Term 1 Flashcards
Prospective Observational Study
Same as cohort study
Certain condition/treatment vs no condition/treatment
Succinylcholine
Class, MOA, dose, range, onset, duration
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
Troubleshoot a low minute volume (LMV) alarm
- check patient (RR, Vt)
- check circuit (disconnect, leak)
- review alarm setting perimeters
Reasons for a high PEEP alarm
- autoPEEP is high
- PEEP dial is set (LTV 1000 circuit)
Case-control study
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.
Cross-sectional study
Observational study of a defined population at a specific point in time.
Exposure and outcome are determined simultaneously
Cohort study
Certain condition/treatment vs no condition/treatment
Rocuronium
Class, MOA, dose, range, onset, duration
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
Random control trial
Study subjects are randomly assigned to study/intervention group vs placebo/standard of care/control group.
How to troubleshoot a low pressure alarm
- check tube placement
- check ET cuff pressure
- check circuit integrity
Causes of low PEEP alarm
- pt working hard to suck air (adjust vCalc to 40-60)
How to troubleshoot a high pressure alarm
- 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)
Alaris pump flow rate ranges
0.1 ml/min - 999 ml/min
High pressure alarm setting
10 cm H2O above PIP
Low pressure alarm setting
5 cmH2O above PEEP
Minute volume alarm setting
10% below VE in L/min
What are the controlled substances (according to government)?
Morphine, fentanyl, lorazepam, midazolam, ketamine
What are the targeted substances?
Midazolam, lorazepam
What are the controlled substances according to BCEHS?
Morphine, fentanyl, midazolam, lorazepam, ketamine, propofol, haloperidol.
What schedules are each controlled substance under?
Morphine (I) Fentanyl (I) Ketamine (I) Lorazepam (IV & benzo act) Midazolam (IV & benzo act)
What is the physiologic zone?
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)
What is the physiologically deficient zone?
The area of the atmosphere where the decreased barometric pressure can cause hypoxia hypoxemia.
(10,000-50,000’ or >520)
What are the types of hypoxia?
Hypoxic
Histotoxic
Stagnant
Hypemic
What is Boyle’s Law?
The volume of a gas is inversely proportional to the pressure to which it is subjected.
What is Charles’ Law?
When pressure is constant, the volume of gas is proportional to its absolute temperature
What is Dalton’s Law?
The total pressure of a gas mixture is the sum of the individual partial pressures of the gases in the mixture.
What is Fick’s Law?
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.
What is the Universal Gas Law?
How a hypothetical gas should act if there are no variables affecting it (a.k.a. Ideal gas law)
What is Gay-Lussac’s Law?
The pressure of a gas when volume is maintained constant is directly proportional to the temperature.
What is Graham’s Law?
The rate at which gases diffuse is related inversely to the square root of their densities.
What is Henry’s Law?
The amount of gas in a solution varies directly with the partial pressure of a gas over the solution.
What are the stages of hypoxia?
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)
What is effective performance time?
The amount of time an individual is able to perform useful duties in an environment of inadequate oxygen.
What is time of useful consciousness?
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.
What is the hierarchy of evidence?
- Meta analyses
- RCT with definitive results
- RCT with non-definitive results
- Cohort studies
- Case-control studies
- Cross-sectional surveys
- Case reports
What are the primary stressors of flight?
Vibrations/noise Decreased humidity Decreased PO2 G forces Thermochanges
What are the characteristics of a good study question?
F - feasible I - interesting N - new E - ethical R - relevant
What is specificity?
“Spin” is able to rule things in.
What is sensitivity?
“Snout” the ability to rule things out.
What are the complications of administering blood?
- anaphylaxis
- hemolytic reaction
- DIC
- transfusion reaction
- infection
What is the definition of a massive transfusion?
4-6 units within 4 hours OR
>10 units OR
>1 blood volume in 24 hr period
What are the signs and symptoms of a transfusion reaction?
Fever
Dyspnea
Urticaria
Hypotension
What is transpulmonary pressure?
The difference between the alveolar pressure and pleural pressures.
Airway pressure - intrapleural pressure = Transpulmonary pressure
PPlat - ESB = transpulmonary pressure
Should be < 25 cmH2O
How many oscillations should you see on a square waveform test?
- <2 = overdampened (pressure bag, poor site, air in line, loose connections)
>2 = underdampened (non-compliant tubing, tachycardia)
