Wilderness and Rescue Medicine 7th Edition Jeffrey Isaac, PA-C and David E. Johnson, MD

Chapter 30: Respiratory Infection

Like abdominal pain, respiratory infections have a variety of causes and effects. Pneumonia is an infection of lung tissue, resulting in the accu- mulation of pus or serous exudate in the alveoli. Bronchitis is an infection of the bronchial tubes of the lower airway causing lower airway constric- tion. Pharyngitis, tonsillitis, and epiglottitis are infections of the structures in the upper airway. Pleurisy involves the chest wall and outer surface of the lung. In the field it can be difficult to tell one respiratory infection from another. The diagnosis often remains generic: serious or not serious?

produce a constellation of symptoms such as runny nose, mild headache, sneezing, coughing, irritated eyes, mild sore throat, muscular aches, and intermittent fever. The patient is usually not impaired in his or her ability to perform normal tasks and continues to eat, drink, urinate, and pro- duce stool more or less on schedule. Respiratory distress is not significant. Problems develop when the virus is particularly virulent, or the viral infection opens the way for a secondary bacterial infection. This is how patients who start with a cold can end up with a bacte- rial pneumonia, bronchitis, or strep throat. More serious infections are indicated by a cough pro- ductive of thick yellow, green, or brown sputum. The patient may experience chills, shortness of breath, and chest pain on respiration. You may hear wheezing, or fine or coarse crackles, when listening to the chest with your stethoscope. Fever will be more persistent. Respiratory infection becomes an emergency when it causes respiratory distress, interferes sig- nificantly with eating and drinking, or shows signs of becoming systemic. Pneumonia, for example, is a frequent source for sepsis and dehydration in older people. Bronchitis can exacerbate asth- ma. A parapharyngeal abscess can cause airway obstruction.

Respiratory Infection

General Principles

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Viral URI Pneumonia Bronchitis Pharyngitis Epiglottitis Laryngitis Etc…

Serious or Not Serious?

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Respiratory Infection Most respiratory infections are what we call a cold or flu and are caused by viruses. They typically