Reference Charts Flashcards
PIP Definition
Peak inspiratory pressure - the point of maximal airway pressure
PEEP Definition
Positive End Expiratory Pressure - the pressure maintained in the airways at the end of exhalation
Vt Definition
Tidal Volume - the volume of gas entering the patient’s lungs during inspiration.
It Definition
Inspiratory time - the duration of inspiration
Et Definition
Expiratory Time - the duration of time in expiration
MAP Definition (in the context of ventilatioe an)
Mean Airway pressure - the average airway pressure throughout the respiratory cycle.
f Definition
Overall frequency - the sum of mandatory and spontaneous respirations
Pplat Definition
Plateau Pressure - the amount of pressure placed against the alveoli showing alveolar health
FiO2 Definition
Fraction of Inspired Oxygen - percentage of oxygen from 0.21-1.0
Pplat - PEEP definition
Driving pressure - alveolar opening pressure
I:E ratio Definition
Inspiratory vs expiratory time - the ratio of the duration of inspiration to the duration of expiration time
Pinsp Definition
Inspiratory pressure - for the pressure initiated ventilation
PS Definition
Pressure Support - pressure applied at the end of vent circut used in SIMV to augment the patient’s spontaneous breath.
Cstat Definition
Static compliance - compliance during periods without gas flow, such as during an inspiratory pause.
Cstat = (Pplat - PEEP)/Vt
Oxygen adjustment calculation
(FiO2 x P1) / P2
P1 = barometric pressure at patient pickup location
P2 = barometric pressure at flying altitude
Measuring oxygen delivery formulas
CaO2 = [1.34 x Hgb x SaO2] + PaO2 x 0.003
DO2 = CaO2 x Q
DO2= the amount of oxygen delivered each minute
CaO2 = the content of oxygen in the arteries
Measuring cellular uptake of Oxygen
Fick Formula = Cellular uptake of oxygen
[1.34 x Hgb x SvO2] + PaO2 x 0.003
O2ER = (SaO2 - SvO2)/SaO2
Inferior Infarct
12 Leads - II, III, aVF, and v4r
Coronary Artery occlusion - RCA
Treatment pearls - v4r, fluids, careful with nitro, watch for bradycardia
Anterior Infarct
12 leads - v1-v4
Coronary artery occlusion - LAD or Left Main
Treatment pearls - papilary muscle rupture, cardiogenic shock, FONA
Lateral Infarct
12 leads - 1, aVL, v5, v6
Coronary artery occlusion - Left circumflex
Treatment pearls - FONA
Posterior Infarct
12 leads - reciprocal v1-v4
Coronary artery occlusion - RCA/LCX
Treatment pearls - associated with inferior wall MI in 97% of cases
Left Main Insufficiency
12 leads - aVR
Coronary artery occlusion - Left Main
Treatment pearls - elevation in aVR - 1 mm with depression in v1-v4
Arterial Blood Gas Norms
pH: 7.35 -7.45
PaCO2: 35-45
HCO3-: 22-26
PaO2: 80-100
SaO2: >92%
BE: -2 to 2
Venous Blood Gas Norms
pH: 7.31-7.41
PaCO2: 41-51
HCO3-: 23-29
PaO2: 30-40
SaO2: 75%
BE: -2 to 2
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Pediatric ETT size >1 year old
(16 + age) / 4
ETT depth
3 times the tube size
Suction/NG/Foley catheter size formula
2 x ETT size
Chest tube size
4 x ETT size
Fluid Resuscitation
Neonates: 10 ml/kg
Pediatrics: 20 ml/kg
Adult: 30 ml/kg
Fluid maintenance for pediatrics
4 - 2 - 1 Rule
1-10 kg: 4 ml/kg
10-20 kg: 2 ml/kg
>20 kg: 1 ml/kg
Blood administration
O negative is the universal donor
10 ml/kg or base on H&H
Target CVP for sepsis
8-12 mmHg
12 - 15 if history of HTN
Normal Range of MAP (in the context of hemodynamics)
Mean Arterial Pressure
70 - 110 mmHg
perfusion goal is >65
Normal range of SVR
Systemic Vascular Resistance
800 - 1200 dynes/cm2
represents the body’s response of vasoconstriction or ability to compensate
