End tidal

Question 1

Physiologic factors causing INCREASE EtCO2?

Answer 1

• Increased muscular metab. (shivering)
• Malignant hyperthermia
• Increased CO (during resuscitation)
• Bicarb infusion
• Tourniquet release
• effective treatment of bronchospasm

Decreased Minute Vent (MV)

Question 1

What tank will be yellow?

Answer 1

Air - yellow tank and yellow hoses

Question 2

Phys. Factors causing a DECREASE in EtCo2?

Answer 2

• decrease muscle activity (paralytics)
• Hypothermia (decreased metabolic demand)
• Decrease CO (cardiac arrest)
• Pulmonary embolism
• Bronchospasm
• Increased MV

Question 3

Oxygen is measured by?

A. Fuel cell

B. Infrared

C. Magnetic

Answer 3

A & C only!

Answer 4

Loss of Alveolar Plateau

• COPD, asthma, Bronchoconstriction, or airway obstruction

Question 4

What do each number represent?

Answer 4

PHASE I: Respiratory Baseline, CO2 free dead space air, normally 0
PHASE II: Expiratory Upstroke, rapid rise due to mixing of dead space air and alveolar air, should be steep
PHASE III: Expiratory Plateau, exhalation of mostly alveolar air
☼: Peak Et CO2 Level , end of exhaled air, peak end tidal CO2 level, normally 35-45mmHg
PHASE IV: Inspiratory Downstroke , inhalation of CO2 free gas, quickly returns to the baseline.

Question 4

How often are cylinders checked?

Answer 4

Visual inspection every 5 years

• test every 10 years - if pass pressure test requal 10 years

if residual expansion less than 10% = requal 5 years

if greater than 10% = removed from medical use!

Question 5

How many Liters of O2 does an E-cylinder contain?

H- Cylinder?

And at what PSI

Answer 5

E: 660 liters/1900psig

H: 6900L/ 2200psig

Question 6

Capnography vs Capno_metry?_

Answer 6

Capnography: displays both ETCO2 value and waveform

Capnometry: displays JUST the numeric value

Answer 7

Hyperventilation

Question 8

Which tank is Grey?

Answer 8

Carbon Dioxide

Question 9

Normal ABG CO2 vs End tidal CO2?

Why are they different normals?

Answer 9

35-45 ABG vs 30-43mmHg ETCO2

end tidal lower than Arterial d/t dead space

Question 10

Which tank is BLUE?

Answer 10

Nitrous Oxide - N2O

Answer 11

Curare Attack -

Paralytics wearing off- diaphramatic breathing

Answer 12

Normal ETCO2 reading

Question 13

Pressure required to Liquify Nitrous Oxide?

Answer 13

745 psig

Question 13

Which tank is Green?

Answer 13

Oxygen

Question 14

Total dead space is the sum of what?

Answer 14

Anatomic deadspace (airways leading to the alveoli)

+

Alveolar deadspace (ventilated areas of lung w/out bloodflow)

+

Mechanical deadspace (artificial airway including ventilator circuit)

Answer 16

Inadequate Seal around ETT

Question 17

What does it mean when N2O pressure gauge starts falling?

Answer 17

CHANGE THE TANK

• you have 250L or less remaining

Answer 18

Faulty ventilator curcuit valve

Question 20

Causes for obstruction slope on EtCo2?

Answer 20

• Partially kinked or occluded artificial airway
• Presence of foreign body in the airway
• Obstruction in expiratory limb of the breathing circuit
• Bronchospasm, asthma, or COPD

Question 21

US Dept. of Transportation Role in medical gases?

Answer 21

Regulates the construction & handling of all medical compressed gas cylinders, including:

– Design, construction, testing, marking, labeling, filling, storage, handling, maintenance, transportation

Answer 22

Hypoventilation

Answer 24

Esophageal Intubation

Answer 25

Apnea/Loss of Waveform

Question 26

What should be done Immediately if you have an airway fire??

Answer 26

Shut off the OXYGEN and extubate immediatley

Oxygen: Supports combustion

N2O will support combustion as well

Question 27

Which tank is Brown?

Answer 27

Helium

Answer 28

Elevated Baseline

Rebreathing CO2

Question 29

Causes for Re-breathing?

Answer 29

• Faulty expiratory valve
• Inadequate inspiratory flow
• Insufficient expiratory flow
• Malfunction of CO2 absorber system

Question 30

Causes for SUDDEN loss of EtCO2 waveform?

Answer 30

• Most common ===> airway disconnection - start @ pt first & work way to machine
• Apnea
• Airway Obstruction
• Dislodged airway (esophageal)
• Airway disconnection
• Ventilator malfunction
• Cardiac Arrest

Answer 31

Hyperventilation