Stanford CA-1 Prep (Basic Monitoring) Flashcards
Oxygen probes emit light at ______ nanometers to detect unoxygenated blood.
660 (red, for Hgb)
Oxygen probes emit light at 940 nanometer for ___________ blood.
oxygenated (infrared)
In the presence of methemoglobinemia, when true SpO₂ is > 85% you will get a falsely _____ reading.
Low
In the presence of methemoglobinemia, when true SpO₂ is < 85% you will get a falsely _____ reading.
High
What is the typical treatment for methemoglobinemia?
What if the patient has a G6PD deficiency?
- Typical: Methylene Blue
- G6PD Deficiency? → Vitamin C
What are common causes of elevated carboyxhemoglobin levels?
- Smoke inhalation
- VAA degradation
- Dessicated soda lime
What is the treatment for excessive carboxyhemoglobin?
- 100% FiO₂
- Hyberbaric O₂
The cardinal sign of cyanide toxicity is….
Clinical cyanosis despite high SpO₂.
What are two common causes of cyanide toxicity?
- Nitroprusside
- Smoke Inhalation
What is the treatment for cyanide toxicity?
Hydroxycobalamin
Which leads in a 5 lead EKG system are 98% sensitive for the detection of ischemic events?
II, V4, V5
Which lead(s) is/are most sensitive to atrial dysrhythmias?
- Lead II
- V1
How is MAP calculated?
(SBP + 2*DBP) ÷ 3
Where would one want to level the transducer for a neurosurgical case?
At the tragus of the ear to assess cerebral perfusion
Whats the mnemonic for assessing the difference in blood pressure between two different sites?
pH 7.410
pressure of 7.4 mmHg occurs with ever height change of 10 cm
In the beach chair position the BP cuff in the leg reads 120/80 but you note that the brain is 60 cm higher than the cuff. What would you anticipate the pressure in the brain to be?
~ 75/35
What would occur with your arterial waveform as you move away from the proximal aorta?
Systolic amplification
What are the phases in a capnographic waveform?
- VD gas exhaled
- VD and alveolar gas transition
- Alveolar plateua
- Inspiration
Pulse Pressure will increase with _________ stroke volume and ________ vessel compliance.
increased ; decreased
When would PPV be at its apex? How about its lowest?
What aspect of the capnography waveform denotes the change from airway gas to alveolar gas?
the α angle
Significant hypotension can be associated with a ______ in EtCO₂ .
drop
What type of capnography waveform would be anticipated in a patient undergoing bronchospasm?
What are the three overarching causes for a drop in EtCO₂?
- ↓ CO₂ elimination
- ↓ CO₂ production
- Circuit problems
What are the four most common causes related to decreased CO₂ elimination?
- CV collapse (↓CI)
- Venous air embolism
- Large PE
- Kinked, dislodge, or esophageal ETT
What are the three greatest reasons for decreased CO₂ production?
↓ CO₂ production = ↓ metabolism
- Hypothermia
- Hypothyroidism
- Neuromuscular blockade
During a diagnostic laparascopy, an intubated and anesthetized patient is placed in trendelenburg. Over the next 20 minutes SpO₂ decreases from 100% to 95%, and EtCO₂ increases from 35 to 40 with no concurrent ventilator setting changes. The most likely reason is:
A. Decreased diaphragmatic excursion
B. Compression of the Vena Cava
C. Carbon Dioxide Embolism
D. Pneumothorax
A. Decreased Diaphragmatic Excursion
What type of capnogram is depicted below?
Normal capnogram
What would you anticipate is the issue based on the capnography below?
Bronchospasm/asthma
- Obstruction
- Kinked ETT or expiratory circuit
What would you anticipate is the issue based on the capnography below?
Hypoventilation likely (increasing CO₂)
- ↓ RR or VT
- ↑ metabolism
- Hyperthermia
What would you anticipate is the issue based on the capnography below?
Hyperventilation likely (decreasing CO₂)
- ↑ resp rate
- ↑ VT
- Metabolic acidosis
- ↓ body temp
What would you anticipate is the issue based on the capnography below?
Rebreathing CO₂
What would you anticipate is the issue based on the capnography below?
Curare Cleft
Indication of neuromuscular blockade wearing off (2-3 minutes until patient movement typically).
