Management
The management of neurological respiratory failure involves an attentive balance between monitoring and treatment:
Monitoring:
- blood gases - good until too late
- counting numbers in one breath
- vital capacity - panic value of less than 1 litre
- negative inspiratory force - not usually in the UK - panic value of less than 25cm of water
Treatment:
- ICU for observation
- frequent low vital capacity and negative inspiratory force - these should be taken in context - i.e. the rate of fall, or fall superimposed on previously poor performance.
- nil by mouth if there is a danger of aspiration
- intubate and ventilate before arrest
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