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Anaesthetics > Critical care > Flashcards

Critical care Flashcards

1
Q

level 1 based care?

A

ward based care

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2
Q

level 2 care?

A

HDU - is designed to offer single organ support

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3
Q

level 3 care?

A

intensive care

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4
Q

Type 1 respiratory failure?

A

oxygenation failure

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5
Q

Type 2 respiratory failure?

A

oxygenation and ventilation failure

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6
Q

20-25% oxygen is about?

A

2-4 litres

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7
Q

highest flow of oxygen on a ward is?

A

15 L per minute

90% oxygen

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8
Q

HFT can go up to?

A

70 litres per minute

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9
Q

benefit of HFT

A

pressure effect in patients airway

- Doesn’t matter how deeply they breathe

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10
Q

how do NIV work?

A

strap tight fitting mask to patient face

  • gives a pressure to support the patients breathing
  • reduces work of breathing
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11
Q

main role of NIV is in?

A

type 2 resp failures

- COPD patients

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12
Q

if patient comes in with severe respiratory failure what should you do?

A

intubate them

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13
Q

inflative cuff in intubation - advantages?

A
  • any pressure of gas put into lungs, doesn’t come back up

- protects the airway from regurgitation etc

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14
Q

when may u intubate?

A

severe lung disease
pneumonia
covid?

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15
Q

if someone is intubated what else do they need?

A

nasogastric tube

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16
Q

what can you offer someone looking at a long course of intubation ?

A

tracheostomy

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17
Q

what is shock?

A

Shock is acute circulatory failure with inadequate or inappropriately distributed tissue perfusion resulting in cellular hypoxia

18
Q

what goes on in Distributive (septic) shock?

A

blood vessels have abnormally dialled - blood to Wrong place - fluid is in the wrong place

19
Q

Hypovolaemic shock can be secondary to?

A

dehydration
bleeding losses
- not enough blood to go around

20
Q

Anaphylactic shock is?

A

blood vessels have abnormally dialled - blood to Wrong place - associated with cardiac stunning, pump failure, peripheral vast problems

21
Q

Neurogenic shock is?

A

trauma to spinal chord - disruption to sympathetic nervous system causes abnormal Vasodilation in tissues and peripheries

22
Q

Cardiogenic shock?

A

the heart can’t get blood round to the body - oxygen not going to the tissues

23
Q

cardiac output is

A

Heart Rate x Stroke Volume

24
Q

Stroke Volume =?

A

Preload / Contractility / Afterload

25
Q

advantages of arterial line

A

beat by beat reading of BP

- repeated blood sampling

26
Q

central line sit in

A

main vein

- potent drugs delivered straight to central system

27
Q

vasopressors cause?

A

vasocontrciton
improve preload
reduce venous volume and bring blood back
- increase after load - more heart contractions

28
Q

Metaraminol - what does it do?

  • used in patients with?
A

alpha 1 agonist
vasoconstriction

  • can be given peripherally
  • septic shock
29
Q

Noradrenaline - what does it do?

  • used in patients with
A

alpha agonist

  • more potent
  • need to give through CL
  • shorter half life
  • septic shock
30
Q

pump dysfunction - you can use? (drug type)

2 types

A

Inotropes

Adrenaline - has beta affect too,
Dobutamine

31
Q

colloids are?

A

rarer use

- fluid with large osmotically active particles in it

32
Q

crystalloids are? give examples

A

fluid with small molecules in them

- saline , dextrose, plasmolite

33
Q

serum chlorlide should be

- too much chloride?

A

less than 100 (92-99)

  • metabolic acidosis
34
Q

patients you need to be careful not to overload?

A

those with chronic heart failure

35
Q

good marker of volume static and haemodynamic status?

A

urine output

36
Q

surviving sepsis - limit volume to give to patient before transferring to critical care?

A

30 ml/kg “limit”

37
Q

septic shock patients are ?

A

fluid unresponsive

38
Q

neurological failure - reduced conscious levels

A

reduced conscious level

  • sepsis
  • inflammation (pancreatitis)
  • renal failure
  • trauma
  • electrolyte disturbances
  • strokes etc
39
Q

traumatic head injuries can lead to?

A

brain swelling - damage - coring- brain tissue through foramen magnum = death

40
Q

reducing co2 can help

A

reduce intra cranial pressure

41
Q

more oxygen reduces

A

intracranial pressure

Anaesthetics (5 decks)

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