[Diagnosis and treatment of respiratory emergencies]

The following six points should be kept in mind for the management of respiratory emergencies in the emergency room. 1 Gram's stain of a sputum smear may reduce the use of broad-spectrum antibiotics. 2 Routine use of a portable pulse oxymeter substantially reduce the number of arterial blood gas tests. 3 In critical illnesses, such as tension pneumothorax, diagnosis should be made and treatment should be begun without a chest X-ray film. 4 Bag-valve-mask systems should be used with a reservoir bag or a gas pocket to increase the concentration of oxygen. 5 To help prevent hypoxemia during endotracheal intubation, pulse oxymetry may be useful. 6 Ambulance personnel should be taught the importance of pre-hospital administration of high concentrations of oxygen to patients with acute respiratory failure, especially severe asthmatic attacks.