Test 2 - ICU Care

Question 1

CAAHEP

Answer 1

commission on accreditation of allied health education programs

Question 2

CAAHEP quote

Answer 2

The anesthesiologist who is responsible for the AA is available to prescribe and direct particular therapeutic interventions in the operating room and INTENSIVE CARE SETTING

Question 3

iron lung

Answer 3

works by negative pressure

Question 4

ICU combines 5 specialties

Answer 4

anesthesiology, internal medicine, pediactrics, surgery, emergency medicine

Question 5

Medicare billing code

Answer 5

99291 and 99292

Question 6

ICU Clinical condition criterion

Answer 6

summary: high likeliness of death, requires preparedness of MD to intervene urgently

Question 7

ICU Treatment Criterion

Answer 7

crit care req direct mamagement by MD, interventions frequently required that without can result in death/deterioration

Question 8

CMS category for Aas

Answer 8

Non-Physician providers (NPPs)

Question 9

NPPs and billing

Answer 9

able to bill under medicare part B for services otherwised billed as physician care

Question 10

ICU Skill set

Answer 10

technical, cognitive, admin, ethical

Question 11

Airway management tools

Answer 11

bronchoscopy, glidescope, surgical airway

Question 12

PA catheters measure 4 things

Answer 12

LVEDV (preload) PA pressure, mixed venous saturation, cardiac output

Question 13

Do PA catheters really change anything?

Answer 13

no

Question 14

Was the 2 hour PA cath explanation a waste of time?

Answer 14

yes

Question 15

Acute Respiratory Distress Syndrome (network)

Answer 15

network to test agents, devices, or mgmt strategies to improve care of pts with ARDS

Question 16

ARDS mechanical ventilation strategies

Answer 16

Low Vt with plat press < 30cmH2O. Keep O2 sat 88-95

Question 17

Liberation vs Weaning

Answer 17

weaning is a misnomer. We ‘liberate’ upon doing a series of tests (getting them to breathe) to see if they’re capable of taking them off the vent completely

Question 18

Use of Nitric Oxide & Helium

Answer 18

He is a lower density gas used in cases of an obstructed upper airway. N2O has some analgesic effects

Question 19

ECMO, ECLS

Answer 19

Life support: for cardiac and pulmonary systems in patients who cannot support their functions. Extra Corporeal membrane oxygenation.

Question 20

VAD

Answer 20

Ventricular Assisted Device, pump that helps the heart

Question 21

Ultrasound - artery vs vein

Answer 21

Vein compresses, artery does not.

Question 22

ICU - Radiology

Answer 22

Stuff we’ve learned before. Radiodensities. more dense=white, densities are ADDITIVE

Question 23

Radiology PA, AP

Answer 23

Posterior to anterior, anterior to posterior.. Direction the xray is being taken

Question 24

Setup of x-ray

Answer 24

Xray, YOU, Device to collect ‘shadow’

Question 25

#1 cause of death in ICU

Answer 25

death. funny, but he said infection.

Question 26

Surviving Sepsis

Answer 26

the earlier you treat it, there's an exponentially higher chance of helping that patient.

Question 27

SIRS

Answer 27

Systemic inflammatory response syndrome

Question 28

Sepsis interventions

Answer 28

draw cultures, start antibiotics, measure lactate, give fluids, measure CVP and ScVO2

Question 29

Kidney measurement of recover

Answer 29

Good benchmark in determining the systemic health improvement or deterioration. "can't out think a kidney."

Question 30

50% of dying that year

Answer 30

109 years old.

Question 31

Which day in the ICU stay carries the highest risk of death for a patient

Answer 31

Day 0

Question 32

Easiest and most difficult cases

Answer 32

5e hardest (going to die), most difficult (elective)

Question 33

4 principles of medical ethic

Answer 33

do no harm, do good, autonomy, social justice

Question 34

swan ganz

Answer 34

v wedge pressure: catheter inserted until “wedges” into a pulmonary artery, no blood flow distal to this point. Pulmonary occlusion pressure is equivalent to left atrial pressure = ventricular end diastolic pressure (when mitral valve open and aortic pressure closed) =LVEDP= preload

Question 35

best feature of swan ganz?

Answer 35

mixed venous blood sample for blood gas

Question 36

ultrasound guided line placement

Answer 36

central, arterial, dialysis. NOT subclavian

Question 37

cardiopulmonary bypass

Answer 37

circulation but no pulse

Question 38

swan ganz

Answer 38

right heart catheterization. insertion: thick line 50 cm, thin line 10 cm

Question 39

pulmonary artery pressure is?

Answer 39

diastolic pressure

Question 40

myocardial length just before contraction

Answer 40

preload

Question 41

thermal dilution

Answer 41

cardiac output calculated using the area under the curve of the temperature/time curve

Question 42

ventilation mode

Answer 42

"proning". facilitates ventilation

Question 43

can change the density of airway gas

Answer 43

helium, lower density, moves faster: useful for airway edema