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PANB > Therapeutics > Flashcards

Therapeutics Flashcards

1
Q

Methods of relieving the symptoms of airway obstruction:

A

Determine if it’s a complete obstruction or poor air exchange, if unconscious, use the head tilt/chin lift, jaw thrust, insert NPA, attempt 2 breaths. Reposition if failed breath, if all fails attempt CPR -> Magill forceps

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2
Q

Types of airway opening manoeuvres for various patients

A

Head tilt/chin lift, jaw thrust, Sellicks maneuver

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3
Q

Indications and contraindications for performing airway manoeuvres:

A

Indications: remove blood or other secretions, vomit
Contraindications: acute neck, facial or head injury, nasal/oral burns, due to infection risk, raised ICP

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4
Q

Purpose and indication for oropharyngeal suctioning:

A

Assist patient to clear excessive secretions, upper airway, to assist patient who is unable to cough effectively and is retaining secretions to clear vomit, blood, foreign object.

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5
Q

Describe suctioning equipment:

A

Handheld, O2 powered, battery powered, non-portable, rigid, tip, whistle tip(soft top)

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6
Q

Identify pressure limitation for suctions various age groups:

A

For pediatrics: decrease pressure to less than 100 mmHg in infants, Suction less than 10 seconds, avoid stimulation of vagus nerve, constantly check for bradycardia.

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7
Q

Identify indications for suctions beyond the oropharynx

A

Patients with tracheostomy, tube to remove secretions and mucus plugs.

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8
Q

Identify equipment for suctioning beyond the oropharynx

A

Endotracheal tube, lubricant, oxygen, sterile water

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9
Q

Indications and purposes for using a OPA:

A

Unconscious patients without a gag reflex, a patient that isn’t breathing adequately

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10
Q

OPA sizes and types:

A

40 mm – 110mm,

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11
Q

Sizing and procedure for an OPA:

A

Measure from the corner of the mouth to the earlobe

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12
Q

Purpose and indications for performing a nasopharyngeal airway:

A

A semi conscious or unconscious patient with a gag reflex

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13
Q

Sizing procedure for an NPA

A

Measure from the tip of the nose to the earlobe

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14
Q

How to use a NPA and OPA

A

OPA: measure, open the patient’s mouth, insert with tip against the roof of the mouth, rotate the OPA
NPA: measure, lubricate, insert in the larger nostril (right) with the bevel facing towards the septum.

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15
Q

Explain the purpose and indications for using airway devices not requiring visualization of the vocal
chords (not endotracheal tubes)

A

quick, convenient, not as invasive, easier

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16
Q

Sizing procedure for airway device not requiring visualization of vocal chords and not endotracheal
tubes:

A

Earlobe to lip or nose to ear (OPA/NPA), King LT (Weight (peds)/height); LMA (Weight); I-Gel (Weight)

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17
Q

Identify the indications for AFB( airway foreign body) removal:

A

Complete blockage, blockage affecting airway

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18
Q

Methods of relieving airway obstructions:

A

Magill forceps, abdominal thrusts, back blows

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19
Q

Describe the differences in removing AFB’s in various age groups:

A

For pediatrics to small to be treated as an adult, should be placed face down in the palm of the rescuer, and back blows are given, and instead of abdominal thrusts, chest compressions are used.

Heimlich for adult no back blows

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20
Q

Complications of removing AFB’s

A

Rib damage, Magill’s causing damage to vocal cords

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21
Q

Identify the purposes of and indications for foreign body removal by forceps:

A

Unable to remove objects using abdominal thrust and back blow method

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22
Q

. Describe equipment used for foreign body removal by direct technique:

A

Laryngoscope, Macintosh blade or Miller blade, Magill forceps

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23
Q

Complications for foreign body removal by direct approach:

A

Damaging vocal cords, pushing the foreign body further into the airway

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24
Q

Identify the purpose of and indications for percutaneous cricothyroidotomy:

A

In face and neck trauma when oral and nasal intubations are impossible

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25
Q

Identify potential complications of percutanous cricothyroidotomy:

A

Vocal cord injury, narrowing of subglottic area, damage to the thyroid and parathyroid

26
Q

. Identify the process of and indications for surgical cricothyroidotomy:

A

Gloves, goggles, gown, set out equipment needed, palpate.

27
Q

Describe equipment used for surgical cricothyroidotomy:

A

Sterile scalpel, small oral airway or shortened #6 ET tube, BVM, sterile dressings, BSI, BVM adapter off of a size 3 ET Tube or a Melker Kit

28
Q

Indications for oxygen administration and purpose:

A

Shortness of breath/difficulty breathing, CO poisoning, poisoning from other chemicals

29
Q

Identify cylinder sizes and types:

A

M tank, D tank, E tank

30
Q

Discuss the safe handling of oxygen delivery systems:

A

Prevent from falling or tipping, keep away from fire/smoking, store with strap or cable, crack the valve before attaching regulator

31
Q

Formulas for O2 cylinder factors, volume (type), max filling volumes

A

Gauge pressure – safe residual pressure x constant tank life in minutes = oxygen delivered in liters per minute.
M tank constant: 1.56
D tank constant: 0.16
2000psi – Safe Residual of 200psi (Tank Factor)/ lpm that tank will be running = 40 minutes tank life

32
Q

Steps for oxygen delivery systems

A

Turn tank on, select mask, attach tubing to mask, select flow rate, inflate bag if applicable, apply to patient’s face

33
Q

Purpose, indication and steps for using a nasal cannula:

A

Indicated for low to moderate oxygen requirements, long-term oxygen therapy

34
Q

Purpose, indication and steps for using a low concentration mask?

