An abrupt stop of pulmonary gas exchange lasting for more than five minutes may permanently damage vital organs, especially the brain.

To save a patient in respiratory arrest, the goal is to restore adequate ventilation and prevent further damage.

Management interventions include supplying oxygen, opening the airway, and means of artificial ventilation.

In some instances, an impending respiratory arrest could be predetermined by signs the patient is showing, such as the increased work of breathing.

Respiratory arrest will ensue once the patient depletes their oxygen reserves and loses the effort to breathe.

The former refers to the complete cessation of breathing, while respiratory failure is the inability to provide adequate ventilation for the body's requirements.

[2] One common sign of respiratory arrest is cyanosis, a bluish discoloration of the skin resulting from an inadequate amount of oxygen in the blood.

Complications from respiratory compromise are increasing rapidly across the clinical spectrum, partly due to expanded use of opioids combined with the lack of standardized guidelines among medical specialties.

While respiratory compromise creates problems that are often serious and potentially life-threatening, they may be prevented with the proper tools and approach.

The first step to determining the cause of arrest is to clear and open the upper airway with correct head and neck positioning.

The practitioner must lengthen and elevate the patient's neck until the external auditory meatus is in the same plane as the sternum.

[15] If a neck or spinal injury is suspected, the provider should avoid performing this maneuver as further nervous system damage may occur.

[16] The C-collar can make ventilatory support more challenging and can increase intracranial pressure, therefore is less preferable than manual stabilization.

[20] Goal of naloxone therapy is to restore respiratory drive in the individual, however mechanical ventilation may still be necessary during initial resuscitation.

Resistance to bag valve mask may suggest presence of a foreign body that is obstructing airways and commonly used as a diagnostic tool and treatment for respiratory arrest.

The purpose of bag-valve-mask is to provide adequate temporary ventilation and allow the body to achieve airway control by itself.

To ensure an adequate seal when using the bag valve mask to ventilate, specific hand positioning is typically used.

Practitioners must tweak valve settings to accurately determine each of their patients to avoid hypoventilation or hyperventilation.

[16] Providing excessive bag pressure can actually impair the blood flow to the heart and brain, so during CPR extra caution should be taken to limit size of tidal volume.

If non-comatose patients are given muscle relaxants before the insertion of the laryngeal mask airway, they may gag and aspirate when the drugs are worn off.

At that point, the laryngeal mask airway should be removed immediately to eliminate the gag response and buy time to start at new alternative intubation technique.

Endotracheal tubes contain high-volume, low-pressure balloon cuffs to minimize air leakage and the risk of aspiration.

The endotracheal tube is a great method for patients who are comatose, have an obstructed airway, or need mechanical ventilation.

The purpose of ventilation with 100% oxygen is to denitrogenate healthy patients and prolong the safe apneic time.

[24] Surgical entry is required when the upper airway is obstructed by a foreign body, massive trauma has occurred, or if ventilation cannot be accomplished by any of the aforementioned methods.

The time depends on pulse rate, pulmonary function, RBC count, and other metabolic factors.

Some physicians even give out vecuronium, which is a neuromuscular blocker to prevent muscle fasciculations in patients over 4 years old.

Each inspiratory effort that is beyond the set sensitivity threshold will be accounted for and fixed to the delivery of the corresponding tidal volume.

Pressure-cycled ventilation can help alleviate symptoms in patients with acute respiratory distress syndrome by limiting the distending pressure of the lungs.

Noninvasive positive pressure ventilation should not be administered to people who are hemodynamically unstable, gastric emptying impaired, bowel obstructed or pregnant.