Critical Care Flashcards
how many levels of critical care is there?
4 levels
0-3
what levels of critical care require intensive care?
2 or 3
how much does critical care most per day?
£1500
what respiratory support is available in critical care?
sophisticated NIV (non-invasive ventilation)
invasive ventilation
advanced respiratory support
what pressure system is used in non-invasive ventilation?
CPAP - continuous positive airway pressure
what are the two types of non-invasive ventilation?
CPAP
Assisted spontaneous ventilation
how does assisted spontaneous ventilation work ?
augmentation of intrinsic respiratory, improves minute volume and increases CO2 clearance
- preventing acidosis
what tubes are used in invasive ventilation in critical care?
endotracheal tubes
can invasive ventilation provide high pressures of ventilation?
yes
what is the difference between maintaining or protecting the airway?
maintaining = keeping patent and open
protecting = protects the trachea from contamination
does invasive ventilation require the patient to be conscious?
no
- no intrinsic effort required
what does HFOV stand for?
High frequency oscillatory ventilation
what does ECMO stand for?
Extracorporeal membrane oxygenation
what is ECMO?
is a temporary mechanical support system used to aid heart and lung function in patients with severe respiratory or cardiac failure. Developed as an offshoot of cardiopulmonary bypass and the membrane oxygenator, ECMO can be used in patients of all ages
bypasses the cardiopulmonary system, blood is transported from vena cava to brachiocephalic arteries after being oxygenated
give some examples of conditions where someone would require ventilatory support?
severe pneumonia
PE
life threatening bronchospasm
SIRS (systemic inflammatory response syndrome)
what cardiovascular support s required in critical care?
invasive monitoring with fluid resuscitation
intra-aortic balloon counter pulsation
- increases coronary blood flow and therefore myocardial perfusion and increases CO
extracorporeal support (VA ECMO)
what are the different types of shock?
hypovoleamic (low volume) septic cardiogenic (pump failure) anaphylactic neurogenic obstructive - such as tension pneumothorax
what is a tension pneumothorax?
hole in chest wall which creates a valve which increases air pressure in the pleural cavity on inspiration
what renal support is available in critical care?
CVVHDF
- Continuous veno-venous haemofiltration
is renal support usually required in critical care form primary or secondary causes?
secondary causes
- such as sepsis or shock
what is MARS for hepatic support?
molecular absorbents recirculating systems
what is MARS?
based on the selective removal of albumin bound molecules and toxins from the blood in patients with acute and acute-on-chronic liver failure
what is the best option for hepatic support?
transplantation
how is intra cranial pressure measured in critical care?
bolts
continuous EEG
