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Flight Paramedic > Acid/Base/Vent Management > Flashcards

Acid/Base/Vent Management Flashcards

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1
Q

The fastest physiological mechanism for acid base correction is:

A

Bicarbonate Buffering System

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2
Q

During aerobic metabolism cell primarily produce:

A

Adenosine Triphosphate

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3
Q

The metabolic byproduct of aerobic metabolism

A

CO2 and Water

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4
Q

The Bohr Effect:

A

Occurs as a result of CO2 binding with Hgb causing a decreased affinity of Hgb for oxygen

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5
Q

Right Shift:

A 
HGB Releases O2
Raised Temp
Raised 2-3DBG
Raised Acidosis
Reduced Oxygenation 
(BohR effect)
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6
Q

Left Shift:

A 
HGB HoLds O2
Low Temp
Low 2-3 DPG
aLkalosis (Low Acidosis)
Lots of CO
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7
Q

Massive transfusion causes a ___________ of 2-3 DPG

A

Lowering

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8
Q

Elimination of fixed acids occurs via

A

The renal system

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9
Q

Increased CO2 removal is facilitated by:

A

Bohr Effect

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10
Q

The majority of CO2 is transported:

A

as bicarbonate in plasma

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11
Q

The relationship of ETCO2 to PaCO2 should

A

demonstrate EtCO2 is slightly lower the PaCO2

**EtCO2 can NEVER be higher then the PaCO2

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12
Q

For every change in pH of_____ you will see a change in the K+ of _____ in the opposite direction.

A

0.1 and 0.6

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13
Q

For every _____ mmHg change in CO2, the pH will change ____ in the opposite direction.

A

10 and 0.08

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14
Q

For every change in HCO3 of ______ mEq, the pH will change _______ in the same direction.

A

10 and 0.15

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15
Q

Potassium administration:

A

May be given via PIV
Should not exceed 0.5-1.0 mEq/kg/hr
Typically occurs at 10-20 mEq/hr

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16
Q

When Glycolysis occurs you get ____ ATP

A

2

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17
Q

Byproduct of Glycolysis is ________

A

Pyruvic Acid

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18
Q

Normal Aerobic Metabolism you get ____ ATP

Byproduct ________

A

38

Water and CO2

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19
Q

Anaerobic metabolism you get as little as _____ ATP

Byproduct is ________

A

2-4

Lactic Acid

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20
Q

To decrease PaCO2

A

Increasing Minute Volume
Verify maximum safe Vt (keep Pplat <30-35)
Increase Rate

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21
Q

To increase PaCO2

A

Decrease Minute Volume
Decrease Rate
Decrease Vt no more than absolutely necessary

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22
Q

To Increase PaO2

A
  1. Verify normal/adequate Ve
  2. Maximize FiO2
  3. Add Peep
  4. Consider reducing I:E ratio
  5. Invert I:E ratio
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23
Q

What is the most common cause of barotrauma related to ventilators

A

High Plateau Pressure

24
Q

Hyperthermia and acetylsalicylate poisoning both promote ______ventilation

A

Hyper

25
Q

Renal failure is most likely to cause which acid/base disturbance?

A

Metabolic Acidosis

26
Q

Continuous OG/NG suctioning would most likely cause which acid/base disturbance?

A

Metabolic Alkalosis

27
Q

To assure optimal O2 delivery to the pulmonary capillaries you must have:

A

Adequate Alveolar Volume

28
Q

Barotrauma caused by ventilators is best prevented by monitoring:

A

Pplat

29
Q

Minute Volume Formula

A

Ve= (Vt x F)

30
Q

Normal Ve

A

4-8 L/MIN

31
Q

An elevated PIP with normal/unchanged Pplat suggest:

A

Asthma

32
Q

Elevated PIP and Pplat suggest

A

Pneumothorax

33
Q

Dead space is approximated by what formula?

A

33% of the tidal volume or approx 1ml/lb (ideal body weight)

34
Q

Asthma patient will demonstrate on CXR:

A

Narrowed mediastinum
Hypodense lung fields
Blunted or Squared Costophrenic Angles
Flattened Diaphragm

35
Q

Who would have a low 2-3 DPG

A

Multiple Transfusions

36
Q

Who would have a raised 2-3 DPG

A

Chronic Lungers

37
Q

If the K+ is high and the pt is acidic do you fix the K+?

A

No this is a false high.

38
Q

____________ stimulates motor end plates acetylcholine receptors causing persistent depolarization

A

Succinylcholine

39
Q

When admin a defasciculating neuromuscular blockade, the dose recommended is ____

A

10% normal RSI dosage of NMBA

40
Q

Early Salicylate Poisoning usually presents with which ABG?

A

Noncomp Resp Alkalosis

41
Q

If PIP does not change on a vented pt with respiratory acidosis, always____

A

Decrease Vt before rate

42
Q

An Elevated anion gap can indicate the presence of which acid base disorder?

A

Metabolic Acidosis

43
Q

Diarrheal dehydration can cause which acid base disturbance?

A

Metabolic Acidosis (esp in peds)

44
Q

Metabolic alkalosis can be caused by a loss of Hydrogen Ions through the ________ and ______

A

Kidney and GI tract

45
Q

Acute Resp Failure is defined as:

A

pO2 50

46
Q

Hammans Sign:

A

Sign of Tracheobronchial Injury

47
Q

Early Signs of Malignant Hyperthermia

A
  1. Increase CO2
  2. Tachycardia
  3. Muscle Rigidity
48
Q

Chest Tubes are usually inserted at

A

4th-5th ICS Anterior Axillary Line

49
Q

Causes of Metabolic Acidosis in Order of most likely to least likely.

A
  1. Lactic Acidosis
  2. DKA
  3. Renal Failure
  4. Toxins? (Heavy Metals Poisonings of ETOH Poisoning)
50
Q

One of the Primary Poisoning that causes Metabolic Acidosis is:

A

Alcohol’s (Ethanol, Methanol, Anti-Freeze)

51
Q

Nitrates can cause what kind of poisoning?

A

Cyanide

52
Q

Metabolic Alkalosis

A

Think Electrolyte Imbalance
Too much Bicarb or not enough Acids
“Worst of the Worst”

53
Q

Treatment of Metabolic Alkalosis

A

Identify and Correct electrolyte abnormalities

54
Q

A-a gradient > _______ you have a shunt

A

20

55
Q

Steps to Increase PaO2

A
  1. Assure adequate Alveolar Min Ventilation (assess Vt and RR) Good Value and Good Rate
  2. Maximize FiO2
  3. Add PEEP
  4. Invert I:E ratio
56
Q

What drives a person to breath

A
  1. Excess CO2

2. Inadequate Oxygen

Flight Paramedic (14 decks)

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