Misc FP-C Flashcards
MCI
More patients than resouces
Do the most good for the most people
When given priority questions
start with the first category that you aren’t given info about
Shock Index
HR/SBP – 0.8 or higher indicated high likelihood of peri-intubation problems
Indication for surgical airway
Cant intubate cant ventilate
Contraindicaitons for extraglottic airway
Obstruction, Intact Gag Reflex, Esophageal Disease]
Test for varices
Hepatic jugular reflex – Lay flat, elevate legs, press on RUQ and look for JVD. Sign of portal hypertension and therefore esophageal varices
Troubleshooting suction
Work from the machine back to the patient
Anion Gap
<12
Na+K)-(HCO3+Cl
Name for alveolar capillary junction
alveolar capillary membrane
Relationship between Ph and PCO2
For every change of 10 pCO2, pH will change by 0.08 in the OPPOSITE DIRECTION
Minute ventilation
6-8L/min or
Nonintubated: 60ml/Kg/min
Intubated: 120ml/Kg/min
Very Acidotic: 240ml/Kg/min
Mean airway pressure
pPlat
Mean Airway Pressure 10-20 Plateau Pressure (pPlat) always <30
DOPES Equipment Failure
Work from pt to vent
Benzo overdose questions
Flumazenil is generally a bad idea
Coronary Perfusion
Closes coronary ostia during systole. Back pressure during closure perfuses coronary arteries.
HEART IS PERFUSED DURING DIASTOLE
Types of hypoxia
Hypemic and Histotoxic will not become cyanotic
Hypoxic (Gas exchange) – Get rid of obstructions or add pressure
Hypemic/Anemic (Hypovolemic or anemic)
Stagnant (Shock states other than hypovolemia)
Changes in altitude and G forces
Histotoxic (Cyanide, CO, etc)
Types of airway obstruction
Complete (CICO)
Obstruction w/ good air exchange (Stridor)
Partial w/ poor air exchange (Stridor, increased WOB, low SPO2)
Vent question w/ pancreatitis
ARDS
Cardiac question re pressors
Look for best measured amount and best physiological effect
Angina
Stable: CP relieved with rest or up to 3 NTG
Unstable: Chest pain unrelieved w/ 3 NTG or rest
NSTEMI: Unstable angina w/ cardiac markers or ischemic changes
Inferior STEMI question
No choice given for inferior, select posterior
Prinzmental’s Angina
CP WITH STEMI changes that goes away w/ NTG
Hypoxia
SPO2 <94%
Coronary Perfusion Pressure
(DBP-PCWP)
Mimics likely to show up on exam
pacemaker, early repol, pericarditis
Antidysrhythmics
“Some Boys Play Cards”
Sodium Beta Potassium Calcium
Cocaine Use
No beta blockers
Paradoxycal tachycardia
Wide complex tachycardia question that mentions another antidysrhythmic:
Procainimide
Push Dose Epi
Epi when no pump available
Bradycardia
"All trained Dogs Eat Iams"
Atropine
TCP
Dopamine
On exam, dopamine dose likely to be inappropriate
Epi
IsoproterenolPercentage Meds
Percentage = mg/mL ie Dextrose 50% = 500mg/mL
“Pre-ecclamptic, hypertensive, no IV, give mag: 4gm of a 50% solution, split it? How many mL?”
Beta Blocker Overdose
Bradycardic + Hypoglycemic – Beta Blocker Overdose
Cereberal Perfusion Pressure
CPP = MAP-ICP
Greater than 60
Assume ICP 10
Replacing volume
Measured amount w/ expected outcome – Warm isotonic crystalloids NS and LR – 10-20mL/Kg
Large bore IV
> 100mL/min, “KVO” = 15mL/min, “Wide Open” = Bolus = 20mL/Kg
Weather secnario
If given pt information followed by weather, weather will be bad
LOAD
Lidocaine: ICP or reactive airway
Opiates: Manage pain, esp in head injury
Atropine: Kids or ketamine
Defasiculate: 10% dose of non depolarizing paralytic
Cholinergic
Anticholinergic
Cholinergic = Sympathetic Anticholinergic = Parasympathetic
Meaning of S1 and S2
S1 - Mitral and Tricuspid Closure
S2 - Aortic and Pulmonic Closure
Leading Cause of Aeromedical Accidents
Pilot Error
ETT Cuff Pressure
20-30
Intrathoracic Pressure During Inhalation
First lower, then higher
Rhabdo Meds
Mannitol, Bicarb
Pregnant Patient Position
Left Lateral
Drug that increases preload
Vasopressin
First line AAA therapy
Beta blockers
Indications for Immediate C Section
Multiple Decel w/ Poor Variability
Sustained Brady
Sinusoidal Waveform
Salicylate Overdose
Tinnitus, Dizziness, Tachy, Hot
TCA Overdose
Hot, dry, seizure, tachy
Metabolic Alkalosis Treatment
Replete Potassium, Fluids
Bicarb Deficit Formula
(Wt/4) X Base Deficit = Bicarb Need
Diabetes Insipidus Treatment
Vasopressin, Desmopressin, DDAVP
DKA / HHNS Treatment
Fluids, Insulin
Unknown overdose, intubated, IV fluids running, foley: What med would you expect to give
Bicarb
