Need to Know Stats Flashcards by Brian Beltz

Vital Signs (Per Egan) Adult
1. Heart Rate (HR) Pulse Rate
2. Respiratory Rate (RR)
3. Blood Pressure
4. Pulse Ox

Heart Rate: 60-100 Beats/Minute
Respiratory Rate: 12-18 Breaths/Minute
Blood Pressure: 90-140 systolic/60-90 diastolic (MMHG)=Millimeters of Mercury
Pulse Ox: >92% (per most hospital policies)

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Vital Signs (Per Wilkins) Adult
1. Heart Rate (HR) Pulse Rate
2. Respiratory Rate (RR)
3. Blood Pressure
4. Pulse Ox

Heart Rate: 60-100 Beats/Minute
Respiratory Rate: 12-20 Breaths/Minute
Blood Pressure: 120 systolic/80 diastolic (MMHG)=Millimeters of Mercury (Median)
Pulse Ox: >92% (per most hospital policies)

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Volume-Pressure (V-P) Conversion Factors

E Cylinder: 622.0 L / 2200 psi = 0.28
H Cylinder: 6900.0 L / 2200 psi = 3.14

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Equation to Determine: How much time there is of O2 in a Cylinder. Using Tank Pressure * V-P Factor / Liter Flow. Example: 2000 psi, E cylinder, 3 L Flow

2000 psi * .28 Factor= 560
560 / 3 L Flow = 186.66
186.66 / 60 min = 3.11
.11 min * 60 sec = 6.6
Answer is 3 hours and 6 minutes

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Room Air Oxygen %
Cylinder Air Oxygen % per Liter for Nasal Canula (NC)

Room Air has 2% Oxygen
Cylinder Air for 1L has 24% Oxygen For NC
*For every liter of air in Cylinder the Oxygen % Increases by 4%
Cylinder Air for 2L has 28% Oxygen NC
Cylinder Air for 3L has 32% Oxygen NC
Cylinder Air for 4L has 36% Oxygen NC

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Reference Intervals for CBC
Red Blood Cell Count

Wilkins: x 10^6/uL (x10^12/L)
Males: 4.20 - 6.00
Females: 3.80 - 5.20

Eagan: x 10^6/mcL
Males: 4.4 - 5.9
Females: 3.8 - 5.2

Red Blood Cells carry O2. If patient has low RBC count it could mean he/she is anemic

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Reference Intervals for CBC
White Blood Cell Count

Wilkins: x 10^3/uL (x10^9/L)
Both: 4.0 - 11.0

White Blood Cells fight off infection. An increase in WBC count could mean patient is fighting an infection

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Reference Intervals for CBC
Hemoglobin (Hb)

Wilkins: g/dL (g/L)
Males: 13.5 - 18.0 (135-180)
Females: 12.0 - 15.0 (120-150)

Egan: g/dL
Males: 13.3 - 17.7
Females: 11.7 - 15.7

Main component of RBC. Protein that carries oxygen to the tissues. Helps maintain acid-base balance by acting as a buffer and by carrying CO2 from tissues to the lungs

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Reference Intervals for CBC
Hematocrit (Hct)

Wilkins: % (L/L)
Males: 40 - 54 (0.40-0.54)
Females: 35 - 49 (0.35-0.49)

Egan:
Males: 40% - 52%
Females: 35% - 47%
WBC count: 3.9 - 11.7 x 10^3/mcL

Hct is the ratio of RBC volume to whole blood. A low Hct occurs with anemia and a high Hct with polycythemia. Hct also reflects patient’s hydration status. High Hct is a sign of dehydration

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Reference Intervals for CBC
Platelet Count

Wilkins: x 10^3/uL (x10^9/L)
Both: 150 - 450

Egan: x 10^3/mcL
Both: 150 - 400

AKA thrombocytes. Abnormally low platelet count is called thrombocytopenia. The lower the platelet count, the more likely the patient will have problems with bleeding.

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Reference Intervals for CBC
“Rule of Five” for RBC, Hemoglobin, Hematocrit

Both Sexes
RBC: 5
Hemoglobin: 5 x 3 = 15 (Hb)
Hematocrit: 15 x 3 = 45 (HcT)

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Reference Intervals for WBC
Segmented Neutrophils

Wilkins:
Relative: 50% -70%
Absolute: 1.5 - 7.5 x 10^3/uL (x10^9/L)

Egan:
Relative: 40% - 75%
Absolute: 1.8 - 6.8 x 10^9/L

Increased with bacterial infection and trauma; reduced with bone marrow diseases (critical value <1.0). Produced in the bone marrow

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Reference Intervals for WBC
Eosinophils

Wilkins:
Relative: 1% - 3%
Absolute: 0 - 0.4 x 10^3/uL (x10^9/L)

Egan:
Relative: 0% - 6%
Absolute: 0 - 0.1 x 10^6/L

Increased with allergic reactions and parasitic infections

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Reference Intervals for WBC
Basophils

Wilkins:
Relative: 0% - 1%
Absolute: 0 - 0.1 x 10^3/uL (x10^9/L)

Egan:
Relative: 0% - 1%
Absolute: 0 - 0.1 x 10^6/L

Increased with allergic reactions

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Reference Intervals for WBC
Lymphocytes

Wilkins:
Relative: 20% - 45%
Absolute: 1.0 - 4.0 x 10^3/uL (x10^9/L)

Egan:
Relative: 20% - 45%
Absolute: 1.0 - 3.4 x 10^9/L

Increased with viral and other infections; reduced with immunodeficiency problems. Useful against viral, fungal, and tuberculosis infections. T cells involved in cell mediated immunity. B cells develop antibodies. Natural Killer (NK) cells 3rd type of lymphocytes.

