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Critical Care 2019 > Term 1 > Flashcards

Term 1 Flashcards

1
Q

Prospective Observational Study

A

Same as cohort study

Certain condition/treatment vs no condition/treatment

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2
Q

Succinylcholine

Class, MOA, dose, range, onset, duration

A 
Class: depolarizing paralytic
MOA: mimics Ach
Dose: 1.5 mg/kg for induction
Range: 1-1.5 mg/kg
Onset: 1 min
Duration: 6 mins
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3
Q

Troubleshoot a low minute volume (LMV) alarm

A
  • check patient (RR, Vt)
  • check circuit (disconnect, leak)
  • review alarm setting perimeters
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4
Q

Reasons for a high PEEP alarm

A
  • autoPEEP is high

- PEEP dial is set (LTV 1000 circuit)

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5
Q

Case-control study

A

Find one case and look for variables.

e.g. look at a group of people who have a known disease and they try to work backwards to determine what they have in common that might have caused the disease.

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6
Q

Cross-sectional study

A

Observational study of a defined population at a specific point in time.

Exposure and outcome are determined simultaneously

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7
Q

Cohort study

A

Certain condition/treatment vs no condition/treatment

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8
Q

Rocuronium

Class, MOA, dose, range, onset, duration

A 
Class: non-depolarizing paralytic
MOA: blocks Ach
Dose: 1 mg/kg 
Range: 0.6-1.2 mg/kg for RSI
Onset: 1-2 mins
Duration: 30 mins
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9
Q

Random control trial

A

Study subjects are randomly assigned to study/intervention group vs placebo/standard of care/control group.

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10
Q

How to troubleshoot a low pressure alarm

A
  • check tube placement
  • check ET cuff pressure
  • check circuit integrity
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11
Q

Causes of low PEEP alarm

A
  • pt working hard to suck air (adjust vCalc to 40-60)
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12
Q

How to troubleshoot a high pressure alarm

A
  • visual inspection (pt coughing, biting tube)
  • auscultate (pneumo, tube displaced, bronchospasm, secretions)
  • suction ET tube (non-visible secretions)
  • inspect chest (subQ air, chest compression, hyperinflation)
  • inspect the circuit (kinks, disconnect, sensor reversal)
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13
Q

Alaris pump flow rate ranges

A

0.1 ml/min - 999 ml/min

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14
Q

High pressure alarm setting

A

10 cm H2O above PIP

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15
Q

Low pressure alarm setting

A

5 cmH2O above PEEP

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16
Q

Minute volume alarm setting

A

10% below VE in L/min

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17
Q

What are the controlled substances (according to government)?

A

Morphine, fentanyl, lorazepam, midazolam, ketamine

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18
Q

What are the targeted substances?

A

Midazolam, lorazepam

19
Q

What are the controlled substances according to BCEHS?

A

Morphine, fentanyl, midazolam, lorazepam, ketamine, propofol, haloperidol.

20
Q

What schedules are each controlled substance under?

A 
Morphine (I)
Fentanyl (I)
Ketamine (I)
Lorazepam (IV & benzo act)
Midazolam (IV & benzo act)
21
Q

What is the physiologic zone?

A

Area of the atmosphere that contains the oxygen content and barometric pressure for a healthy person to live.

(Sea level - 10,000’ or pressure of 520)

22
Q

What is the physiologically deficient zone?

A

The area of the atmosphere where the decreased barometric pressure can cause hypoxia hypoxemia.

(10,000-50,000’ or >520)

23
Q

What are the types of hypoxia?

A

Hypoxic
Histotoxic
Stagnant
Hypemic

24
Q

What is Boyle’s Law?

A

The volume of a gas is inversely proportional to the pressure to which it is subjected.

25
Q

What is Charles’ Law?

A

When pressure is constant, the volume of gas is proportional to its absolute temperature

26
Q

What is Dalton’s Law?

A

The total pressure of a gas mixture is the sum of the individual partial pressures of the gases in the mixture.

27
Q

What is Fick’s Law?

A

The net diffusion rate of a gas across a fluid membrane is proportional to the difference in partial pressure, proportional to the area of the membrane and inversely proportional to the thickness of the membrane.

28
Q

What is the Universal Gas Law?

A

How a hypothetical gas should act if there are no variables affecting it (a.k.a. Ideal gas law)

29
Q

What is Gay-Lussac’s Law?

A

The pressure of a gas when volume is maintained constant is directly proportional to the temperature.

30
Q

What is Graham’s Law?

A

The rate at which gases diffuse is related inversely to the square root of their densities.

31
Q

What is Henry’s Law?

A

The amount of gas in a solution varies directly with the partial pressure of a gas over the solution.

32
Q

What are the stages of hypoxia?

A 
Indifferent stage (night vision affected)
Compensatory stage (tachycardia, tachypnea, increased cardiac outpt)
Disturbance stage (weakness, confusion, irritability) 
Critical stage (loss of consciousness, seizures, respiratory arrest, death)
33
Q

What is effective performance time?

A

The amount of time an individual is able to perform useful duties in an environment of inadequate oxygen.

34
Q

What is time of useful consciousness?

A

The time between a person’s sudden deprivation of oxygen at a given altitude to the point at which deliberate function is loss. A person is no longer capable of taking proper corrective or protective actions.

35
Q

What is the hierarchy of evidence?

A
  1. Meta analyses
  2. RCT with definitive results
  3. RCT with non-definitive results
  4. Cohort studies
  5. Case-control studies
  6. Cross-sectional surveys
  7. Case reports
36
Q

What are the primary stressors of flight?

A 
Vibrations/noise
Decreased humidity
Decreased PO2
G forces
Thermochanges
37
Q

What are the characteristics of a good study question?

A 
F - feasible 
I - interesting
N - new
E - ethical
R - relevant
38
Q

What is specificity?

A

“Spin” is able to rule things in.

39
Q

What is sensitivity?

A

“Snout” the ability to rule things out.

40
Q

What are the complications of administering blood?

A
  • anaphylaxis
  • hemolytic reaction
  • DIC
  • transfusion reaction
  • infection
41
Q

What is the definition of a massive transfusion?

A

4-6 units within 4 hours OR
>10 units OR
>1 blood volume in 24 hr period

42
Q

What are the signs and symptoms of a transfusion reaction?

A

Fever
Dyspnea
Urticaria
Hypotension

43
Q

What is transpulmonary pressure?

A

The difference between the alveolar pressure and pleural pressures.

Airway pressure - intrapleural pressure = Transpulmonary pressure

PPlat - ESB = transpulmonary pressure

Should be < 25 cmH2O

44
Q

How many oscillations should you see on a square waveform test?

A
  1. <2 = overdampened (pressure bag, poor site, air in line, loose connections)
    >2 = underdampened (non-compliant tubing, tachycardia)

Critical Care 2019 (1 decks)

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