Critical Care Flashcards
What is critical care?
- Initial assessment - ABCDE
- Organ system support
- Single vs multiple
What are the different levels of critical care?
- Level 1 care
- Ward based care
- Level 2 care
- Used to be called high dependency unit (HDU)
- Single organ support
- Level 3 care
- Intensive care
- Multiple organ support
What are the different classifications of respiratory failure?
- Type 1
- Oxygenation failure
- Type 2
- Oxygenation and ventilation
Describe the management of type 1 respiratory failure?
- Give oxygen
- On ward can give 0-15L/min
- Nasal canuli (2-4L/min, 25-30% oxygen)
- Hudson mask (4-10L/min, 40% oxygen)
- Trolley mask (15L/min, 90% oxygen)
- In critical care
- High flow nasal canuli (humidifies air so can give more oxygen than normal ward, 70L/min, 100% oxygen)
- On ward can give 0-15L/min
How much oxygen can be given in a ward?
0-15L
- Nasal canuli (2-4L/min, 25-30% oxygen)
- Hudson mask (4-10L/min, 40% oxygen)
- Trolley mask (15L/min, 90% oxygen)
How much oxygen can be given in critical care?
- High flow nasal canuli (humidifies air so can give more oxygen than normal ward, 70L/min, 100% oxygen)
Describe the management of type 2 respiratory failure?
- Non-invasive ventilator – applies pressure to airways to keep them open and reduce work of breathing
- Invasive ventilator – stops air from escaping, protects the airway from secretions
- Need NG tube for feeding, cannot talk
- Tracheostomy – for long term, allows patient to swallow
What is shock?
Shock = acute circulatory failure with inadequate or inappropriately distributed tissue perfusion resulting in cellular hypoxia
What are the different classifications of shock?
- Distributive (septic)
- Blood going to wrong places
- Hypovolemic
- Aetiology – blood loss, trauma, surgery
- Anaphylactic
- Blood vessels abnormally dilated so blood going to wrong places, but also pump failure (unlike distributive)
- Neurogenic
- Disruption of sympathetic nervous system causes abnormal vasodilation – blood in wrong places
- Cardiogenic
- ‘Heart failure’ – heart cannot pump blood around the body
What is distributive shock also called?
Septic shock
What is septic shock?
- Blood going to wrong places
What is the cause of hypovolaemic shock?
- Aetiology – blood loss, trauma, surgery
What is anaphylactic shock?
- Blood vessels abnormally dilated so blood going to wrong places, but also pump failure (unlike distributive)
What is neurogenic shock?
- Disruption of sympathetic nervous system causes abnormal vasodilation – blood in wrong places