Final Flashcards
(132 cards)
What are s/s of sympathomimetic toxidrome poisoning?
Hyperthermia Tachycardia Hypertension Warm/moist skin Agitated delirium
What are some examples of sympathomimetic toxins?
No antidote?? Supportive care??
Cocaine
Amphetamine/meth
Phencyclidine (PCP)
Withdrawal
What are s/s of cholinergic toxidrome poisoning?
Muscarinic: DUMBELS (diarrhea/diaphoresis, urination, miosis, bradycardia, emesis, lacrimation, salivation) or SLUDGE
Nicotinic (opposite of muscarinic) & CNS receptor effects
What are some examples of cholinergic toxins?
Antidote?
Pesticides, nerve agents
Antidote: Atropine, 2-pralidoxime
What are s/s of anticholinergic toxidrome poisoning?
Hyperthermia (HOT) Tachycardia/HTN Red, hot, dry skin (DRY, RED) Mydriasis (BLIND) Absent bowel sounds Urinary retention Confusion/hallucinations (MAD)
What are some examples of anticholinergic toxins?
Antidote?
Antihistamines Antipsychotics Atropine/scopolamine Tricyclic antidepressants Skeletal muscle relaxants
Antidote: Physostigmine
What are s/s of opioid toxidrome poisoning?
Miosis, CNS depression, respiratory depression
What are some examples of opioid toxins?
Antidote?
Opiates (morphine, codeine), Opioids
Antidote: Naloxone
How does serotonin syndrome present?
Antidote?
Agitation, autonomic (VS) instability, NMJ effects (tremor, hyperreflexia)
Antidote: Cyproheptadine
What poison is glucagon used as an antidote?
Insulin?
Beta blocker
Calcium channel blocker
What is the antidote for iron poisoning?
Supportive care, deferoxamine chelation
What is the antidote for benzodiazepines?
Flumazenil
What are 4 causes of respiratory failure?
Mechanical dysfunction of the lung
Loss of respiratory control d/t impaired central respiratory drive
Upper/lower airway obstruction
Multisystem organ failure, cardiac arrest
What ventilator changes can you make when the problem is oxygenation (low O2)?
Increase mean airway pressure (MAP) by increasing PIP, PEEP, or I-time
Increase FiO2
What ventilator changes can you make when the problem is ventilation (high CO2)?
Increase alveolar ventilation by increasing tidal volume or rate
What are some examples of restrictive lung disease?
What vent mode and settings do you want?
ARDS, aspiration pneumonia
Mode: AC
Settings: high PEEP, low tidal volume
What are some examples of obstructive airway disease?
What vent mode and settings do you want?
COPD, asthma
Mode: AC (volume > pressure) or SIMV+ PS
Settings: low rate, short I-time
What is part of the respiratory exam for a patient on mechanical ventilation?
WOB (retractions, belly-breathing, nasal flaring, head bobbing), breath sounds, waveforms on vent, patient-ventilator “synchrony”
What are 4 causes/troubleshooting for a distressed vent patient or decompensation on mechanical vent?
D - displacement of tube
O - obstruction
P - pneumothorax
E - equipment failure
Capnography - decreasing EtCO2
Causes?
ETT cuff leak
ETT in hypopharynx
partial obstruction
Capnography - sudden increase in EtCO2
Causes?
ROSC
Capnography - bronchospasm (shark fin appearance)
Causes?
Asthma
COPD
Capnography - decreased EtCO2 (variable changes)
Causes?
Apnea
Sedation
Vent adjustments for dynamic hyperinflation. and evidence of auto-PEEP?
decrease rate, I-time