Blood Gas Evaluation and E cylinder Calculation

Question 1

Calculate how much is left in an E cylinder with a psi of 15.

Answer 1

psi / 3 = L

15/3 = 5L

Question 2

Calculate how many minutes remain in a E cylinder with a psi of 15 at a flow of 2L/min

Answer 2

psi / 3 = L
15/3 = 5L

Minutes remaining = L/Flow (L/min)
5L/2(L/min) = 2.5min remaining

Question 3

What does blood gas measure- what is it the gold standard for?

Answer 3

oxygenation and ventilation

Question 4

Difference between arterial and venous samples on a blood gass

Answer 4

Venous samples are better for analysis of acid base disorders. They have lower pH (7.3-7.35) and higher pCO2 due to local tissue metabolism

Question 5

Normal pH, PaCO2, PaO2 (room air and 100% O2), HCO3, BE, SaO2, Lactate

Answer 5

pH= 7.35-7.45
PaCO2 = 35-45 mmHg
PaO2 (room air)= 80-100 mmHg
PaO2 (100%O2)= 400-500 mmHg
HCO3= 15-25mmol/L (carnivore), 20-28 (herbivore)
BE= +/-4
SaO2= 95-100%
Lactate=

Question 6

What is the Issue:
pH = 7.30
PaCO2 = 50 mmHg
HCO3 = 20 mmol/L
Why is this occuring? how do we fix it?

Answer 6

Respiratory Acidosis

Due to hypoventilation
Fix it by providing PPV (positive pressure ventilation)

Question 7

What is the Issue:
pH = 7.30
PaCO2 = 35 mmHg
HCO3 = 10 mmol/L
Why is this happening and how to fix?

Answer 7

Metabolic Acidosis

Due to loss of HCO3 through kidneys or intestinal tract
Fix it by improving O2 delivery to tissues

Question 8

What is the issue: 
pH = 7.47
PaCO2 = 30 mmHg
HCO3 = 15 mmol/L
Why is this and how do we fix?

Answer 8

Respiratory Alkalosis

Due to hypoxemia, hyperventilation
Fix the underlying issue

Question 9

What is the issue:
pH = 7.47
PaCO2 = 35mmHg
HCO3 = 30mmol/L

Answer 9

Metabolic Alkalosis

Due to GI obstruction, loop diuretics, NaHCO3 adminitration
Correct by volume expanding

Question 10

Respiratory Acidosis

How to fix it

Answer 10

IPPV

Question 11

Respiratory Alkalosis

How to fix it

Answer 11

Turn up the inhalent

Question 12

Hypothermia- 2 consequences

Answer 12

1. Prolonged recovery times

2. Prolonged healing

Question 13

Hypothermia- 2 ways to fix it

Answer 13

1. Heating blankets/pads
2. Warm IV fluids
3. Turn the anesthetic gas down

Question 14

Hyperthermia- how do we fix it

Answer 14

1. Cool the patient down by placing cool towels, ice packs

2. turn the anesthetic gas up