COVID-19 Flashcards
What is the pathogen?
SARS-Cov2
Management?
ABCDE History Examination Investigations Treatment
What is the number for the crash call?
22 22 - Trust phone only
Airway - what are the three manoeuvres?
Head tilt
Jaw thrust
Chin lift
How much oxygen can you give through a venturi mask?
15L
How much oxygen can you give through a venturi mask?
Up to 15L but better to give non-rebreathe mask as this would probably
How much oxygen can you give through a non-rebreathe mask?
15L
other symptoms of COVID
Sore throat Myalgia Chills/rigors Headache Rhinorrhea/nasal congestion NV Diarrhoea Fatigue Confusion Chest pain or pressure
PMH for COVID
CVD DM HTN Chronic lung disease Cancer Chronic kidney disease Obesity Smoking
Signs
SOB
Febrile
Dry because of fever and tachypnoea
Check calves for DVT
Investigations
Bloods Lymphopaenia Elevated CRP Elevated D-Dimer Elevated Troponin (COVID related cardiomyopathy/myocarditis) Abnormal kidney function tests ABG
Investigations
Bloods
Lymphopaenia
Elevated CRP
Elevated D-Dimer
Elevated Troponin (COVID related cardiomyopathy/myocarditis)
Abnormal kidney function tests (acute tubular necrosis, sepsis, prerenal AKI hypoperfusion etc)
ABG
Management and medication in COVID
Non invasive and invasive ventilation Proning Dexamethasone Remdesivir Anticoagulation Dialysis
Improving ventilation
Positive pressure - increasing air into lungs
If pt is unconscious, you can also take control of rate
What kind of pressure do you need to improve ventilation?
Positive pressure - increasing air into lungs
If pt is unconscious, you can also take control of rate
What changes happen in ARDS?
Destroyed alveolar membrane due to inflammation
No longer elastic
Collapse easily
Fill with pus or fluid
Blood vessels become inflamed and leaky
Lots of gunk, stasis, endothelial injury and
What is VQ?
V = Ventilation Q = perfusion
Explain two mechanisms of VQ mismatch
Poorly oxygenated blood means decreased oxygenation (increased shunt)
OR
Oxygenated blood but no blood flow due to vasoconstriction / lack of blood flow due to PE
(increased dead space)
What does the body try to do to compensate for the lack of oxygen in the lungs?
Vasoconstricts, leading to pulmonary hypertension
What pressure is normal breathing and how does this compare to mechanical ventilation
Normally, inspiration creates negative pressure (a vacuum) that passively draws air in, it’s the opposite of positive pressure
What is PEEP? What does it do?
Positive end expiratory pressure
Keeps the alveoli open throughout the respiratory cycle, improving oxygenation (perfusion)
What can be done to improve ventilation?
Positive pressure during inspiration
Air pushed in through
Give types of NIV
High flow nasal prongs
CPAP
BiPAP
What is the point of the ‘high flow’ of the high flow nasal prongs? What is the downside?
Increasing the flow of air creates some positive pressure (PEEP), however this can make the mouth/nose dry and create nose bleeds
ALSO can leak oxygen therefore wastes it
