accs Flashcards
rule out narrowing of coronary arteries under fluoroscopy
angiogram
best position to prevent aspiration
lateral flat
cohb normal
1-3% 5-12% for smokers
chocolate abg
methb
treatment for metHb
methylene blue
transudative pleural fluid
chf
exudative pleural fluid
infection/inflammation
what is the absolute contraindication for lung transplant
progressive neuromuscular disease
c/t placement
2nd interspace
hemothoracic placement
4/5
how to intubate with cervical/spinal precautions
modified jaw thrust/flex bronchoscopy
vfib
shock at 360
pvc
lidocaine/amio
afib shock
start at 50
how to diagnosie CF
sweat chrolide >60
brady
atropine
CXR tuburculosis
caviation in upper lobes
inhaled anesthetics
halothane, enflurane
another name for auto peep
dynamin hyperinflation
magnesium
1.4-2
anion gap
3-11
cortisol
10-20
head injury with seizures give what
dilantin
MG meds
mestion/neostigmine
ast
5-40
alt
7-56
what can rule out pe
d-dimer
stroke volume
50-100st
stroke volume equation
HRxCO
cardiac index equation
co/2
RBC
4-6
hematocrit
45%
HB equation
RBC x 3
neutrophils show
bacterial
lymphocytes show
viral
eosinophils show
allergic
troponin
<.2
platelet
150,000-400,00
BNP greater can show
CHF
normal BNP
100
creatinine
.6-1.2
BUN
6-24
ammonia
10-20
CK-MB greater then10.5 show
MI
INR
.8-1.3
what do you see on an EKG with an MI
flipped t waves
higher the INR means
thinner
lower INR means
thicker
GFR
100-130
what is the flow rate at which blood passes through the kidneys
GFR
if GFR is less then 60 waht does that show
kidneys compromised
GFR is less then 15 what does that show
kidney failure
na
135-145
CL
80-100
phospate
25-45
increase in phosphate shows
renal failure
calcium
88-104
spiral CT is the best choice to rule out
PE
central venous catheter should be in what location
right atrium or vena cava
may be seen in patients exposed to chemicals, near drowning, etc
DAH diffuse alveolar hemorrhage
cvp
2-6
pap
14
pcwp
4-12
central sleep apnea med
dopram
another name for cisatracurium
nimbex
another name for cisatracurium
cardiogenic
what drug increases cardiac contractility
dopamine
IBW for males
50 + 2.3 (ht in inch-60)
IBW females
45.5 + 2.3(ht in inch - 60)
medications to lower pulmonary blood pressure
sildenafil (revatio) hydralazine (apresoline) and flolan
treatment for ischemic strokes
thrombolytics
most accurate lab for renal function
creatininer
normal creatinine
.6-1.2
normal urine output
.5ml/hr/kg
anuria
no urine production
oliquire
decrease in urine production
gi prophylaxis
VAP bundle
for refractory hypoxia what should you do
inhaled prostacyclin
COPD feeding is
high protein low carbs
hormones produced by the ventricles of the heart
BNP
protein
6-8.5
CXR deep sulcus sign
Pneumo
copd pt s/p surgery requiring multi days on vent, think what ETT
cass
stroke volume
50-100
hyperlucent fields on CXR
bronchitis
SVR normal
1440
PVR normal
160-200
k
3.5-5
ICP
5-10
normal ET placement at what rib
4th rib
normal ET placement near heart
aortic notch
normal ET placement at what t level
t4
Pulm art cath location
tip in the right lower lung field
what scan detects pulmonary emboli
v/q scan
costophrenic angles on CXR
pleural effusions
flattened diaphragm on cxr
copd
fluffy infiltrates on cxr
pulm edema
wedge shaped infiltrates
pulm edema
butterfly or bat wing on cxr
pulm edema
plate like or patchy infiltrates
ards/ atelectasis
reticulogranular pattern
ARDS
concave border or interface
pleural effusion
consolidation or haziness
pneumonia
deep sulcus sign on CXR
pneumo
when you hear third space shifting what do you need to think of
renal fail, fluid overload
hematocrit equation
HBG x 3
HGB equation
RBC x 3
what two lab values will test for thyroid function
t4 tsh
ventilation is determined by what in HFOV
delta p and frequency
what xray can determine masses or pulm lesions
oblique
off balance K+ can lead to what
cardiac dysfunction
what xray determines pleural effusion
lateral decubitus
what can relax the heart muscle during an MI
nitro
precedex
dexmedetomidine
what reverses ativan/versed
romazicon (flumazenil)
romazicon reverses what
benzos
when can tb pts come out of isolation
until afb is done x 3 days
tx for tb
inh, ethambutol
what med should you avoid giving to a pt with thermal injuries
succs
meds that lower pre load
digitalis (digoxin)
normal PAP
9-18
PCWP normal
4-12
what tube ventilates each lung
double lumen, endobronchial, carlens tube
what ETT will reduce VAP and prevents cuff channel formation
polyeurethane cuffed ETT
what MMHG should you set CASS at
20
what reverses vecuronium
neostigmine
ve equation
RR x VT
what is coumadin
blood thinner
prone position is contraindicated with
copd, paralyzed, pulm hemmorrhage
nasally intubated at
26-28
pulm art pressure greater then what suggest PHTN
25t
average output of urine
600-1800
if you see terminology like third spacing, fluid shifting what med should you give
aldactaline
wedge shaped infiltrates on CXR
PE
air bronchograms on CXR
pneumonia
what is a contraindication of a heart cath
high INR
fent
sublimaze
dilaudid
hydromorphone
tx for central sleep apnea
dopram
if you have a pt with increasing ICP despite hyperventilation what drug should you use
mannitol
if a pt is having a cholinergic crisis with MG what should you give
atropine
levels to look at to know if ETT is in the right place
t4 4th rib level with aortic notch
normal INR
.8-1.3
what med do you nebulize with TB
isoniazid (INH)
what disease can you see diplopia or ptosis with
MG
tensilon test is for
MG
what test do you pay attention to when giving heparin
PTT
what test do you pay attention to when giving coumadin
PT
what does pentobarbital (nembutal) used for
high ICP
what is the name of the bougie that has ventilation and oxygenation ports
airway exchange cath
good trach for a pt with trachial malacia
foam cuff
good trach for abnormal airway
distal
precedex
dexmetomidinep
prop
dipravan
aerosolized med for HIV
pentamadine
if you have a pt that is actively bleeding but also has a PE what is your tx choice
IVC filter
HFOV what adjust oxygenation
map and %insp
HFOV what adjust ventilation
amp and frequency
1 hz =
60 RR
HFOV amplitude
VT
HFOV frequency
RR
a decrease in frequency in HFOV does what with VT
increase
an increase in frequency in HFOV does what with VT
decreases
normal bias flow
40l/min
to decrease PACO2 in HFOV what 3 things to do
increase amplitude, decreases frequency, increase insp time
+ cultures “coccus” treat with
think “icillian”
- cultures think what for treatmetn
“mycin:
normal o2 index for ecmo
40
Heliox another name is
flolan/prostaglandin
normal hertz for HFOV
5-6
normal bias flow in HFOV
40l/min
if paco2 is off by a little bit what do we adjust
vt
if paco2 is off by alot what should we adjust
rr
cstat equation
vt/plat-peep
cdyn
vt/pip-peep
starting dose for nitric
20
if you have rebound hypertension or hypoxemia
increase dose
tensilon test
mg
anticholinesternase therapy another names
neostigmine/mestinonin
1st degree heart block
pr interval prolonger
2nd degree heart block
p wave occasional missing QRS
3rd degree
no correlation between p and QRS
n resp quotent on indirect calometry
1.2
what serum protein shows exudative
> .5
what serum protein shows transudatiev
<.5
amount available for a squeeze with heart
pre load
normal PVR
20-200
normal svr
800-1600
pulmonary afterload is
PVR
force the right ventricle must overcome to produce pulm blood flow
PVR
force the left ventricle must overcome to produce systemic blood flow
SVR
hydromorphone
dilaudid
naloxone
narcan
lorazapam
ativan
midazolam
VERSED
diazepam
valiu
diprivan
prop
dexmedetomidine
precedex
formula for MAP
diastolic + diastolic + systolic /3
formula for CPP (cerebral perfusion pressure)
map-icp
increase in PAP does what with PCWO
decrease
an increase in PAP and decrease in PCWP means what problem
pulm vasculature
what does nipride do
pulm vasodialator
nipride does what with v/q mismatch
increases (nipride dilates the pulm vasculature)
what is a side affect of anectine
increased ICP and malignant hyper
best order for parameters for weaning
rsbi, nif (mip), vc, ve
hypotension does waht with SV
decreases
hypotension does what with svr
decreases
deep sulcus sign
pneumo
when dapson is used orally what can it cause
methemaglobin
what can treat fungal infection
fluconazole (diflucan)
what is your first reaction to a vent alarm
manual ventilation, and then problem solve
presence of protein in pleural fluid means what
indicated exudative pleural effusion
fluid coming from outside the pleural space in a pleural effusion
treansudative
tea colored urine can present with waht
rhabdo
if a pts breath does not return to baseline on your wavefor
increase flow rate or decrease rr
what is helpfl with you have impared vision of epiglottis when intubating
gum elastic bougie
video assist device requres what
rigid stylet
normal WOB
<1 joules
Increase in pap what does
increases right heart pressure
increase in hematocrit does what to the blood
increase in blood viscosity
increase in d- dimer does what for clotting
increase
increase in platelets does what for clotting
increases clotting ability
systolic pulm art pressure exceeding what is a clear indication of PHTN
25
normal anion gap
3-11
anion gap equation
NA+ - (CL- + HCOB3)
order of a leaking/ruptured cuff
- stopcock on pilot. 2. blunted needle in pulot end. 3. clamp pilot line. 4. replace
how do you wean in nitric
reduce by 10 every 2 hours until at less then 10 go by 2
indications for heliox
airway tumors, obstructions, asthma, post ex stridor
two methods for heliox delivery by NRB
80/20 (1.8) and 70-30 (1.6)
in HFOV 1 ht equals how many RR
60
what are the two things that helo with oxygenation in hFOV
map and % insp
what are the two things that help with ventilaiton in HFOV
amp and freq
normal bias flow in HFOV
40l/min (this adjsut map)
in hfov a decrease in frequency does what with VT
increases
in HFOV a increase in frequency does what with VT
decrease
to decrease PACO2 in HFOV what should you do (
increase in amp (this will decrease frequency) or vise versa, increase in % time
when you are in APRV and you are having hypoxia issues what can you adjust
increase p high, increase t high or recruitment
APRV does what with v/q mismatch
increases due to pulm dialation
weanin in APRV
drop p high by 1-2 and increase t high by .5 by every 1 drop in p high(drop and stretch)
in GCS for eye opening what is the order
- spont
- speech
- pain
- o
in GCS for verbal what is the order
- oriented
- confused
- inapp
- incomp
1.0
in GCS for motor what is the order
- commands.
- loc to pain
- wdrwls from pain
- flexion to pain
- extention to pain
1.0
what is the reversal agent versed adn ativan
flumazenl (romazicon
reversal agent for paralytic
cholinesterase inhibitors like peostigmine, pyridostigmine
what do inotropes do
increase strength of heart contraction
drugs that can affect methb
dapsone, nitric, nitroprusside, benzocaine, lidocaine
cf can cause what other issues
GI
in cardiogenic shock what happens to vp, hr, bp, co
increased cvp, hr decreased co bp
an increase in physiologic deadspace does what with ETCO2
decrease
if you have a pt in renal failure that already has high + what is a good lasix to give that will spare the k+
aldactalone
normal proteint
6-8.5
what can cause a decrease in protein
infection, tb, diarrhea
normal blood albumin
3.5-5
normal urine albumin
10-100
if albumin is increased what does that show
liver fail, shock, dehydration
if albumin is decreased what does that show
diarrhea, burn, infection
bnp above what indicates CHF
300
inr higher then normal means blood is what
less likely to clot
normal INR for valve replacement pts
3
s/s of high bilirubin
dark tea colored urine
normal bilirubin
.2-1.2
s3 heart sounds indicates
chf
s4 heart sound indicates
mi/cardiomegaly
air bronchograms on CXR
pneumonia
peep does what to PAP and CVP
increases
peep does what with Co
decreases
anectine can cause what
malig hyperthermia
nipride does what with v/q mismatch
incerases
nipride does what with pulm vasculature
dialates
increase in PAP with decrease in PCWP is what problem
pulm vasculature
normal platelet count
150,000-400,000
pwcp does what in CHF/pulm edema
increases
common pathologies causing pneumonia for CF pts
pseudomonas aeruginosa staph a
lateral decubitus xray
pleural effusion
another name for flolan
prostaglandins
what is iloprost(ventavis)
pulm vasodialator
what should you caution for with iloprost
platelets less then 50,000 and hypotension
what are some vasodialators
hydralazine, labetalol, metoprolol, nicardipine, sodium nitroprusside, nitro
aprv what with QS/QT
decrease
