Critical Care

Question 1

What are the key components of AC/VC ventilation mode?

Answer 1

You control the Tidal volume

• RR/Tidal Volume
• PEEP/FiO2
• Ppeak, Pplateau

Question 2

How do you chose a tidal volume for a pt?

Answer 2

6ml/kg of Ideal Body Weight (IBW)

Question 3

What are upsides of AC/VC mode?

Answer 3

you can completely take over the work of breathing for a patient

Question 4

What are downsides of AC/VC mode?

Answer 4

without adequate sedation, a tachypneic pt will get the full TV each breath, leading to resp alkalosis (so not so good in COPD or asthma ppl)

Question 5

What does increasing Ppeak mean?

Answer 5

High airway resistance

• mucous plugging
• tube kink
• bronchospasm
• too narrow ET tube

Question 6

What does increasing Pplateau mean?

Answer 6

Something wrong in the alveoli

• ARDS
• Pulmonary edema
• PTX
• atelectasis
• main stem intubation

Question 7

Induction agents for RSI?

Answer 7

• Midazolam
• Etomidate
• Ketamine
• Propofol

Question 8

Dosing and considerations for Midazolam for induction agent?

Answer 8

Dose: 0.2-0.3mg/kg
Onset: 30-60sec
Duration: 15-30min
Slow onset, apnea hypotension, no analgesia, frequently underdosed for RSI

Question 9

Dosing and considerations for Etomidate for induction agent?

Answer 9

Dose: 0.3mg/kg
Onset: 25sec
Duration: 3-12min
Myoclonic jerks, no analgesia

Question 10

Dosing and considerations for Ketamine for induction agent?

Answer 10

Dose: 1-2mg/kg
Onset: 50sec
Duration: 10-20min
Increased secretions, emergence phenomena

Question 11

Dosing and considerations for Propofol for induction agent?

Answer 11

Dose: 1.5mg/kg
Onset: 40sec
Duration: 3min
Apnea and hypotension