Part 2 Flashcards by Unknown Unknown

What is the mechanism of action of Ketamine in trauma?

Ketamine does not suppress laryngeal reflexes, helping to maintain the patient’s airway.

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What is the dose of Morphine for mild pain control?

2 mg IV/IM/IO (Q4H as needed)

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What is the preferred route for administering Morphine?

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What are common side effects of Morphine?

Hypotension
Pruritis
Nausea
Flushing

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What is the reversal agent for Morphine?

Naloxone (Narcan) 0.4-2 mg

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Fentanyl is how many times more powerful than Morphine?

100 times

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What are the available strengths of Fentanyl lozenges (Actiq)?

400 mcg
800 mcg

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What is the onset time and duration of Fentanyl?

Onset: 1-2 minutes, Duration: 45-60 minutes

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What is the tidal volume (Vt) definition?

The amount of air the patient breathes in a normal breath.

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What can excessive tidal volume cause?

Ventilator-Induced Lung Injury (VILI)

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What is the formula for Vital Capacity (VC)?

VC = Tidal Volume (Vt) + Inspiratory Reserve Volume (IRV) + Expiratory Reserve Volume (ERV)

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Where are central chemoreceptors located?

In the medulla/pons

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What drives the response of central chemoreceptors?

CO2 and H+ levels in cerebral spinal fluid (CSF)

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What is the definition of V/Q in respiratory physiology?

Ventilation/Perfusion ratio

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What is the Fick formula used for?

To measure oxygen uptake by the lungs.

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What characterizes hypercarbic respiratory failure?

Inability to remove CO2, evidenced by respiratory acidosis.

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What is the treatment for hypoxic respiratory failure?

Increase tidal volume and O2 concentration.

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What are apneustic respirations characterized by?

Deep, gasping inspiration with a pause at full inspiration.

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What is the primary goal of ventilator management?

Ensure adequate tidal volume and respiratory rate.

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What does PEEP stand for?

Positive End Expiratory Pressure

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What is the normal range for tidal volume (Vt) settings?

6-8 cc/kg of ideal body weight (IBW)

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What is the purpose of CPAP?

To maintain a continuous level of PEEP.

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What does the acronym DOPE stand for in ventilator alarms?

Dislodged
Obstructed
Pneumothorax
Equipment failure

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What is the definition of Peak Expiratory Flow Rate (PEFR)?

Maximum speed of expiration, measured with a peak flow meter.

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What is the typical PEFR range for males?

500 to 700 L/min

What is the primary treatment for asthma exacerbation?

* Increase I:E ratio to 1:4 * High flow O2 * Bronchodilators * IV Fluids

What characterizes COPD?

The problem is breathing out.

What is the most common cause of pneumonia?

Viral infections

What does ARDS stand for?

Acute Respiratory Distress Syndrome

What is the main focus in managing ARDS?

Oxygenation with increased PEEP and high tidal volumes.

What are the typical cardiac output (CO) values?

4-8 L/min

What does stroke volume (SV) depend on?

* Preload * Contractility * Afterload

What is pulmonary hypertension?

A condition where pulmonary arteries constrict.

What is the relationship between systemic perfusion and blood vessels?

In response to decreased systemic perfusion, blood vessels constrict.

What happens to cardiac output (CO) with increased systemic vasoconstriction?

Cardiac output increases.

How is cardiac output (CO) calculated?

CO = HR x SV.

What is the normal range for cardiac output (CO)?

4-8 L/min.

What does stroke volume (SV) depend on?

Preload, contractility, and afterload.

Define preload.

The load that stretches cardiac tissue before contraction.

What is contractility?

The intrinsic ability of the myocardium to contract.

What does the Frank-Starling law state?

Stroke volume increases in response to an increase in blood volume filling the heart.

What is afterload?

The degree of vascular resistance to ventricular contraction.

What factors affect right heart afterload?

Pulmonary arteries.

What factors affect left heart afterload?

Systemic vascular resistance.

What is pulmonary vascular resistance (PVR)?

A measure of afterload of the right heart.

What is the normal range for pulmonary vascular resistance (PVR)?

50-250 dynes.

What can increase pulmonary vascular resistance (PVR)?

* Acidosis * Hypercapnia * Hypoxia * Atelectasis * ARDS

What decreases pulmonary vascular resistance (PVR)?

* Alkalosis * Hypocapnea * Vasodilating drugs

What is systemic vascular resistance (SVR)?

A measure of afterload of the left heart.

What is the normal range for systemic vascular resistance (SVR)?

800-1200 dynes.

What factors can increase systemic vascular resistance (SVR)?

* Hypothermia * Hypovolemic shock * Decreased CO

What factors can decrease systemic vascular resistance (SVR)?

* Anaphylaxis * Neurogenic shock * Spinal shock * Septic shock * Vasodilating drugs

What does S1 heart sound represent?

Closure of the bicuspid and tricuspid valves.

What does S2 heart sound represent?

Closure of the aortic and pulmonic valves.

What does S3 heart sound indicate?

Excess filling of the ventricles.

What are common causes of S3 heart sound?

* Congestive heart failure * Chordae tendineae dysfunction

What does S4 heart sound indicate?

Blood forced into a stiff ventricle.

What are common causes of S4 heart sound?

* Hypertrophic cardiomyopathy * Hypertension * Myocardial infarction

What is the Right Coronary Artery (RCA) responsible for?

Supplying the right ventricle and SA node in most of the population.

What is the significance of a blockage in the Left Coronary Artery (LCA)?

It is called the 'widow maker' due to its critical importance.

What does STEMI stand for?

ST Segment Elevation Myocardial Infarction.

What is a hallmark of STEMI on an EKG?

ST elevation in 2 contiguous leads >2mm.

What are positive cardiac markers associated with STEMI?

* CK-MB * Troponin * MB

What differentiates Non-STEMI from STEMI?

ST depression or dynamic T wave changes in 2 contiguous leads.

What is the main characteristic of unstable angina?

Angina not relieved by rest or nitroglycerin.

What does a cardiac panel typically include?

* Troponin I * CK-MB * MB

How long after onset can Troponin I be detected?

2 hours.

When does Myoglobin peak after an event?

4 to 9 hours.

What is the approach to interpreting a 12 lead EKG?

Be consistent and identify normal/abnormal patterns.

What does the PAILS approach refer to in EKG interpretation?

A systematic method for identifying MI types.

What is the treatment for an inferior MI?

2L fluid challenge, no nitro or beta blockers.

What are reciprocal changes in EKG?

Inverted QRS complex or ST segment depression.

In what leads would you find ST segment changes for an anterior MI?

V2, V3, V4.

What is the treatment for lateral MI?

MONA.

Fill in the blank: The degree of vascular resistance to ventricular contraction is called _______.

[afterload]