Respiratory Flashcards
If pCO2 is high, pH is
low (acidosis)
If pCO2 is low, pH is
high (alkalosis)
If HCO3 is high, pH is
high (alkalosis)
If HCO3 is low, pH is
low (acidosis)
pCO2 normal range
35-45 mmHg (respiratory)
pO2 normal range
80-100 mmHg
pH normal range
7.35-7.45 (metabolic)
HCO3 normal range
22-26
B-type natriuretic peptide (BNP) is
heart failure marker, released by an over-distention of the heart ventricles
B-type natriuretic peptide (BNP) - normal, critical ranges
500 - heart failure
Define PaO2
Pressure of arterial oxygen (mmHg)
Bariobariatrauma
nitrogen release by obese patients at altitude - preoxygenate with NRB for at least 15 minutes prior to lift-off
Three killers of vented patients during flight
tension pneumothorax pericardial tamponade hypovolemia
Define SaO2
Saturation of arterial oxygen (%)
Define SAO2
Saturation of alveolar oxygen (%)
Proper site for chest tube insertion is
4-5th ICS anterior axillary line
A patient in early shock will likely have what acid-base imbalance?
respiratory alkalosis (from hyperventillation)
Appropriate sites for NCD insertion are
2d ICS mid-clavicular line 4-5th ICS anterior axillary line 5-6th ICS mid-axillary line
Electrical alternans may be seen with
Pericardial tamponade (
The antidote for malignant hyperthermia is
Dantroline
Signs of malignant hyperthermia include
Tachycardia, muscle rigidity, rapid increase in ETCO2
What is Hamman’s sign? What does it indicate?
Crunching sound heard with auscultation of anterior chest during heartbeats. Tracheobronchial injury
The first step to increase PaO2 is
Increase FiO2
Minute ventilation is
Respiratory Rate * Tidal Volume
High pressure vent alarms can be caused by __? What is the mnemonic?
D isplaced tube (Down, mainstem) O bstructed tube P neumothorax (Tension) E quipment failure S tacked breaths
Low pressure vent alarms can be caused by __?
Hypovolemia Displaced tube (extubated) Tubing Leaks Loose connections
Normal tidal volume is
6-10 mL/kg
Acute respiratory failure is defined as
PaO2 50mmHg
Adult ideal weight (for vent) is calculated as
Men = 50kg, Women = 45kg Above + (2.3kg / 1” over 60”) ex: 69” Male = 70.7kg
A left shift in the oxyhemoglobin dissociation curve can be caused by?
Left = low
“L” in “alkalosis” (low H+)
A right shift in the oxyhemoglobin dissociation curve can be caused by?
Right = raised
No “L” in “acidosis” (raised H+)
A left shift in the oxyhemoglobin dissociation curve causes oxygen to be?
Increased affinity of oxygen to hemoglobin - oxygen is released less easily (at tissues), but bound more easily (in lungs)
A right shift in the oxyhemoglobin dissociation curve causes oxygen to be?
Reduced affinity of oxygen to hemoglobin - oxygen is released more easily (at tissues), but bound less easily (in lungs)
The defasiculating dose of a non-depolarizing neuromuscular agent is usually
10% of the normal RSI dose
If PIP does not change on a vented patient, always increase
Tidal volume before rate
An elevated anion gap may indicate what acid/base disturbance?
Metabolic acidosis
Ketamine is the drug of choice for patients requiring intubation due to what problem?
Asthma
A vented ARDS patient would require what unusual vent settings?
Low Vt
High PEEP
Excessive mucous secretions and chronic inflammation defines what disease process?
Chronic bronchitis
What is the typical description of the chest x-ray for a COPD patient?
Hyperinflated lungs
Narrow, elongated heart shadow
Increase A-P diameter
Flattened hemidiaphragm
What is the typical description of the chest x-ray for an ARDS patient?
Widespread infiltrates
“Ground-glass” appearance
What is the typical description of the chest x-ray for a pneumonia patient?
Lobular infiltrates and consolidation
What is the typical description of the chest x-ray for a CHF patient?
Cardiomegaly
Pulmonary Congestion
The nickname for patients with chronic bronchitis is
Blue bloaters (obstructed airflow leads to barrel chest and cyanotic appearance)
The nickname for patients with emphysema is
Pink puffers (destruction of alveoli leads to increased hematocrit)
Metabolic alkalosis may be caused by
Excessive vomiting Prolonged NG suctioning Diuretics
An increase of 10 in the PaCO2 causes the pH to
Decrease by approximately 0.08
A decrease of 10 in the PaCO2 causes the pH to
Increase by approximately 0.08
Anion gap is calculated by
AG = (Na + K) - (Cl + HCO3) K is usually omitted since a low value
Normal anion gap is
8 - 16
An elevated anion gap suggests
Metabolic acidosis
The causes of high anion gap acidosis are? What is the mnemonic?
M ethanol
U remia
D KA
P araldehyde/Propylene glycol
I Iron
L actic Acidosis
E thanol/Ethylene glycol
R enal Failure/Rhabdo
S alycylates/Starvation
