Respiratory Distress Flashcards
1
Q
causes of hypoxemia
A
- hypoventilation
- right to left shunt
- ventilation-perfusion (V/Q) mismatch
- diffusion impairment
- low inspired oxygen
2
Q
- caused by alveolar hypoventilation
- causes: depressed respiratory drive, brainstem lesions, drugs, toxins, thoracic cage disorders, obesity, neuromuscular impairment/disease/toxin, intrinsic lung disease, COPD, upper airway obstruction
- acute–> Increased ICP: headache–> confusion–> lethargy–> seizures–> coma–>cardiovascular collapse
- chronic may be well tolerated
A
Hypercapnea
3
Q
pH > 7.4
A
primary alkalosis
4
Q
pH < 7.4
A
primary acidosis
5
Q
pCO2 > 40
A
metabolic alkalosis
respiratory acidosis
6
Q
pCO2 < 40
A
respiratory alkalosis
metabolic acidosis
7
Q
Cardiac vs. Non-cardiac
A
- negative BNP rules out cardiac cause
- echocardiography
- “all that wheezes is not asthma”
8
Q
what predicts difficulty with non-invasive advanced measures
A
BONES
- Beard
- obese
- no teeth
- elderly
- snoring/osa
9
Q
pressure that the machine delivers on inspiration
A
IPAP
10
Q
expiratory positive airway pressure that is mainted during expiration to keep alveoli open and mainted to improve oxygenation
A
EPAP
11
Q
indications for intubation
A
- A= airway protection and patency
- B= respiratory failure, increase FRC, decrease WOB, secretion management/pulmonary toilet, facilitate bronchoscopy
- C= minimize oxygen consumption and optimize oxygen delivery (e.g, sepsis)
- D= unresponsive to pain, terminate seizure, prevent secondary brain injury
- E= temperature control
- F= for humanitarian reasons (e.g, procedures) and for safety and transport
12
Q
status asthmaticus: adjuncts
A
- magnesium
- nippv- decreases need for intubation, hospitalization
- ketamine- inhibits reuptake of norepinephrine
- heliox
13
Q
Admit astham pts if
A
poor response to treatment, persistent symptoms
PEF < 40% expected
status asmaticus
mecahnical ventilation
ABG: progressive hypercarbia, acidosis
exhaustion or confusion
