Question

Suppose after a high-smog alert day in your city, a 5-year-old child with asthma, a 50-year-old male smoker with emphysema, and a 75-year-old of average health all come to the emergency room complaining of a cough and chest pain.

Which patient’s health would you be the most concerned about and why?

How do breathed-in air pollutants, such as smoke or asbestos, interfere with or worsen the respiration process in each of these scenarios?

Answer 1

A 5-year-old child with asthma must be most concerned because untreated asthma leads to status asthmaticus, which is an emergency condition that leads to respiratory arrest. An emphysema patient is an elderly person, which can be managed to some extent by providing the nursing care and improving the hypoxia condition.

The air pollutants and smoke worsen the symptoms of asthma and emphysema. Emphysema causes the lungs remain overinflated for chronic periods, so the ribcage expands partially. The loss of elastic recoiling of the chest wall, deposition of collagen and overinflation of lungs all contribute to the “barrel chest” configuration in emphysema. Due to the decreased surface area of the lungs and central airway inflammation, the patients suffer from dyspnea or shortness of breath. The arterial blood gas values of an emphysema patient generally reveal high carbon dioxide and low oxygen levels.