Oxygen therapy

Question 1

causes of airway obstruction

Answer 1

CNS depression
foreign body (blood, vomit, secretions, food) 
trauma 
blocked tracheostomy 
swelling (infection, oedema) 
laryngospasm, bronchospasm

Question 2

causes of breathing porblem

Answer 2

CNS depression causing decreased repsiratory drive
poor/diminished respiratory effort from muscle weakness/pain/restrictive abnormalities
disorders of lung function - pneumonia, pneumothorax, haemothorax, asthma, PE, ARDS, oedema

Question 3

cause of circulatory problem

Answer 3

primary cardiac –> ischaemia, arrhytjmia, cardiac failure, tamponade, rupture, myocarditis, HOCM

secondary cardiac –> asphyxia, tension pneumothorax, blood loss, hypoxia, hypothermia, septic shock, hyperthermia, rhabdomyolysis

Question 4

assessing breathing

Answer 4

Look for signs of respiratory distress
• Count respiratory rate
• Assess depth/quality of breathing
• Note chest deformity, raised JVP, abdominal
distension
• Record FiO2 and SpO2
• Listen near the face then palpate, percuss &
auscultate the chest
• Trachea position?
• Decide upon specific treatments

Question 5

oxygen flow l/min and FiO2: 1

Answer 5

24%

Question 6

oxygen flow l/min and FiO2: 2

Answer 6

28%

Question 7

oxygen flow l/min and FiO2: 3

Answer 7

32%

Question 8

oxygen flow l/min and FiO2: 4

Answer 8

36%

Question 9

oxygen flow l/min and FiO2: 5

Answer 9

40%

Question 10

oxygen flow l/min and FiO2: 6

Answer 10

44%

Question 11

oxygen flow l/min and FiO2: 7

Answer 11

48%

Question 12

oxygen flow l/min and FiO2: 8

Answer 12

52%

Question 13

oxygen flow l/min and FiO2: 9

Answer 13

56%

Question 14

oxygen flow l/min and FiO2: 10

Answer 14

60%

Question 15

nasal cannulae flow rate

Answer 15

1-6l/min

Question 16

hudson mask flow rate

Answer 16

5-10l/min

Question 17

NRM

Answer 17

12-15l/min

Question 18

BVM

Answer 18

15l/min + positive pressure

Question 19

CPAP

Answer 19

1-15L + positive pressure

Question 20

ventilator

Answer 20

1-15L + invasive positive pressure

Question 21

blue venturi flow rate and oxgyen delivered

Answer 21

2L/min 24%

Question 22

white venturi flow rate and oxgyen delivered

Answer 22

4l/min 28%

Question 23

yellow venturi flow rate and oxgyen delivered

Answer 23

8l/min 35%

Question 24

red venturi flow rate and oxgyen delivered

Answer 24

10l/min 40%

Question 25

green venturi flow rate and oxgyen delivered

Answer 25

15l/min 60%

Question 26

NRBM

Answer 26

15l/min 85%

Question 27

What criteria do you look at if spontaneous pneumothorax

Answer 27

age>50 and significant smoking history

evidence of underlying lung disease on exam / CXR

Question 28

what to do if bilateral/ahemodynamically unstable pneumothorax

Answer 28

proceed to chest chain

Question 29

primary pneumothorax mx if >2cm / breathless

Answer 29

aspiration with 15-18G cannula

Question 30

primary pneumothorax mx if not <2cm / breathless q

Answer 30

consider discharge review in OPD 2-4 weeks time

Question 31

secondary pneumothorax >2cm/breathless

Answer 31

chest drain size 8-14

Question 32

secondary pneumothorax size 1-2cm mx

Answer 32

aspirate with a 16-18G cannula

Question 33

secondary pneumothorax <1cm

Answer 33

admit with high flow oxygen and observe for 24 hours

Question 34

what happens if you aspirate a pneumothorax size 1-2cm and it is unsuccessful

Answer 34

insert a chest drain

Question 35

triangle of safety

Answer 35

lateral border of pec major
mid axillary line
level of nipple

Question 36

ECG findings PE

Answer 36

sinus tachy 
S1Q3T3 
non specific ST changes 
RAD 
s wave (I and aVL) >1.5mm 
Q wave in III and avf 
p pulmonale 
RBBB