Basic life supports: community hospital management of respiratory failure

Respiratory failure is often associated with multiple systems failure and must be suspected in a number of serious illnesses such as septic shock, major trauma and acute pancreatitis. It is a common presentation in patients with advanced obstructive or nonobstructive pulmonary disease or neuromuscular disorders leading to alveolar hypoventilation or severe hypoxemia. To determine the presence and severity of respiratory failure requires the ability to measure and interpret blood gases, understanding of important respiratory physiological concepts and facilities to implement and monitor appropriate therapy. Since the longterm management of such patients is complex, transfer to a major treatment centre is usually advisable once the acute phase of the problem has been controlled.