APO

Question 1

Indication for nitrates in APO

Answer 1

SOB w/ crackles

Question 2

Indication for CPAP in APO

Answer 2

No improvement with nitrates or full-field APO

Question 3

cmH2o for CPAP in APO

Answer 3

10cmH2O, with concurrent nitrate admin

Question 4

BiPAP parameters for APO

Answer 4

IPAP 10cm
EPAP 5cm
FiO2 1.0

Increase to IPAP15 and EPAP10 if no improvement.

Titrate FIO2 to 92-96% once improved.

Question 5

Indication for Frusemide in APO

Answer 5

Normotensive/hypertension resolved, consider 20-40mg IV or pt daily dose as single dose (max 100mg) IV

Question 6

Contraindications to CPAP

Answer 6

1. Inability to Mx own airway
2. Upper airway obstruction
3. Hypoventilation
4. TPT
5. Haemodynamic instability
6. Injuries precluding mask application

Question 7

Indications for removal of CPAP (8)

Answer 7

1. Ineffective
2. Cardiac arrest
3. Mask intolerance
4. Decreasing resp effort
5. Nil improvement after 1hr
6. Deteriorating VSS
7. Secretions/vomiting
8. Loss of airway control

Question 8

Rationale for PAP in APO

Answer 8

Decreases effects of alveolar surface oedema on gas exchange

Increased intrathoracic pressure improves LV performance by decreasing preload/afterload

Decreased WOB reducing sympathetic myocardial demand