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Anaesthetics and Genetics > Critical Care > Flashcards

Critical Care Flashcards

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1
Q

Na+ requirements for patients

A

1 - 2 mmol/kg/day

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2
Q

K+ requirements for patients

A

0.5 - 1mmol/kg/day

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3
Q

Fluid requirements for patients

A

25 - 30 ml/kg/day

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4
Q

Glucose requirements for patients

A

50 - 100 g/day

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5
Q

Care levels

A 
0 = primary care
1 = ward based
2 = HDU 
3 = ITU
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6
Q

What is involved in HDU?

A

Single organ support

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7
Q

What is involved in ITU?

A

Multi organ support

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8
Q

What levels of the care levels are classed as “critical care”?

A

Levels 2 and 3

  • HDU
  • ITU
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9
Q

What is the other factor, as well as organ support, which would mean you would need to come to the ITU?

A

Invasive ventilation

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10
Q

What does a definitive airway mean?

A

Gases go in and out without any problems / fancy instruments

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11
Q

What signs would indicate a bad airway?

A

See-saw breathing
Tracheal tug
Silent patient
Stridor

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12
Q

Which type of tubes do you need anaesthesia for?

A

Endotracheal tube = need anaesthetic

Tracheostomy tube = do not need sedation as does not hit the gag reflex

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13
Q

Airway manoeuvres

A 
Head tilt, chin lift and jaw thrust most simple 
insert an airway 
- endotracheal tube
- tracheostomy tube
Intubation
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14
Q

Two types of respiratory failure

A

Type 1

Type 2

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15
Q

Type 1 respiratory failure

A

One problem = low O2

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16
Q

Type 2 respiratory failure

A

Two problems = low O2 and high CO2

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17
Q

What is the most common type of respiratory failure?

A

Type 1

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18
Q

What is the most sensitive marker of a deteriorating patient? (although not very specific)

A

Respiratory rate

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19
Q

Treatment if the patient has an issue with oxygenation

A 
High flow nasal cannula 
- 2-4L at 20-30%
Face mask (Hudson mask) 
- 4-10L at 40% O2
Trauma mask 
- 15L on ward at 80-90% 
CPAP 
Intubation and invasive ventilation 
ECMO
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20
Q

Treatment if the patient has an issue with CO2 removal

A

Some oxygenation might help

Invasive ventilation more indicated

21
Q

What do CO = ?

A

CO = HR x SV

22
Q

What does stroke volume involve?

A

Preload / contractility / afterload

23
Q

What do beta blockers do to your HR?

A

Slow it down

24
Q

What do chronotropes do to your HR?

A

Speed it up

25
Q

What do inotropes do to your HR/CVS?

A

Drive contractility

26
Q

What do vasopressors do to your HR/CVS?

A

Drive the afterload

27
Q

What do fluids do to your HR/CVS?

A

Improve preload

28
Q

Types of fluids

A

Crystalloids

Colloids

29
Q

What is crystalloids?

A

Fluid that contains small molecules/electrolytes suspended in fluid

30
Q

What are crystalloids used for?

A

To maintain the osmolarity

31
Q

What are colloids?

A

Fluids that contain big molecules e.g. blood, starch. If given these, the big molecules are least likely to leak across the capillary bed and therefore stay in the vasculature longer.

32
Q

What should never be used as a resuscitation fluid?

A

Dextrose

33
Q

Cannulas vs central lines

A 
Cannulas 
- can stay in for 72 hours 
- more flimsy 
Central lines
- 7- 10 days
34
Q

What do vasopressors do?

A

They are alpha-1-agonists which constrict blood vessels, predominately veins (“capacitance vessels”)

35
Q

What do inotropes do?

A

Beta-1-agonists which improve contractility

36
Q

How are inotropes usually given?

A

Via central lines

37
Q

How to measure the results of drugs….

A 
Look at end organ perfusion 
BP
urine output 
Conscious level 
Capillary refill 
Lactate
38
Q

What does looking at the urine output indicate?

A

If the kidney is perfused

39
Q

What does looking at the conscious level indicate?

A

If the brain is perfused

40
Q

What does looking at the capillary refill indicate?

A

If the skin is perfused

41
Q

What is lactate a marker of?

A

Tissue hypoperfusion

42
Q

Above what level of lactate is abnormal and what level is very bad?

A

abnormal = > 2

very bad > 4

43
Q

What GCS score requires intubation?

A

8

44
Q

Failure of which organs can occur in Disability?

A 
Raised ICP = brain failure
GI failure
Pancreatic failure 
Kidney failure 
liver failure
45
Q

How to treat raised ICP

A

Sedation to reduce BP to the brain

Neurosurgery

46
Q

How to treat GI failure

A

Unblock / surgery

Feeding (NG tube)

47
Q

How to treat pancreatic failure

A

Support diabetic function

48
Q

How to treat kidney failure

A

Dialysis

CVVF in ITU

49
Q

How to treat liver failure

A

not much you can do apart from liver transplant

Anaesthetics and Genetics (15 decks)

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