4th Year ARDS and Resp Failure

Question 1

diagnostic criteria for ARDS

Answer 1

acute onset
CXR infiltrates bilaterally
PCWP <19mmHg or lack of CCF
refractory hypoxaemia PaO2 : FiO2 <200

Question 2

management of type 1 respiratory failure

Answer 2

treat underlying cause
O2 24-60%
assisted ventilation if PaO2 <8 kPa

Question 3

management of type 2 respiratory failure

Answer 3

treat underlying cause
O2 therapy
recheck ABGs after 20 mins
consider intubation

Question 4

when are ABGs indicated?

Answer 4

• unexpected deterioration
• acute exacerbation of chronic chest condition
• impaired consciousness or impaired respiratory effort
• signs of CO2 retention
• pulse oximetry validation

Question 5

signs of CO2 retention

Answer 5

bounding pulse
drowsy
tremor
headache

Question 6

flow rate and O2 % with nasal cannula?

Answer 6

1-4ml/min 24-40%

Question 7

when can simple face masks not be used?

Answer 7

variable amount of O2 so don’t use if hypercapnia or type 2 respiratory failure

Question 8

blue venturi mask

Answer 8

24%

Question 9

white venturi mask

Answer 9

28%

Question 10

orange venturi mask

Answer 10

31%

Question 11

yellow venturi mask

Answer 11

35%

Question 12

red venturi mask

Answer 12

40%

Question 13

green venturi mask

Answer 13

60%

Question 14

non-rebreather mask O2 % and flow rate

Answer 14

60-90% 10-15L/min

Question 15

what is doxapram?

Answer 15

respiratory stimulant

Question 16

when is doxapram used?

Answer 16

NIV or intubation not appropriate

Question 17

two types of NIV

Answer 17

1. BiPAP

2. CPAP

Question 18

what is BiPAP?

Answer 18

bilateral positive airway pressure

Question 19

when is BiPAP used?

Answer 19

type 2 respiratory failure

Question 20

when is BiPAP CI?

Answer 20

pneumothorax

structural pathology

Question 21

what do you need prior to starting BiPAP?

Answer 21

CXR

Question 22

what is CPAP used in?

Answer 22

OSA
CCF
acute pulmonary oedema