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Undeleted > Airway/Ventilation > Flashcards

Airway/Ventilation Flashcards

1
Q

LEMONS Stands for what?

A 
Look Externally
Evaluate 3-3-2
Mallampati Score
Obstruction
Neck Mobility
Saturations
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2
Q

What does SOAPPP Stand for? What is it for?

A

Prepare for Intubation

Suction
Oxygen
All Adjuncts
Positioning
Plan A,B, and C
Pharmaceuticals
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3
Q

What is the proper position for intubation? What is it called for obese patients?

A

The Sniffing or Ear to Sternal Notch Position. In the obese we bring the ear to sternal notch with the ramped position.

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4
Q

How much mmHG should you use when suctioning the ET Tube?

A

80mmHG

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5
Q

What are the subjective techniques for confirming the placement of an ET tube?

A

Direct Visualization
Tube Misting
Auscultation

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6
Q

What are the objective techniques for confirming the placement of an ET tube?

A

Capnography
Esophageal Detector Device
ET Tube Introducer (Bougie) Depth
Pulse Oximetry

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7
Q

What is retrograde intubation?

A

Where a needle is placed into the airway through the cricoid membrane from the outside and directed superiorly. A guide wire is then passed through the needle and hopefully retrieved in the oral cavity.

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8
Q

What is the total atmospheric pressure? What is the partial pressure of O2? How do you determine it?

A

Total atomospheric pressure is 760mmHG.
The partial pressure of O2 is 159.6mmHG.
To get the partial pressure you take the % of O2 (21%) and multiply it by the total Atmospheric pressure of 760mmHG.

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9
Q

What is Dalton’s law?

A

The law that the total pressure exerted by a mixture of gases is equal to the sum of the partial pressures of the gases of the mixture.

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10
Q

Changes in what stimulates Medullary Response centers to change breathing rate/depth?

A

Changes in CSF pH.

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11
Q

What drives ventilation?

A

CO2

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12
Q

What is the Herring Breuer Reflex?

A

Stretch receptors in lungs that limits the respiration when stimulated by over inflation.

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13
Q

What are J-Receptors?

A

They are O2 sensing receptors that stimulate brain centers for breathing.

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14
Q

Inspiration is Active or Passive? What kind of pressure does it create in the Thoracic cavity?

A

It is Active and creates a negative pressure.

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15
Q

What is Boyle’s law?

A

The principle that at a constant temperature the volume of a gas varies inversely with the pressure exerted upon it.

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16
Q

What is Henry’s Law?

A

The amount of gas dissolved in a given volume of liquid is directly proportional to the partial pressure of that gas in the gas phase.

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17
Q

What is a Shunt?

A

An area of the lung that is being perfused but no ventilation is taking place. Can be caused by a number of disease processes. Shunting causes increased Deadspace.

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18
Q

In a normal 70kg male how much tidal volume is there?
How much is the Inspiratory Reserve Volume?
How much is the expiratory reserve volume?
What is the Residual volume?

A

500ml: Tidal Volume
Inspiratory Reserve: 3000ml
Expiratory Reserve: 1000ml
Residual Volume: 1200ml

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19
Q

How is Inspiratory Capacity calculated?

A

Vt+IRV= 3500ml

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20
Q

How is Vital Capacity calculated?

A

Vt+IRV+ERV=4500ml

21
Q

How is Functional Residual Volume calculated?

A

ERV+RV=2200ml

22
Q

How is Total Lung Capacity calculated?

A

Vt+ERV+IRV+RV=5700ml

23
Q

What can increase Functional Residual Capacity?

A

CPAP

24
Q

CO2 does what to the Vasculature?

A

An Increase in CO2 causes Vasodialation

A Decrease in CO2 causes Vasoconstriction

25
Q

What is ARDS?

A

Acute Respiratory Distress Syndrome

26
Q

Describe Kussmaul Breathing and What are some potential causes?

A

Deep rapid respirations.

Causes: Metabolic Acidosis (Diabetes Mellitus), Hyperpnoea
Keytones
Uremia
Sepsis
Salicylates
Methanol
Aldehydes
U
Lactic Acid/Lactic Acidosis
27
Q

Describe Cheyne-Stokes Respirations and what are some potential causes? Who is this commonly seen in and when?

A

Respirations that gradually increase from shallow to deep then back to shallow with periods of apnoea between them.

Causes: Sleep/Hypoxemia/Drugs, Hypoperfusion of the Brain

Seen in the elderly before death.

28
Q

Describe Biot’s Respirations and what are some potential causes?

A

Ataxic respirations. Deep rapid respirations with periods of apnoea.

Causes: Neuron Damage/Head Trauma/Brainstem Injury

29
Q

What can help us estimate the PaO2 from SPO2?

A

The Oxyhemoglobin Curve

30
Q

What does a Right Shift mean?

A

It means the patient is shifting right on the Oxyhemoglobin curve causing an Increased Temp, Increased DPG, and Increased H+ (Acidity)

31
Q

What does a Left Shift mean?

A

It means the patient is shifting left on the Oxyhemoglobin curve causing a decreased temp, decreased DPG and a decreased H+ (Alkalosis)

32
Q

What does SpMET measure? What does it mean?

A

It measures Methemoglobin and it shows how much of the Iron in hemoglobin is in a Ferric (Fe3+) state and is unable to carry O2.

33
Q

What is Capnometry?

A

The measurement of expired CO2

34
Q

What is Capnography?

A

A Graphic recording or display of the capnometry over time.

35
Q

What is Capnograph?

A

A device that measures CO2

36
Q

What is a Capnogram?

A

A Visual representation of expired CO2 (The Waveform)

37
Q

What is PaCO2?

A

The partial pressure of CO2 in the arterial blood.

38
Q

Describe a normal Capnogram

A

AB: Phase 1: Late Inspiration/Early Expiration (No CO2)
BC: Phase 2: Appearance of CO2 in exhaled gas.
CD: Phase 3: Plateau, Constant CO2
D: Highest Point (ETCO2)
DE: Phase 4: The rapid descent during inspiration.
EA/AB: Respiratory Pause/Late Inspiration/Early Expiration

39
Q

Draw a “shark fin” Capnogram, What does it indicate?

A

It indicates possible Obstructive Pulmonary Disease such as Asthma/COPD

40
Q

What does an elevation in the baseline on a Capnogram indicate?

A

The rebreathing of CO2 and it is generally seen with Hyperventilation.

41
Q

What does DOPE stand for? When do you need to remember it.

A

Displacement
Obstruction
Pneumothorax
Equipment Failure

You need to remember it when you see a capnogram shows NO waveform your ET Tube should be removed immediately.

42
Q

What does a progressive reduction in ETCO2 levels indicate?

A

Blowing off more CO2, consistent with hyperventilation.

43
Q

What does a progressive increase in ETCO2 levels indicate?

A

Trapping or retaining CO2 consistent with hypoventilation or improving perfusion (Cardiac arrest)

44
Q

What is the approx. normal ET Tube depth for a male?

A

21-24cm at the teeth.

45
Q

What is the approx. normal ET Tube depth for a female?

A

20-23cm at the teeth.

46
Q

An increase in CO2 causes what changes in Consciousness? ICP?

A

Causes a decrease in consciousness.

Causes an increase in ICP.

47
Q

What are the two causes of unresponsiveness?

A

Hypoxia and Hypercapnea

48
Q

A GCS of ? or less might require airway management?

A

8

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