Hypoxemia and Hypercarbia

Question 1

What is the definition of hypoxemia?

Answer 1

deficiency in the concentration of dissolved oxygen in the arterial blood

Question 2

What is the definition of hypoxia?

Answer 2

abnormally low oxygen availability to the body or a specific tissue

Question 3

Causes of hypoxemia: OR/intubated?

Answer 3

Wall to airway, disconnection from oxygen supply, wrong gas compistion (check FiO2)
Airway to lungs: endobronchial intubation, dislodged ETT, obstructed, kinked
Outside to inside of chest: Weakness due to NMBD, flail chest in trauma, PTX, HTX
Congestion from CHF
PE, VAE< anemia, fat emboli,
Atelectasis, aspiration, infsxn

Question 4

How do you respond to hypoxemia?

Answer 4

Place pt on 100% O2 while looking at other VS includeing PIP, TV, FIo2, check ETT, auscultate, check pulse ox, suction ETT, maually ventilate
Consider ABG with HCT

Question 5

If you apply 100% O2 without resolutio of hypoxemia,

Answer 5

Then its a shunt

Question 6

With trauma patients, always apply:

Answer 6

In line stabilization

Question 7

Bronchospasm: what are you doing?

Answer 7

Deepen the anesthetic, albuterol, IV epinephrine

Question 8

How do you treat tension PTX? How does it present?

Answer 8

Presents like: unilateral absence of breath sounds, tracheal deviation, unexplainable hypotension, distended neck veins
TX: find 2nd intercostal space on side of PTX, find mid clavicular line, insert 14 g angiocath into space over top of rib. Listen for decompressive air rush
Leave angiocath in place
Place a chest tube

Question 9

What is hypercarbia?

Answer 9

AKA hypercpaneia (too much CO2 in the blood)

Question 10

Causes of hypercarbia/hypercapnea:

Answer 10

Overproduction of CO2: MH, thyrotoxicosis, sepsis/fever, pheo
Underelimination of CO2: low minute ventilation, weak pt, drugs/nm dz, bronchospasm, narcotizd, exhausted CO2 absorber.

Question 11

What does hypercapnea due to bp?

Answer 11

increases PVR and catecholamine release