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ITE '23 > Ch. 1 Resuscitation > Flashcards

Ch. 1 Resuscitation Flashcards

1
Q

What is a more sensitive indicator for inability to protect airway than gag reflex?

A

inability to swallow

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2
Q

How do you measure correct OPA size?

A

the flange of the OPA should be placed at the mouth and the tip should
reach the angle of the mandible.

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3
Q

How do you place an OPA?

A

rotate 180° once well into the mouth
(in order to avoid pushing the tongue posteriorly) → advance distal end
into the hypopharynx.

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4
Q

What are five ways to trouble shoot BVM?

A

(1) consider two-handed technique;
(2) make sure an OPA or NPA is in place;
(3) make sure proper
mask size is being used;
(4) if patient has dentures that have been removed consider replacing dentures;
(5) if patient has a beard, considering
lubricating with KY jelly.

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5
Q

How do you calculate pediatric cuff size?

A

cuffed: (age/4)+3.5

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6
Q

How do you determine blade size?

A

■ Premature infants: Size 0
■ Normal infants: Size 1
■ Older children: Size 2
■ Adults: Sizes 3-4

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7
Q

What is the best way to confirm ETT placement?

A

Detecting end-tidal CO2 (ETco2) (yellow color change or 5% CO2) after 6
manual breaths is the best single means of confirming ET tube placement.

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8
Q

What pretreatment medication can be given to prevent elevation in ICP during RSI? and what is the dose?

A

Lidocaine
1.5 mg/kg

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9
Q

In pediatric patients, what pretreatment medication can be given to decrease symptomatic bradycardia during RSI? and what is the dose?

A

Atropine
0.02 mg/kg

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10
Q

When should you avoid Ketamine as induction med for RSI?

A

known CAD, because it causes tachycardia which can worsen demand ischemia

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11
Q

Which induction medication is good for awake intubations?

A

Ketamine because it preserves respiratory drive

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12
Q

RSI Meds: What is the dose for etomidate?

A

0.3mg/kg

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13
Q

RSI Meds: What is the dose for Ketamine?

A

1-2mg/kg

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14
Q

RSI Meds: What is the dose for Midazolam?

A

0.1-0.2mg/kg

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15
Q

RSI Meds: What is the dose for Propofol?

A

1.5-3mg/kg

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16
Q

Awake intubation: What meds and respective doses?

A

Lidocaine 4% nebulized
topical benzocaine 4+ccs
Ketamine 10-20 mg/dose

17
Q

Needle cricothyroidotomy is performed up to age _____.

A

10-12 yrs old

18
Q

What size needle catheter do you use for needle cric in peds?

A

12 or 14 gauge, connected to 3mL syringe

19
Q

In a choking patient, in whom abdominal/back thrusts fail, what is the next step?

A

consider using an ET tube to
push the foreign body into the right main-stem bronchus, then withdrawing
the tube several centimeters to allow ventilation of the left lung.

20
Q

What are examples of low V/Q ratio?

A

COPD, asthma, hepato-pulmonary syndrome, and pulmonary edema

21
Q

Whats an example of a high V/Q ratio?

A

pulmonary embolus

22
Q

The oxyhemoglobin dissociation curve describes ________.

A

The strength with which Hgb binds O2

23
Q

What does a right shift of the oxyhemoglobin dissociation curve represent?

A

Hgb more readily gives up O2 to the tissue

24
Q

What are some causes of a right shift of the oxyhemoglobin dissociation curve?

A

Acidosis, hyperthermia, increased 2,3-diglycerophosphate
(2,3-DPG), increased Paco2

25
Q

What are some causes of a left shift of the oxyhemoglobin dissociation curve?

A

Alkalosis, hypothermia, abnormal hemoglobin,
decreased 2,3-DPG, decreased Paco2

26
Q

What are contraindications to NIV?

A
  1. Apnea
  2. Inability to protect airway
  3. copious secretions
  4. Recent OMFS surgery
  5. Untreated pneumothorax
27
Q

When it comes to ventilation in patients with head injury, it is important to avoid ____capnia. Why?

A

HYPERcapnia – bc causes cerebral vasodilation and increased ICP (Goal PaCO2=35)

28
Q

What are some causes of Mobitz II heart block?

A

ACS – commonly anteroseptal MI
hyperkalemia
fibrosing disease (Lenegre Disease)
Infiltrative myocardial disease (sarcoidosis, amyloidosis)
Structural Heart Disease (Congenital or surgical)
Autoimmune Disease (eg lupus)

29
Q

What medication is CONTRAINDICATED in Mobitz II or INFRAnodal Type III heart block (<40BPM and wide complex)?

A

ATROPINE – MAY WORSEN conduction ratio

30
Q

How many joules are needed for cardioversion in Aflutter?

A

25-50J – much more sensitive than Afib

31
Q

How many joules should be used for cardioversion in Afib present for greater than 24-48h?

A

200J or 360J (instead of 50-100J)

32
Q

In unknown duration of Afib, target rate control. How do you decide if anticoagulation is necessary?

A

CHADS2 score

33
Q

What is the CHADS 2 scoring?

A

C - CHF - 1 point
H - HTN - 1 point
A - age >75 - 1 point
D - DM - 1 point
S - prior TIA or Stroke - 2 points

0: nothing or full-dose ASA
1: full-dose ASA
>1: warfarin with INR goal between 2 and 3

34
Q

What are ECG findings of SVT?

A

narrow QRS, rate between 140-280, with NO visible p waves
inverted p waves - representing retrograde conduction - are buried in QRS complex and therefore typically not seen. If visible, typically seen in II, III, and AVF

35
Q

What is the treatment for unstable SVT?

A

synchronized DC cardioversion (100-200J), unless adenosine immediately available

36
Q

What does Brugada syndrome look like on ECG?

A

Coved/downward humped ST segment in V1-V3, that can simulate a right bundle branch block
(RBBB), and history of symptoms (eg, syncope)

37
Q

What is the treatment for Brugada syndrome?

A

implanted defibrillator; if asymptomatic, but findings on ECG – refer to cardiology

38
Q

What is the treatment for stable VTach?

A

Amiodarone 150 mg IV over 10 minutes followed by infusion 1mg/min for 6 hours and 0.5 mg/min for 18 hours

39
Q

What is the accessory pathway in WPW?

A

Bundle of Kent (bypasses the AV node, bypassing the atrium directly to the ventricle)

ITE '23 (20 decks)

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