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Reference Intervals for WBC
Monocytes

Wilkins:
Relative: 2% - 11%
Absolute: 0.1 - 1.3 x 10^3/uL (x10^9/L)

Egan:
Relative: 2% - 10%
Absolute: 0.2 - 0.8 x 10^6/L

Increased with invasion of foreign material. Largest of the WBCs. Plays key role in clearing the lung of inhaled dust through phagocytosis by macrophage.

Reference Intervals for BMP (Basic Metabolic Panel)
Sodium
Potassium
Chloride
Total CO2
Glucose
BUN
Creatinine

Wilkins/Egan
1. Sodium (NA+): 135-145 mmol/L / 136-145 mmol/L
2. Potassium (K+): 3.5-5.0 mmol/L / 3.5-5.0 mmol/L
3. Chloride (CL-): 98-107 mmol/L / 98-109 mmol/L
4. Total CO2: 22-30 mmol/L / 22-29 mmol/L
5. Glucose (fasting): 70-99 mg/dL / 70-139 mg/dL
6. BUN: 7-20 mg/dL / 8-23 mg/dL
7. Creatinine: 0.7-1.3 mg/dL / 0.7-1.3 mg/dL

Reference Intervals for Renal Panel
BUN
Creatinine
GFR
Urinalysis

Wilkins/Egan
1. BUN: 7-20 mg/dL / 8-23 mg/dL
2. Creatinine: 0.7-1.3 mg/dL / 0.7-1.3 mg/dL
3. GFR: 90-120 mL/min/1.73 m2
4. Urinalysis: Multiple tests

Reference Intervals for Hepatic Panel
Albumin
Total Protein
ALP
ALT
AST
Bilirubin

Wilkins/Egan
1. Albumin: 3.5-5.0 g/dL / 3.4-4.8 g/dL
2. Total Protein: 6.3-8.0 g/dL / 6.4-8.3 g/dL
3. ALP: 38-126 U/L
4. ALT: 10-40 U/L / 10-40 U/L male 7-35 U/L female
5. AST: 5-30 U/L / 10-41 U/L
6. Bilirubin (total): 0.3-1.9 mg/dL / 0.1-1.2 mg/dL

Reference Intervals for Lipid Profile
Total Cholesterol
HDL-C
LDL-C
Triglycerides

Total Cholesterol: <200 mg/dL
HDL-C: >39 mg/dL
LDL-C: <100 mg/dL
Triglycerides: 30-149 mg/dL

Reference Intervals for Cardiac Biomarkers
Total CK
CK-MB
cTnl
Myoglobin
BNP

Total CK: 50-200 U/L
CK-MB: <5% total CK
cTnl: <0.01 ng/ML
Myoglobin: 19-92 ug/L
BNP: <20 pg/L

Oxygen Devices: Nasal Cannula Normal
FiO2 Range
Flow Rate

FiO2 = 24% - 44% Variable stability
Flow = 1- 6 L/min Adult

2 - 4 L/min with 28% O2 is what is norm for Nasal Cannula at the hospital setting

If flow rate is greater than 4 L/min or Patient complains of dryness, you will utilize a humidifier.

Oxygen Devices: Simple Mask
FiO2 Range
Flow Rate

FiO2 = 35% - 50% Variable stability
Flow = 5 - 10 L/min

Flow rate of 5 L/min minimum so that CO2 gas can get flushed out of the mask.

Oxygen Devices: Partial Breathing Mask
FiO2 Range
Flow Rate

FiO2 = 40% - 70% Variable stability
Flow = Minimum of 10 L/min

Flow rate of must be at least 10 L/min to prevent the bag from collapsing during inspiration

Oxygen Devices: Non-Breathing Mask FiO2 Range Flow Rate

FiO2 = 60% - 80% Variable stability Flow = Minimum of 10 L/min Flow rate of must be at least 10 L/min to prevent the bag from collapsing during inspiration

Oxygen Devices: Venturi Mask (AEM) FiO2 Range Flow Rate

FiO2 = 24% - 50% Fixed stability Flow = Varies; should provide output flow >60 L/min

Oxygen Devices: HFNC: Optiflow FiO2 Range Flow Rate

FiO2 = 21% - 100% Fixed stability Flow = 5 - 60 L/min 1. The flowmeter on the optiflow can go up to 70 L/min 2. Heater Pot Temps: 31C Invasive - 37C Vasive. Start at 37C and work down to 31C if patient complains. 3. Prongs on HFNC should not occlude more than 50% of patient's nares.

Oxygen Devices: HFNC: Vapotherm FiO2 Range Flow Rate

FiO2 = 21% - 100% Fixed stability Flow = 5 - 40 L/min

PEEP: Positive End Expository Pressure

1. For every 10 L/min of air flow you get 1cm of PEEP 2. Example: 60 L/min = 6 cm of PEEP 3. PEEP is indicated when Pt's oxygenation is not improving (Refractory hypoxemia) 4. PEEP valve is placed on the Respiratory Valve on the AMBU Bag 5. PEEP has a start value of 5cmH2O. 5 - 20 cmH2O is the range of PEEP given to patients.

Total Flow: Patient on 50% VM running at 10 lpm

Liters Air/Liter O2 = (100-50) / (50-21) = 50/29 = 1.7 1.7 : 1 = 1.7 + 1 = 2.7 2.7 x 10 lpm = 27 lpm Total Flow 1. Use 20 if desired O2 is greater than 40% 2. Use 21 if desired O2 is less than 40% 3. "Magic Box" Method

Suction Pressure: Normal (adult, child, neonates)

Adult: 100 - 120 mmHg Child: 80 - 100 mmHg Neonate: 60 - 80 mmHg