Critical care

Question 1

level 1 based care?

Answer 1

ward based care

Question 2

level 2 care?

Answer 2

HDU - is designed to offer single organ support

Question 3

level 3 care?

Answer 3

intensive care

Question 4

Type 1 respiratory failure?

Answer 4

oxygenation failure

Question 5

Type 2 respiratory failure?

Answer 5

oxygenation and ventilation failure

Question 6

20-25% oxygen is about?

Answer 6

2-4 litres

Question 7

highest flow of oxygen on a ward is?

Answer 7

15 L per minute

90% oxygen

Question 8

HFT can go up to?

Answer 8

70 litres per minute

Question 9

benefit of HFT

Answer 9

pressure effect in patients airway

- Doesn’t matter how deeply they breathe

Question 10

how do NIV work?

Answer 10

strap tight fitting mask to patient face

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

Question 11

main role of NIV is in?

Answer 11

type 2 resp failures

- COPD patients

Question 12

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

Answer 12

intubate them

Question 13

inflative cuff in intubation - advantages?

Answer 13

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

- protects the airway from regurgitation etc

Question 14

when may u intubate?

Answer 14

severe lung disease
pneumonia
covid?

Question 15

if someone is intubated what else do they need?

Answer 15

nasogastric tube

Question 16

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

Answer 16

tracheostomy

Question 17

what is shock?

Answer 17

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

Question 18

what goes on in Distributive (septic) shock?

Answer 18

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

Question 19

Hypovolaemic shock can be secondary to?

Answer 19

dehydration
bleeding losses
- not enough blood to go around

Question 20

Anaphylactic shock is?

Answer 20

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

Question 21

Neurogenic shock is?

Answer 21

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

Question 22

Cardiogenic shock?

Answer 22

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

Question 23

cardiac output is

Answer 23

Heart Rate x Stroke Volume

Question 24

Stroke Volume =?

Answer 24

Preload / Contractility / Afterload

Question 25

advantages of arterial line

Answer 25

beat by beat reading of BP | - repeated blood sampling

Question 26

central line sit in

Answer 26

main vein | - potent drugs delivered straight to central system

Question 27

vasopressors cause?

Answer 27

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

Question 28

Metaraminol - what does it do? - used in patients with?

Answer 28

alpha 1 agonist vasoconstriction - can be given peripherally - septic shock

Question 29

Noradrenaline - what does it do? - used in patients with

Answer 29

alpha agonist - more potent - need to give through CL - shorter half life - septic shock

Question 30

pump dysfunction - you can use? (drug type) 2 types

Answer 30

Inotropes Adrenaline - has beta affect too, Dobutamine

Question 31

colloids are?

Answer 31

rarer use | - fluid with large osmotically active particles in it

Question 32

crystalloids are? give examples

Answer 32

fluid with small molecules in them | - saline , dextrose, plasmolite

Question 33

serum chlorlide should be | - too much chloride?

Answer 33

less than 100 (92-99) - metabolic acidosis

Question 34

patients you need to be careful not to overload?

Answer 34

those with chronic heart failure

Question 35

good marker of volume static and haemodynamic status?

Answer 35

urine output

Question 36

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

Answer 36

30 ml/kg “limit”

Question 37

septic shock patients are ?

Answer 37

fluid unresponsive

Question 38

neurological failure - reduced conscious levels

Answer 38

reduced conscious level - sepsis - inflammation (pancreatitis) - renal failure - trauma - electrolyte disturbances - strokes etc

Question 39

traumatic head injuries can lead to?

Answer 39

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

Question 40

reducing co2 can help

Answer 40

reduce intra cranial pressure

Question 41

more oxygen reduces

Answer 41

intracranial pressure