Respiratory depression occurs when ventilation is inadequate to perform gaseous exchange. This can lead to an increase in carbon dioxide and respiratory acidosis. This requires immediate management and the patient should be assessed using an ABC (Airway, Breathing, Circulation) approach: stabilise the airway and breathing and administer high flow oxygen.

Try to identify the underlying cause.

Review the patient’s history, investigations and the perioperative management. Look in particular at the anaesthetic chart for what drugs were given and when.

The causes of respiratory depression can be divided into: Decreased ventilatory drive Neuromuscular dysfunction Pre-existing lung disease

If a cause can be found, treat as indicated on the following pages.