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564 > ECMO > Flashcards

ECMO Flashcards

1
Q

what is ecmo

A

provides prolonged cardiac and respiratory support to sustain life and give gas exchange/perfusion

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2
Q

what does veno venous support

A

lung

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3
Q

what does veno arterial do

A

heart, but also lung

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4
Q

does single lumen or bi caval allow mobility

A

bi caval

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5
Q

where does a patient need to be on RASS as a screen to mobilize on ECMO

A

-1 to 1 , conscious, orientated, responsive

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6
Q

what is considered a major adverse event

A

cannula movement
bleeding
fall

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7
Q

what is considered a minor event

A

hypotension
arthrymia
persistent drops in flow

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8
Q

difference analgesia anesethetic

A

analgesia - pain relief

anesthetic - blocking sensation (including pain)

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9
Q

Acetaminophen

onset
peak
duration

A

onset: 30-1 hr
peak : 1-2 hrs
duration: 4-6 hr

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10
Q

NSAIDS
onset
peak
duration

A

onset: 30min-1 hr
peak : 1-2 hrs
duration: 4-6 hours

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11
Q

Gabapentin
onset
peak
duration

A

onset: 1 hr
peak : 2-4 hrs
duration: 6-8 hrs

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12
Q

morphine
onset
peak
duration

A

onset 5-10 mins
peak 30 mins
duration 4 hrs

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13
Q

Hydromorphine
onset
peak
duration

A

onset 5-15 mins
peak 30-60 mins
duration 4-5 hrs

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14
Q

Fentanyl
onset
peak
duration

A

onset 1-2 mins
peak 15 mins
duration 1 hr

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15
Q

opioid side effects

A

decreased LC, respiration, gut mobility, rash, decreased cardiac status

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16
Q

if someone has prior substance abuse do you give them sedative

A

yes its a pre disposing factor

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17
Q

if someone has severe hypoexemia and shock do you give them sedative

A

yes

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18
Q

benzodiazepines, propofol ,and dexmedetomidine are examples of

A

sedatives

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19
Q

sedative side effects

A

decreased LOC, decreased respiration, decreased cardiac status

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20
Q

RASS -5/-4 what do you do

A

PROM

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21
Q

RASS -3/-2 what do you do

A

PROM sit

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22
Q

RASS -1/0/1 what do you do

A

AROM
active exercise
sit stand walk
ADL

23
Q

when are paralytics used

A

endotracheal intubation
decrease shock state
manage ICP

24
Q

do paralytics have analgesics

A

no so they better be sedated properly

25
Q

which drug can cause renal failure

A

NSAIDS

26
Q

iontropes do what

A

increase CO

27
Q

vasopressors do what

A

increase vasoconstriction, increase MAP

28
Q

why treat low BP or hypotension

A

blood to vital organs
restore tissue perfusion
reduce mortality

29
Q

dopamine is a vasopressor or inotrope

A

mixed but primary increases inotrophy

30
Q

whats dobutamine do

A

increase CO (inotropic), vasodilator

31
Q

whats milrinone do

A

inotrophy and vasodilator, but longer therapeutic effect than dobutamine

32
Q

name three vasopressors

A

norepinephrine
epinephrine
midodrine

33
Q

what are vasopressors and iodtropes used for

A

hypotension

34
Q

side effects of vasopressors and iodtropes

A

hypo perfusion (blood to vital organs, you could amputate digits)
cardiac dysrhymias
myocardial ischemia

35
Q

activity mobility guidelines

A

no increased dose of vasopressor for 2 hours

no evidence of MI 24 hours

no new artiarthymic agent 24 hours

HR <75% predicted max HR at rest

less than 20% variability of BP

on low dose of inotrope support <10

36
Q

heparin is an example of what kind of drug

A

anticoag

37
Q

is heparin brief onset brief duration

A

yes

38
Q

T/f heparin is used over the counter

A

hospital only

39
Q

difference warfarin and heparin

A

slower onset, longer duration

40
Q

physio considerations for anticoags

A

they could bleed or clot

could be on specific bed rest

41
Q

with low INR they __ with high INR they

A

clot

bleed

42
Q

how to assess for delrium

A

confusion assessment method

43
Q

common anti psychotics

A

haloperidol
methotrime
loxapine
quetiapine

44
Q

can transplant patients be on EMCO

A

yes

45
Q

signs symptoms of transplant rejection

A 
pain at site of transplant
ill, flu like symptoms 
fever
weight change
swelling
decreased urine output
46
Q

side effects of immunsuppression

A

mm weakness, tremors
peripheral neuropathy, myopathy
increased likelihood of CAD

47
Q

t/f early post transplant failure has high mortality rate

A

true

48
Q

heart transplant peak HR

A

only 80% of normal

49
Q

do heart transplant patients get angina

A

no

50
Q

difference transplant heart ECG

A

2 p waves

first P wave not followed by QRS

51
Q

Pt considerations in heart transplant

A

there tacky all the time
longer warm up cool down
heart can’t respond quickly (orthostatic hypotension)

52
Q

lung transplant consideration for PT

A

decreased mucus clearance
ineffective cough
decreased strength
increased reliance on anaerobic metabolism

53
Q

considerations for liver transplant

A

hemorrhage
mm weakness
tacky

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