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CR2 > 20 - Respiratory Failure > Flashcards

20 - Respiratory Failure Flashcards

1
Q

Concentration of oxygen in air

A

20.94%

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2
Q

Barometric pressure (atmospheric pressure)

A

101.3kpa

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3
Q

PO2 of dry air at sea level

A

21.2kpa

o2 in air x atmospheric pressure

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4
Q

What is tracheal gas

A

PO2 after humidification

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5
Q

How to work out tracheal gas

A 
•	Fractional concentration of oxygen in the dry gas phase x (barometric pressure - SVP)
FiO2 x (PB - SVP)
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6
Q

What effects alveolar PO2

A

Ventilation

O2 consumption/CO2 production

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7
Q

Alveolar PaO2

A

dry barometric pressure x (FiO2-VO2 / VA)

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8
Q

What is FiO2, VO2 and Va

A

o FiO2 – inspired oxygen concentration- 21/20.93
o VO2- oxygen consumption(round 250 ml/min)
o VA- alveolar ventilation

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9
Q

What is the alveolar to arterial PO2 difference determined by

A

Shunting

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10
Q

What is the normal A-A O2 difference

A

not normally greater than 2 kPa

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11
Q

What is shunting

A

An area of the lung that is perfused but not ventilated

Has blood supply but not oxygen

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12
Q

What is oxygen delviery

A

= [Hb] x Oxygen Saturation of Hb x 1.34 x 10 x Cardiac Output
o Round 1 litre per minute

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13
Q

Signs of respiratory compensation

A

Tachypnoea > 20
Use of accessory muscles
Nasal flaring

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14
Q

Signs of increased sympathetic tone

A

Tachycardia
Hypertension
Sweating

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15
Q

Signs of end-organ hypoxia

A

Altered mental status

Bradycardia and hypotension

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16
Q

Signs of haemoglobin desaturation

A

Cyanosis

17
Q

Signs of CO2 retention

A

Flap

Bounding pulse

18
Q

Type I respiratory failure

A

Hypoxaemia only- caused by shunting (hypoxia)

PaO2 < 8kpa

19
Q

Causes of Type I resp failure

A 
Pneumonia
Pulmonary oedema
Asthma/COPD
PE
Pneumothorax
20
Q

Type II respiratory failure

A

o Hypoxaemia and hypercapnia
PaO2 <8kPa
PaCO2 > 6.5kPa

21
Q

Symptoms of type I resp failure

A

Type I with fatigue

22
Q

What can cause type 1 to turn into type 2

A

COPD

- After tired muscle

23
Q

What causes type 2 resp failure

A 
Brainstem
Neuropathy 
Airway obstruction
Depressant drugs
Nerve root injury, or Chest wall compliance, nothing to do with lung
24
Q

Indications for oxygen therapy

A

• Respiratory failure, cardiac or respiratory arrest, tachypnoea, cyanosis, hypotension, metabolic acidosis

25
Q

Treatment for respiratory failure

A

Oxygen

26
Q

When do you use oxygen mask, nasal cannulae

A

Patient with normal vital signs (post op)

27
Q

When trauma mask

A

Higher o2 conc needed
Asthma attack, pneumonia, sepsis
(60% oxygen)

28
Q

When to use venturi mask

A

Controlled treatment in long term resp failure e,g COPD

29
Q

What does pulse oximetry tell us (SpO2)

A

oxygenation NOT ventilation

30
Q

What is the critical threshold for pulse oximetry saturation

A

94%

31
Q

Sources of error in pulse oximetry

A

 Poor peripheral perfusion
 Dark skin (oximeter over-reads slightly)
 False nails or nail varnish
 Lipaemia / hyperlipidaemia / propofol infusion

32
Q

What is arterial blood gas monitoring for

A

• Arterial blood gas monitoring is used to keep the FiO2 to the minimum required to achieve adequate oxygenation
Too high O2 –> free radicals which damage the body
ABG also used to evaluate pH changes

33
Q

What percentage of COPD patients are CO2 retainers

A

10%

34
Q

What do do if unknown CO2 retainer

A

o Start high flow oxygen
o Monitor for drowsiness/signs of CO2 retention
o Check ABGs after 30 minutes

35
Q

What to do if known CO2 RETAINER

A 
o	Controlled mask
o	Titrate – use lowest O2 possible
o	Aim for stats 90% - 92% (may need 85%+) 
o	Measure ABGs ASAP
o	Repeat ABGs after 30mins of O2 change
36
Q

When do you give ventilation

A
  • Not for hypoxia
  • Ventilation Used for hypercapnea
  • i.e. give oxygen in hypoxia and ventilate in hypercapnea (= hypoventilation)

CR2 (34 decks)

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