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ALS Paramedic CPG cards > oxygen therapy > Flashcards

oxygen therapy Flashcards

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1
Q

Who does the oxygen therapy guideline apply to?

A

anyone above the age of 12

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2
Q

define adequate oxygen levels according to spo2?

A

Spo2 > 92% RA

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3
Q

Spo2 range for Mild- mod hypoxaemia

A

85-91%

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4
Q

Management of mild-mod hypoxaemia

A

Nasal cannula 2-6l/min

hudson mask 5-10l/min

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5
Q

Spo2 range for severe hypoxaemia

A

<85% or critical illness

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6
Q

outline the critical illness

A
  1. cardiac arrest/resus
  2. major trauma/head injury
  3. anaphylaxis
  4. shock
  5. status epilepticus (seizure)
  6. severe sepsis
  7. ketamine sedation
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7
Q

Management of severe hypoxaemia

A

Non-rebreather 10-15l/min
if inadequate Tidal volume ventilate BVM
once haemodynamically stable titrate to 92-96%
if deteriorate continue BVM 100% O2, consider SGA

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8
Q

list of chronic hypoxaemia

A
  1. COPD
  2. Obesity
  3. Cystic fibrosis
  4. bronchiectasis
  5. Neuromuscular disorder
  6. severe kyphoscoliosis
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9
Q

Management of chronic hypoxaemia

A

titrate to 88-92%
Nasal prongs 2-6l/min
Hudson mask 5-10l/min
if deteriorates treat as severe

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10
Q

regardless of SPO2

A
  1. Toxic gases
  2. Decompression illness
  3. Cord prolapse
  4. Post partum haemorrhage
  5. Shoulder dystocia
  6. Cluster headache

Mx with Non-rebreather 10-15l/min

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11
Q

What conditions are not routinely treated with oxygen?

WHY???

A
  1. Acute coronary syndrome
  2. stroke
  3. arrhythmia
    Why? this pts may c/o feeling SOB, the cause of SOB is a reduction in blood flow to tissues, due to obstruction (clot), leading to ischaemia of tissues
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12
Q

what do you do if you are unable to obtain SPO2?

A

if pt appears hypoxic or SOB admin oxygen 2-6l/min via nasal prongs, or 5-10l/min via hudson mask

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13
Q

SPO2 can be unreliable in pt with?

A
  1. nail polish
  2. hypotension
  3. cold hands
  4. peripheral vascular disease
  5. anaemia
  6. peripherally shutdown
  7. severe asthma
  8. carbon dioxide poisoning
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14
Q

Spo2 goal for paraquat & bleomycin poisoning?

A

85-88%

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15
Q

why do we aim for 85-88% Spo2 in paraquat/bleomycin poisoning?

A

these substances lead to pulmonary damage by triggering the release of oxygen free radicals which can lead to lung damage, causing pulmonary oedema/fibrosis

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16
Q

what is bleomycin?

A

bleomycin is a type of antibiotic used in the treatment of cancers such as non-Hodgkin’s/Hodgkin lymphoma, testicular and cervical cancer. Bleomycin works by inhibiting DNA synthesis, stopping or slowing the growth of cancer cells

17
Q

what is paraquat?

A

paraquat is a form of herbicide, different to organophosphates.

18
Q

benefit of upright position in pts

A
  • aids in inspiration/expiration
  • gas exchange improves
  • gravity exerts pressure on the lungs, compressing the base of the lungs against the diaphragm, increasing surface area & exposing more alveoli for gas exchange. alveoli in bases are smaller, more numerous, meaning less o2 required for gas exchange.
19
Q

what is kyphoscoliosis?

A

Kyphoscoliosis is a condition that causes the abnormal curvature of the thoracic lumbar spine. this condition can lead to the chest wall malformation. this impairs mechanics of respiration, leading to poor chest wall compliance, causing hypoventilation, hypercapnia and respiratory failure. impairs muscles at nerve junctions impairing respiration

20
Q

what is bronchiectasis?

A

Bronchiectasis is a condition in which the lungs/bronchioles become damaged causing airway to permanently widen & impairs mucus clearance, leading to infection and increased dead space.

21
Q

What is capnography?

A

Capnography is the numerical measurement & graphical display of CO2 through respiratory cycle.

ETCO2 – is the measurement of Co2 in the airway at the end of each breath

22
Q

normal ETCO2 range

A

35-45mmHg

arterial 38-45mmHg

23
Q

what happens to ETCO2 when you get rosc

A

spike due to restoration of circulation (restores co2)

24
Q

what happens to ETCO when patient arrests

A

fall or drop, due to loss of circulation

25
Q

What is the purpose of PEEP?

A

The benefit of PEEP is to increase the functional residual capacity and reduce pulmonary compliance.

Meaning increases pressure in the lungs at the end of expiration, reducing the stretch of the lungs, decreasing the lung volume, improving gas exchange

26
Q

What does PEEP stand for?

A

Positive end expiratory pressure

27
Q

What is the benefit of elastic recoild in the lungs?

A

Helps return lungs to resting state and enables passive exhalation. Assists in gas exchange

28
Q

What does work of breathing refer to?

A

WoB refers to the effort required to move air throughout the conducting airways and the ease of lung compliance

29
Q

What is shunting?

A

Refers to deoxygenated blood that does not participate in gas exchange

30
Q

Deadspace refers to

A

An area of no gas exchange

31
Q

Affinity hypoxia is

A

Hypoxia as a result of failure of haemoglobin to release oxygen to tissues

32
Q

Anaemic hypoxia is

A

Hypoxia that is due to reduce oxygen carrying capacity of blood as a result of decrease in haemoglobin or alteration of haemoglobin

33
Q

Historic hypoxia is

A

Impair utilisation of oxygen by tissues

34
Q

Hypoxemic hypoxia is

A

A lack of oxygen reaching the blood, for example high altitude

35
Q

Stagnant hypoxia is

A

Failure to transport sufficient oxygen because of inadequate blood flow

ALS Paramedic CPG cards (22 decks)

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