alongside respiratory arrest — they often coexist.
• ⚡ The first priority is airway + ventilation: bag–mask ventilation while preparing for intubation.
• 🧪 ABG helps distinguish type 1 vs type 2 respiratory failure and guides management.
• ❌ Do not delay resuscitation for investigations — stabilise first, investigate later.
• 🧠 Think of reversible causes: foreign body, opioid overdose, tension pneumothorax, hypoglycaemia — treat them immediately if suspected.
• 🏥 In the UK, follow Resus Council ALS guidelines for combined cardiac–respiratory arrest.