Normal CVP (RAP)
Central Venous Pressure (Right Atrial Pressure)
2 - 6 mmHg
Identifies preload (low = dry, high = overloaded)
Normal CI
Cardiac Index
2 - 4 L/min
Reflection of cardiac output to BMI
Normal RV
Right Ventricular Pressure
20-30 / 0-5 mmHg
Reflection of right atrial kick
Normal PA S/D
Pulmonary Artery pressure
15-25 / 8-15 mmHg
Indirectly reflects LV end diastolic pressure
Normal PCWP
Pulmonary Capillary Wedge Pressure
8-12 mmHg
Direct reflection of left atrial pressure. Indirectly reflects LV end - diastolic pressure
Normal Q
Cardiac Output
4 - 8 L/min
Normal DO2
Delivery of oxygen
700 - 1400 ml/min
Normal VO2
Consumption of oxygen
180 - 280 ml/min
O2ER
Oxygen extraction ratio
20 - 25%
oxygen removed from the blood as it passes through capillaries
SvO2
Central venous oxygen saturation via pulmonary artery catheter
>70%
ScvO2
Central venous oxygen saturation via central line (reflects 5-8% > SvO2)
>70%
Hemodynamic response to shock : Right Failure
CVP: high
CI: low
SVR: high
PCWP: low
Hemodynamic response to shock: Hypovolemia
CVP: low
CI: low
SVR: high
PCWP: low
Hemodynamic response to shock: Cardiogenic
CVP: high
CI: low
SVR: high
PCWP: high
Hemodynamic response to shock: Neurogenic
CVP: low
CI: normal
SVR: low
PCWP: low
Hemodynamic response to shock: Obstructive
CVP: high
CI: low
SVR: high
PCWP: high
Hemodynamic response to shock: Sepsis
CVP: low
CI: low
SVR: low
PCWP: low
CAMTS Day minimums
Non Mountainous, Local: 800’ - 2 miles
Non Mountainous, Cross country: 800’ - 3 miles
Mountainous, Local: 800’ - 3 miles
Mountainous, Cross country: 1000’ - 3 miles
CAMTS Night minimums with NVGs
Non Mountainous, Local: 800’ - 3 miles
Non Mountainous Cross country: 1000’ - 3 miles
Mountainous, Local: 1000’ - 3 miles
Mountainous Cross country: 1000’ - 5 miles
CAMTS Night minimums without NVG
Non Mountainous, local: 1000’ - 3 miles
Non Mountainous, cross counstry: 1000’ 5 miles
Mountainous, Local: 1500’ - 3 miles
Mountainous, Cross country: 1500’ - 5 miles
Brudzinski’s sign
In meningitis, flexion of the neck causes flexion of the hip and knees
Chvostek’s sign
Spasm of the facial fuscles elicited by tapping the facial nerves secondary to hypocalcemia
Cullen’s sign
Bluish discoloration around the umbilicus associated with intraperitoneal hemorrhage or uterine rupture
Grey Turner’s sign
Bruising of the flank due to retroperitoneal bleeding often seen in pancreatitis.
Kernig’s sign
In meningitis, the inability to completely extend the leg when sitting or lying
Kehr’s sign
Referred left shoulder pain secondary to splenic injury
McBurney’s Point
Rebound tenderness in RLQ with deep palpation secondary to appendicitis
Trousseau’s sign
Place BP cuff on upper arm and inflate cuff. Keep the cuff inflated for 3 minutes, the hand will withdraw up and spasm due to hypocalcemia
ASA (aspirin) antidote
No specific antidote so treat with ventilatory support (Ve = 240 ml/kg/min), fluids, and bicarb
Benzodiazepine antodote
Romazicon (Flumazenil)
Beta - Blocker antidote
glucagon
Calcium channel blocker antidote
Calcium gluconate or chloride
Cocaine antidote
Benzodiazepine
Coumadin antidote
Vitamin K
Cyanide antidote
Amyl Nitrate, sodium nitrate, Sodium thiosulfate
Digitalis antidote
Digibind
Ethylene glycol/propylene glycol antidote
IV ethanol, Fomepizole
Methanol antidote
IV ethanol, Fomepizole, folic acid
Opioids antidote
Narcan
Organophosphate antidote
Atropine, 2-Pam Chloride
Potassium Cyanide antidote
Methylene Blue
Tricyclic antidepressant antidote
Bicarb and hypertonic saline
Tylenol antidote
Mucomyst