Critically Ill

Question 1

What are the most important things you can do in the management of the critically ill? (general)

Answer 1

accurate pre-op

Question 2

How is StO2 different than SpO2?

Answer 2

they both measure O2 saturation of Hb, but StO2 measures more superficially (<14mm)

Question 3

To what is a Vigilance connected? a Vigileo?

Answer 3

Vigilance connected to PAC; Vigileo connected to a-line

Question 4

What are complications of passing a PAC?

Answer 4

knotting, dysrhythmias, perforation (cardiac or PA)

Question 5

What are complications of a PAC in situ?

Answer 5

dysrhythmias, pulmonary infarct/embolism, endocarditis, PA perforation

Question 6

What are the effects of Mg++ on conduction and where?

Answer 6

decreases conduction: AV node, antegrade/retrograde in accessory ptwys, His-ventricular; prolongs SA node recovery time; reduces automaticity

Question 7

What is Mg++ used to PREVENT and what is the dose?

Answer 7

a-fib, v-arrhythmias, WPW, multifocal a-tach, polymorphic v-tach, v-fib; 2-3g

Question 8

Which is preferred, Ca+chloride or Ca+gluconate and why? What is a concern when giving Ca+?

Answer 8

Ca+chloride because is dissolves more rapidly? Ca+ can cause extravasation, bradycardia and asystole if given too rapidly - give slowly and thru central line.

Question 9

What is the effect of giving Ca+? What is a typical dose?

Answer 9

increased inotropy and contractility; 20mg/kg

Question 10

What is the best temp probe for determining brain temp? core body temp (non-CPB)? respiratory gas temp? What is the downside of rectal temp probe? bladder temp probe?

Answer 10

nasal temp probe; lower esophageal; upper esophageal; rectal is slow to respond to core temp changes; bladder is dependent on urine flow