Ch. 5: Oxygen Delivery and Mechanical Ventilation Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

Safe Apnea Time

A

1) From onset of paralysis until saturation of 90%

  • 2.5min obese adult
  • 3.5 min 22# child
  • 5 min mod ill adult
  • 7.5 min normal adult.

2) Recovery from succinylcholine

  • 10% at 7 min
  • 50% at 8.5 min
  • 90% at 10 min.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

PreOxygenation

A

1) Want 100% of the patients FRC (30cc/kg) filled with oxygen
2) Accomplished with 3-5 min tidal breathing w 100% FIO2

OR 8 maximal breaths.

3) Best sitting up
4) If lung pathology PEEP my expand FRC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Oxygen Delivery Methods

Low Flow

A

LOW FLOW

  • NC 2-4L 30% FiO2
    • 6L 40
  • Simple mask 6 45
    • 10 55
  • Venturi mask 15 50
  • NRB 15 70
  • BVM w leak 15 <50
  • BVM w/o leak 15 90
    • w one way valve.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Oxygen Delivery Methods

High Flow

A

High Flow

  • Anesthesia Machine 30 LPM 100%
  • BVM no leak w valve 15 LPM 100%
  • NPPV 50 LPM 100%
  • HFNC 40-60 100%
  • NRB mask >40 LPM 100%
  • Simple mask >40 LPM 70-90%

High flow adds some PEEP which can recruit alveoli.

NPPV especially good in pneumonia, HF, ARDS preox

Use Bipap mode or use vent with PS and PEEP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Flow Meters

A
  • Flush rate listed on the side. Usually 40 to 60
  • Special flowmeters can go to 70 or 90 LPM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Delayed Sequence Intubation

A
  • A stepped pause in agitated patients.
  • Get them calm enough to preoxygenation
  • Often Ketamine 1.5 mg/kg
  • BE Vigilant and prepared for a crash airway.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Apneic Oxygenation

A
  • Even in apnea there is passive inspiration due to Aventilatory mass flow.
  • During preoxygenation also have a NC on. When paralysis sets in turn to 15LPM or more.
  • Show to reduce hypoxia during intubation.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Rescue Oxygenation

A

When intubation attempt fails and Sat drops below 93%

  • FOCUS on ventilation.
  • BVM with good positioning. Monitor ETCO2
  • 30s or more delay between adequate ventilation and saturation increase.
  • If unable to bag place an EXTRAGlottic Device-LMA
  • Consider using an intubating LMA.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly