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Respiratory > 1(E) Respiratory Failure > Flashcards

1(E) Respiratory Failure Flashcards

1
Q

When does respiratory failure occur

A

When gas exchange is inadequate resulting in hypoxia

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2
Q

What defines respiratory failure

A

PaO2 less-than 8kPa

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3
Q

What is type I respiratory failure

A

PaO2 less than 8kPa

Normal PCO2

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4
Q

What causes type I respiratory failure mainly

A

V-Q mismatch

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5
Q

What are 6 causes of V-Q mismatch

A
  • PE
  • Pneumonia
  • Pulmonary oedema
  • Asthma
  • Emphysema
  • Pulmonary Fibrosis
  • ARDS
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6
Q

What else can cause type I resp failure

A

Alveolar Hyperventilation

Right-to-Left cardiac shunt

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7
Q

Define type II respiratory failure

A

Hypoxia (PaO2 < 8) with hypercapnia (PaCO2 >6)

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8
Q

What is the main mechanism if type 2 respiratory failure

A

Alveolar hypoventilation without V-Q mismatch

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9
Q

What are the 4 etiological categories of type 2 respiratory failure

A
  1. NM Disease
  2. Pulmonary Disease
  3. Chest wall disease
  4. Reduced resp drive
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10
Q

What are the 4 pulmonary diseases causing type 2 respiratory failure

A
  • COPD
  • Asthma
  • End-stage pulmonary fibrosis
  • OSA
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11
Q

What are 3 causes of reduced resp drive

A

CNS Tumour
Medication (Opioids)
Trauma

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12
Q

What NM disease may cause type 2 resp failure

A 
Myasthenia Gravis 
MND 
Poliomyelitis 
Gullian Barre 
Cervical Cord Lesion
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13
Q

What does poliomyelitis affect

A

Anterior horn cells - causing a LMN lesion

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14
Q

What chest wall deformities can cause T2RF

A

Flail chest

Kyphoscoliosis

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15
Q

What is a mnemonic to remember symptoms of hypoxia

A

DRAC

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16
Q

What are symptoms of hypoxia

A

Dyspnoea

Restless

Agitated

Confused

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17
Q

What is a sign of hypoxia

A

Cyanosis

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18
Q

What are 3 consequences of long-term hypoxia

A

Polycythaemia
Pulmonary HTN
Cor Pulmonale

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19
Q

What is the main symptom of hypercapnia

A

Headache

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20
Q

What are 5 symptoms of hypercapnia

A 
Headache 
Confusion 
Drowsiness 
Coma
Peripheral Vasodilation
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21
Q

What are 4 signs of hypercapnia

A

Bounding pulse
Tachycardia
CO2 Flap
Papilloedema

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22
Q

If someone has a metabolic acidosis, what should be done

A

Calculate anion gap

23
Q

How is the anion gap calculated

A

[Na+ + K+] - [Cl- + HCO3-]

24
Q

What is a normal anion gap

A

10-18mmol/L

25
Q

How is type I respiratory failure managed

A

15L Oxygen via non re-breathe mask

26
Q

When is assisted ventilation indicated in type I respiratory failure

A

If hypoxic despite 60% oxygen

27
Q

How is type II respiratory failure managed

A

Controlled oxygen therapy - start with 24% Venturi mask

28
Q

What oxygen saturations are aimed for if a person is at risk of type 2 respiratory failure

A

88-92

29
Q

If just given someone oxygen for type 2 respiratory failure, when should ABG next be checked

A

20-minutes later

30
Q

If PCO2 is steady or lower in second ABG, what should be done regarding oxygen

A

increase to 28% venturi

31
Q

When is NIPPV considered

A

PCO2 increased by 1.5kPa

32
Q

If NIPPV is ineffective, what is performed

A

Intubation and mechanical ventilation

33
Q

What are the two methods of oxygen delivery

A

Variable performance device

Fixed performance device

34
Q

What are fixed performance devices

A

Able to control FiO2

35
Q

Give an example of fixed performance device

A

Venturi mask

36
Q

What are variable oxygen device

A

Cannot control exactly how much oxygen the individual recieves

37
Q

What rate can nasal cannula deliver oxygen

A

1-4L/min

38
Q

What % oxygen can nasal cannula deliver

A

25-40%

39
Q

What is the advantage of nasal cannula

A

Patient is able to eat and drink

40
Q

What are disadvantages of nasal cannula

A
  • Nasal soreness

- High-flow oxygen can cause epistaxis

41
Q

What is a Hudson mask also known as

A

Simple Face Mask

42
Q

What concentration of oxygen can go through a Hudson mask

A

15L/min Oxygen

43
Q

What is problem with simple face mask and what does this mean for its use

A

Imprecise concentration of oxygen. Means should not be used in type II resp failure

44
Q

What is a non re-breathe mask

A

Hudson mask with reservoir bag

45
Q

What is the action of the reservoir bag

A

Bag fills during expiration and empties during inspiration - increasing FiO2

46
Q

What oxygen concentration can pass through non re-breathe mask

A

15L

47
Q

When is non re-breathe mask used

A

Emergencies

48
Q

What is a Venturi mask

A

Provides precise FiO2 - used for type II resp failure

49
Q

What colour is the 24% Venturi mask

A

blue

50
Q

What colour is the 28% Venturi mask

A

white

51
Q

What colour is the 35% Venturi mask

A

yellow

52
Q

What colour is the 40% Venturi mask

A

green

53
Q

What colour is the 60% Venturi mask

A

red

54
Q

According to BTS what are indications for non-invasive ventilation

A
  • COPD with respiratory acidosis
  • T2 RF due to chest wall deformity
  • Cariogenic pulmonary oedema unresponsive to CPAP
  • Weaning from tracheal intubation

Respiratory (19 decks)

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