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MACHS > respiratory > Flashcards

respiratory Flashcards

1
Q

General priorities for respiratory distress

A
  1. Give O2 - British Thoracic society 2017
  2. Positioning - sit upright
  3. Bronchodilator - adrenergic or antichologenic (relax muscle or stop contraction) - BNF 2024 - BNFC 2023
  4. Blood gas - CO2 type 2 failure or O2 type 1 - pH ROME - and electrolyte fluid therapy
  5. Fluid therapy with IV access
  6. Investigations eg. CXR for chest drain
  7. COPD - resp hygeine and cough etiquette
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2
Q

Whats normal range of carbon dioxide?

A

4.6-6.4

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3
Q

Normal pH range

A

7.35-7.45

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4
Q

Whats normal bicarbonate range?

A

22-26

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5
Q

Examples of respiratory acidosis?

A

type 2 respiratory fail;ure
sedation
chronic lung disease
hyperopia causes it

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6
Q

Examples f metabolic acidosis

A

acute kidney injury
diabetetic ketoacidosis

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7
Q

what causes metabolic alkalosis

A

vomiting and diuretics

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8
Q

What does ROME stand for?

A

Respiration opposite
- acidosis - decrease pH and increased Carbon Dioxide
- alkalosis - increased pH and decreased Carbon dioxide

Metabolic equal
- acidosis - decrease pH and decrease bicarbonate
- alkalosis - increase pH and increase bicarbonate

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9
Q

What is type 2 respiration failure?

A

Inability to remove Carbon Dioxide

Hypercapnia
increased RR to compensate

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10
Q

Whats type 1 respiration failure?

A

not enough Oxygen so hypoxia

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11
Q

How does priorities change if type 1 or 2 resp failure?

A

type 1 can use nasal cannula not need peep high flow

type 2 use biPAP as provide peep to open lungs and remove carbon dioxide - as higher pressurised than air

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12
Q

Symptoms of Carbon dioxide retention?

A

type 2 resp failure

  1. drowsy
  2. headache
  3. flushed face
  4. flapping tremor
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13
Q

Why use steroids in respiration deterioration?

A
  1. reduce inflammation
  2. reduce immune response to widen airway
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14
Q

Why use mucolyties in respiration deterioration?

A
  1. expectoration of sputum (coughing up and spitting out sputum)
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15
Q

Why use nebulisers in respiratory distress?

A

replace every 48hrs

  1. increase pressure of oxygen and air o convert liquified to fine spray
  2. inhaled to bronchioles

HELP LOOSEN LUNG SECRETIONS

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16
Q

Normal sodium level

A

135-145

17
Q

Normal potassium levels

A

3.5-5.0

18
Q

Normal acid base balance

A

number of hydrogen ions

same as pH

7.35-7.45

19
Q

Normal carbon dioxide

A

4.6-6.4 kPa

20
Q

Normal oxygen levels

A

11-14 kPa

21
Q

Normal bicarbonate levels

A

22-26 kPa

mop up lactate and carbon dioxide to lower the amount of each if there’s not enough oxygen

22
Q

Normal lactate

A

0.5-2.2 mmol/l

23
Q

Normal glucose levels

A

Before - 4-7
After - 5-9

NICE 2015

24
Q

Reference for lower oxygen sats

A

Beasley et al. 2017

92-96%

25
Q

Which best position?

A

upright as reduce diaphragm compression and assist lung expansion

prone as improve VQ mismatch and decrease pressure on the lungs

Supine causes atelectasis and slumped reduced lung expansion and residual capacity

26
Q

State three types of bronchodilators

A

antichologenic - black reactors stop contraction

adrenergic - beta receptors tro relax smooth muscle (can effect heart)

Methylxanthine - enzyme blocker

27
Q

Why try to avoid intubation?

A

decrease cardiac utput
preload
hepatic perfusion
cause raised intracranial pressure
cause oxygen toxicity
barotrauam
endotracheal tube - infection risk
generate excessive secretions

28
Q

Normal. volume of nasal cannula

A

2-6L

Try stay low
Alternative use 24 or 28% oxygen in venturi mask

29
Q

What are three oxygen methods to use in an emergency?

A
  • Non-rebreath mask - 15L
  • face mask
  • ayres T piece (can change pressure given)
30
Q

DIfference between optiflow and airvo

A

Wall givens 15litres (children) - machine gives 30L (adult)

optiflow is more in neonates it needs specialist as needs Oxyegn and Air piping
- optiflow machines can not be transferred with patients
- both humidified but airvo only requires oxygen in the wall

31
Q

How much oxygen in non-rebreath mask?

A

15 litres

32
Q

How much oxygen in nasal cannula?

A

PIER NETWORK 2015

Adult and Child - 2L - nasal cannula
Can go up to 6Litres

People prefer to face mask which can go 5-10Litre

33
Q

How much oxygen in simple face mask?

A

5-10Litres

British thoracic society guideline 2017

MACHS (6 decks)

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