Caused by damage to lungs/airway - Emphysema/bronchitis

respiratory week Flashcards by Sio FitzGerald

EXTERNAL RESPIRATION

External respiration is the formal term for gas exchange. It describes both the bulk flow of air into and out of the lungs and the transfer of oxygen and carbon dioxide into the bloodstream through diffusion.

KP: HAPPENS IN THE ALVEOLI

How well did you know this?

Not at all

Perfectly

INTERNAL RESPIRATION

Internal respiration is the process of diffusing oxygen from the blood, into the interstitial fluid and into the cells

KP: HAPPENS AT A CELLULAR LEVEL

How well did you know this?

Not at all

Perfectly

PARTIAL PRESSURE

Allows gases to flow from an area of high pressure to an area of low pressure

How well did you know this?

Not at all

Perfectly

PASSIVE DIFFUSION

The movement of material from an area of high concentration to an area of low concentration without any energy input

How well did you know this?

Not at all

Perfectly

PERFUSION

Passage of fluid from a system (respiratory/lymphatic) to an organ/tissue.

KP: Passage of blood to capillary bed in tissue

How well did you know this?

Not at all

Perfectly

WHAT POSITION WOULD A DCI PATIENT TRAVEL IN

SUPINE

How well did you know this?

Not at all

Perfectly

TOTAL LUNG CAPACITY

The volume of air in the lungs upon the maximum effort of inspiration

KP: AVERAGE MALE = 6L

How well did you know this?

Not at all

Perfectly

TIDAL VOLUME

The amount of air that can be inhaled or exhaled during one respiratory cycle

KP: TYPICALLY 500-600ml

How well did you know this?

Not at all

Perfectly

INSPIRATORY RESERVE VOLUME

Amount of air that can be forcibly inhaled after a normal tidal volume. IRV usually kept in reserve, but is used during deep breathing

KP: TYPICALLY 1900-3300ml

How well did you know this?

Not at all

Perfectly

EXPIRATORY RESERVE VOLUME

The volume of air that can be exhaled forcibly after exhalation of normal tidal volume.

KP: TYPICALLY 700-1200ml
ERV reduced with obesity/ recent upper abdominal surgery etc.

How well did you know this?

Not at all

Perfectly

RESIDUAL VOLUME

The volume of air remaining in the lungs after exhalation

KP: TYPICALLY 1200ml

How well did you know this?

Not at all

Perfectly

MINUTE VOLUME

Amount of gas inhaled and exhaled from a persons lung in 1 minute

How well did you know this?

Not at all

Perfectly

PULMONARY EMBOLISM

Blood clot that blocks and stops blood flow to an artery in the lung

How well did you know this?

Not at all

Perfectly

PULMONARY OEDEMA

Too much fluid in the lungs

How well did you know this?

Not at all

Perfectly

ASTHMA

Chronic inflammatory Response
Narrowing of airways

How well did you know this?

Not at all

Perfectly

CYSTIC FIBROSIS

Mucus build up in respiratory tract/ digestive tract

How well did you know this?

Not at all

Perfectly

COPD

Caused by damage to lungs/airway

Emphysema/bronchitis

How well did you know this?

Not at all

Perfectly

BRONCHITIS

Inflammation of lining of Bronchial Tree

How well did you know this?

Not at all

Perfectly

EMPHYSEMA

Damage to alveoli - caused by smoking

How well did you know this?

Not at all

Perfectly

PNEUMONIA (RESP. SEPSIS)

Infection that inflames alveoli and surrounding tissue

How well did you know this?

Not at all

Perfectly

PNEUMOTHORAX

Collapsed lung

KP: OPEN/CLOSED
TREATMENT: OCCLUSIVE DRESSING
NEEDLE DECOMPRESSION

How well did you know this?

Not at all

Perfectly

HYPOXIC DRIVE

CENTRAL CHEMORECEPTORS - in medulla oblongata - operates off getting CO2 out

PERIPHERAL CHEMORECEPTORS - in arch of AORTA - operate on getting O2 in

How well did you know this?

Not at all

Perfectly

TYPES OF Adventitious lung sounds

WHEEZE
RALES (CRACKLES)
STRIDOR
RHONCHI/ RHONCHUS
PLEURAL RUB

How well did you know this?

Not at all

Perfectly

WHAT CAN RALES (CRACKLES) INDICATE

PNEUMONIA
CONGESTIVE HEART FAILURE

How well did you know this?

