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학습 자료 둘러보기 →A silent chest in a patient with severe dyspnea is an ominous sign. The absence of wheeze indicates airflow is critically low, not that the patient is improving. This often precedes respiratory arrest.
Paradoxical breathing (inward abdominal movement on inspiration) is a clinical sign of diaphragmatic fatigue and exhaustion. This signals that the primary muscle of respiration is failing.
Altered mental status (confusion, somnolence) in this context reflects severe hypercapnia and hypoxia, indicating end-organ cerebral dysfunction and the need for immediate positive pressure ventilation.
Do not delay intervention to obtain a peak expiratory flow rate (PEFR) in a patient with these signs. A PEFR of <40% predicted or an inability to perform the test is expected in a life-threatening episode. Prepare for immediate airway management and non-invasive or invasive ventilation.
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