Airway ALL CARDS Flashcards
(81 cards)
What does end tidal Co2 measure
Normal range?
It is the amount of exhaled carbon dioxide.
35-45 mmhg
T/F
End tidal Co2 is a good indication of late respiratory distress
False.
It is an EARLY sign of respiratory distress. If it is outside the 35-45 range, we can tell something is wrong early on.
Three methods to monitor Co2
Colorimetric
Capnometric
Capnographic
Colorimetric definition
Colorimetric is monitoring co2 based off the color changes of a paper
Capnometric defintion
A numeric reading of co2 amount
Capnographic defintion
Gives a numeric value and a visual waveform to monitor co2
What is a Filter line?
What else can it do?
It is the filter on a nosepiece that collects the co2 sample after exhaling
Filterline can deliver 5 Liters of O2
How can you tell there is a filterline occlusion?
What do you do if theres an occlusion?
Sat drops
Co2 levels are off
Feel it
- make sure you check this before you call doctor if there is a problem
You replace the Filterline
Three examples of reasons to monitor ETCO2?
Sleep apnea
PCA Pumps
Sedation
Who are common candidates for end tidal co2 monitoring due to sleep apnea?
Males
Obsese patients
Thick neck
Post surgery pts
Why would we use ETCO2 monitoring for a pca pump?
Narcotic medications are used with these pumps and it can affect respiratory drive
Why would a sedated patient need to have their ETCO2 monitored?
Due to sedation meds they won’t be able to notify us if they are having breathing issues so the filter can help us make sure they are
- they too can cause resp depression
- colonoscopy, tee, etc
Your patient has a ETCO2 reading is 34. Their RR is 13. What do you do?
You would need to continue to monitor them and check the trends. The range is 35-45. It being 34 is not too concerning right now.
- you can ask them if they are feeling ok
What happens to a patients ETCO2 reading levels if you ventilate them too quickly?
Not enough Co2 will be able to build up in the alveoli - which causes a LOWER ETCO2 reading.
What happens to a patients ETCO2 reading levels if you ventilate a patient too slowly?
Sort of odd but by ventilating too slowly extra amount of Co2 will be able to build up in the alveoli which will cause HIGHER ETCO2 reading.
Can you get an O2 sat reading on a patient that is coding?
What about end tidal Co2?
No, you can’t. They’re not perfusing.
Yes the end tidal CO2 can be read and it can help you see if you’re doing good compressions.
What do you consider if you are consistently getting low Co2 readings?
How can a pulmonary embolism cause a low ETCO2 reading?
Is this perfusion, metabolic, or a psych problem?
Think about the perfusion, metabolic, psych problems causing it
A blocked pulmonary artery will cause less Co2 rich blood to return to the lungs and so you can’t breath co2 out
A perfusion issue
How can DKA cause a low ETCO2 reading?
What type of breathing occurs in DKA?
DKA involves the body being in an acidosis state. CO = acid. In order to get read of the acid, the body will start to breath rapidly to breath off more Co2 to compensate…… which then turns more slow and labored ultimately leads to LOW ETCo2 levels.
In order to compensate the hyperventilation going on is called Kussmauls = rapid, shallow breathing (like a sigh). The worse the acidosis from dka gets the slower and more labored the kussmauls become due to air hunger.
Clinical presentations of a pulmonary embolism that would cause a low etco2?
SOB
D-dimer labs
What is the likely reason someone’s ETCO2 would be high?
Respiratory failure of some sort due to not being able to breath off the normal of co2 at first. And it accumulates - so eventually your end tidal volume rises
If someone is going into respiratory arrest which is the best early indicator and why : O2 sat or ETCO2?
ETCO2.
You can inhale enough oxygen and still go into arrest due to just being fatigued. The CO2 however doesn’t lie.
What is a later sign of respiratory arrest?
LOC changes
- but you should be able to identify these before they become HUGE issues
What is the RR and ETCO2 gonna be like if a patient is hyperventilating?
High RR and ETCO2 will be low
- pt is blowing off co2 at quicker rates leading to less ETco2
What is arterial co2?
what happen to arterial co2if the etco2 is low from hyperventilation
co2 level drawn with abg
it will drop as well