Not at all

Perfectly

WHAT CAN STRIDOR INDICATE

UPPER AIRWAY OBSTRUCTION/ INFECTION INFLAMMATION OF AIRWAY

WHAT CAN RHONCHI INDICATE

PNEUMONIA COPD CYSTIC FIBROSIS

WHAT CAN PLEURAL RUB FRICTION INDICATE

PULMONARY EMBOLISM RECENT CHEST TRAUMA/SURGERY VIRAL/BACTERIAL INFECTION

WHAT CAN A WHEEZE INDICATE

ASTHMA COPD UPPER RESPIRATORY INFECTION

DESCRIBE RHONCHI

LOW- PITCH SNORING GURGLING

SIGNS AND SYMPTOMS FOR MODERATE ASTHMA EXACERBATION

PEFR > 50-75% INCREASED SYMPTOMS NO SIGNS OF ACUTE SEVERE ASTHMA

SIGNS AND SYMPTOMS FOR ACUTE SEVERE ASTHMA

PEFR 33-50% RR ≥25 HR ≥ 110

SIGNS AND SYMPTOMS FOR LIFE THREATENING ASTHMA

PEFR <33% ANY ONE OF THE FOLLOWING: - SPO2 <92

SPECIAL CLINICAL CONSIDERATIONS FOR ADVANCED AIRWAY MANAGEMENT

GCS = 3 SPO2 < 92% RR ≤ 9 BVM ineffective (All above must be present)

VENTILATION RATE FOLLOWING SUCCESSFUL ADVANCED AIRWAY

8-10 per minute

UNSYNCHRONISED CHEST COMPRESSION RATE

100-120 per minute

WHAT MUST BE ENSURED AFTER SUCCESSFUL AIRWAY MANAGEMENT

CO2 detection device in ventilation circuit

ABNORMAL WORK OF BREATHING - ADULT WHAT PERCENTAGE OF OXYGEN IS GIVEN?

100% O2 initially unless patient has known COPD Titrate O2 to standard as clinical condition improves

What would you do if patient presents with Raised ETCO2 + Reduced SPO2

Consider assisted ventilation

What would you do if patient presents with raised ETCO2 + Normal SPO2

Encourage deep breaths

WHAT WOULD BE CONSIDERED FOLLOWING ASYMMETRICAL BREATH SOUNDS

Consider collapse, consolidation & fluid

EXACERBATION OF COPD if there is no oxygen alert card What percentage would you commence oxygen therapy at?

28% Titrate to SPO2 92%

EXACERBATION OF COPD What is the medication plan?

- Oxygen therapy - Salbutamol 5mg NEB - IPRATROPIUM BROMIDE 500mcg + Salbutamol 5mg NEB mixed If condition deteriorates/ becomes unstable? REQUEST ALS - Hydrocortisone 200mg IM

EXACERBATION OF COPD What can be considered for profound refractory hypoxia

CPAP

ASTHMA - adult What is considered prior to administering salbutamol?

PEFR

ASTHMA - adult What is considered prior to administering salbutamol?

PEFR

ASTHMA - adult At what point would you consider ALS?

If patient does not improve following administration of salbutamol

ASTHMA - adult If no improvement Salbutamol aerosol 100mcg may be repeated how many times?

Up to 11 times as required

ASTHMA - adult What is the medication treatment plan?

Salbutamol 5mg NEB/ Salbutamol (100mcg) metered aerosol *No improvement* Salbutamol 5mg NEB OR IPRATROPIUM BROMIDE + SALBUTAMOL NEB mixed *No improvement* Salbutamol 5mg NEB *No improvement* Salbutamol 5mg NEB *No improvement* Salbutamol 5mg NEB

ASTHMA - adult What is the medication treatment plan?

CPAP volumes?

5cm - 8L 10cm - 12L

Inclusion criteria for CPAP

Clinical signs of APO RR > 25 SPO2 < 95%

Exclusion criteria for CPAP

SBP < 90mmHg Persistent nausea/vomiting Inability to sit up Pneumothorax GI bleed/recent gastric surgery

What is the medication plan for APO?

Oxygen therapy GTN 800mcg SL (repeat x1 PRN) Consider CPAP

Operating CPAP

- commence with 5cm H2O - Titrate up to 10cm H2O as tolerated - monitor clinical response - Titrate O2 to maintain SPO2 >95%

HOW MANY LITRES IN CD CYLINDER

460

HOW MANY LITRES IN F CYLINDER

1,360

HOW MANY LITRES IN E CYLINDER

680

HOW MANY LITRES IN ZX CYLINDER

3040

WHAT IS A POTENTIAL SIDE EFFECT OF PROLONGED USE OF OXYGEN WITH COPD PATIENTS

Reduction in ventilation stimulus

WHAT SHOULD BE CONSIDERED FOR PAEDIATRIC PATIENTS RECEIVING OXYGEN FOR >30 MINS

Humidified oxygen

WHAT IS THE SPO2 INDICATION FOR THE ADMINISTRATION OF OXYGEN FOR A.P.O

<92%