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Similarly, examination may reveal wheezing and prolonged expiratory phase, or may be quite normal. Consequently, a potential for under-diagnosis exists. Measurement of airflow, such as peak expiratory flow rates, which can be done inexpensively on the track or sideline, may prove helpful.
Shortness of breath and wheezing are present in many cases. [5] Exacerbations may be accompanied by increased amount of cough and sputum productions, and a change in appearance of sputum. [citation needed] An abrupt worsening in COPD symptoms may cause rupture of the airways in the lungs, which in turn may cause a spontaneous pneumothorax. [4]
Bronchospasm or a bronchial spasm is a sudden constriction of the muscles in the walls of the bronchioles.It is caused by the release (degranulation) of substances from mast cells or basophils under the influence of anaphylatoxins.
COPD is defined as a forced expiratory volume in 1 second divided by the forced vital capacity (FEV1/FVC) that is less than 0.7 (or 70%). [8] The residual volume, the volume of air left in the lungs following full expiration, is often increased in COPD, as is the total lung capacity, while the vital capacity remains relatively normal.
A wheeze is a clinical symptom of a continuous, coarse, whistling sound produced in the respiratory airways during breathing. [1] For wheezes to occur, part of the respiratory tree must be narrowed or obstructed (for example narrowing of the lower respiratory tract in an asthmatic attack), or airflow velocity within the respiratory tree must be heightened.
Treatment of the underlying cause is the next priority; pulmonary edema secondary to infection, for instance, would require the administration of appropriate antibiotics or antivirals. [ 2 ] [ 3 ] Cardiogenic pulmonary edema
Reduced oxygen saturation levels (but above 92%) are often encountered. Examination of the lungs with a stethoscope may reveal reduced air entry and/or widespread wheeze. [6] The peak expiratory flow can be measured at the bedside; in acute severe asthma, the flow is less than 50% of a person's normal or predicted flow. [6]
In cases of overdose leading to respiratory arrest, the recommended treatment according to the 2015 American Heart Association guidelines is to administer intramuscular or intranasal naloxone at an initial dose of 0.04-0.4 mg. Dosing may be repeated up to 2 mg if initial dose is ineffective.