A

Simple face mask: ask patients requiring moderate to high oxygen concentration, 6L-10L/min

35
Q

Purpose, indication and steps for using controlled concentration masks?

A

Venturi mask: precise oxygen concentrations, useful in COPS patients

36
Q

Indications, purpose and steps for using a high concentration mask:

A

The simple face mask is indicated for patients requiring moderate to high concentrations. Flow rates generally range from about 6L/min to 10L/min providing 10-60% O2 at a maximum rate, depending on a patients respiratory rate and depth. Delivery of volumes beyond 10L/min does not enhance oxygen concentration

37
Q

Indications, purpose and steps for using a pocket mask:

A

The pocket mask is a clear plastic device that you place over a patients mouth and nose. It prevents direct contact between you and your patients mouth thus reducing the risk of contamination and subsequent infection.

38
Q

What is a positive pressure device?

A

Device used in hospitals to improve the ability of the lungs to exchange oxygen and carbon dioxide and decrease the work of breathing ie BVM, CPAP, etc.

39
Q

Identify the purpose of and indications for use of manual positive pressure device:

A

PEEP a method of holding the alveoli open by increasing expiratory pressure, some units used in EMS have PEEP attachments. EMS personnel sometimes transport patients who are on ventilators with PEEP attachments.

40
Q

Steps for administering oxygen by a manual positive pressure device:

A

Ensure equipment is attached and not expired. same as other oxygen devices

41
Q

Discuss rate, rhythm, volume, compliance and end expiratory pressure:

A

Rate = how many breaths per minute
Compliance = the stiffness or flexibility of lung tissue
Rhythm should be regular, rate appropriate to age and volume based on size of patient Volume = how much air is inspired in one breath
Expiratory Pressure = the amount of force in the expired breath

42
Q

Define mechanical ventilation:

A

The process of moving air in and out of the lungs

43
Q

Types of mechanical ventilation equipment:

A

BVM, Ventilators

44
Q

List indications for mechanical ventilation:

A

Indicated when a patient’s spontaneous ventilation is inadequate to maintain life

45
Q

List potential complications and safety issues when using mechanical ventilation:

A

Barotrauma, ventalor associated lung injury, atrophy of the diaphragm, motility of mucocele in the airways

46
Q

Describe vent circuit and safety, end-tidal carbon dioxide manometer, respirometer:

A

The cycle is what causes the breath to transition from inspiration phase to expiration phase safely-> breaths may be limited to a max circuit pressure or a set maximum flow.
Monometer -> a device used to measure pressure
Respometer -> used to measure rate of respirations in a living organism
Capnography -> is used for monitoring concentration/partial pressure of CO2

47
Q

Difference between intermittent mandatory ventilation, continuous mandatory ventilation,
assist control, inverse ratio:

A

Intermittent mandatory ventilation – method of partial ventilator support to facilitate liberation from mechanical ventilation
Continuous mandatory ventilation – mechanical ventilation where breaths are delivered based on a set of variables (no patient effort required)
Assist control – “volume control” patients may either receive controlled or assisted breaths. When the patient triggers the vent, the patient will receive a breath.
Inverse ratio – strategy of ventilating the lungs in such a way that the amount of ?

48
Q

Discuss continuous positive airway pressure, end expiratory pressure, non-invasive, positive
pressure ventilation:

A

PEEP – used to keep alveoli open, provides a little batch of pressure at the end of expiration CPAP – continuous pressure used to keep pharyngeal structures from collapsing. Mostly used in patients with sleep apnea and as a nasal mask
BiPAP – Provides two levels of pressure. One on inspiration and one on exhalation. Used for patients who require higher levels of pressure than CPAP.

49
Q

Describe blender, saturated oxygen:

A

A device that can be wall mounted at hospital or used with a venturi mask to control the percentage of oxygen being received.

50
Q

Define compliance:

A

The stiffness or flexibility of lung tissue felt when ventilating a patient.

51
Q

Define resistance:

A

Degree of difficulty met when providing bag valve mask. Ventilations to a patient. Stiffness of lung tissue.

52
Q

Define plateau pressure:

A

The pressure applied to small airways and alveoli during positive pressure mechanical ventilation.

53
Q

Define inspiratory pressure:

A

The pressure change above end expiratory pressure required to deliver a tidal volume.

54
Q

Define expiratory pressure:

A

The pressure at the end of the expiratory phase, relative to atmospheric pressure

55
Q

Define peak expiratory pressure:

A

Measure of airflow. The great of airflow that can be achieved during forced exhalation with lungs fully inflated.

56
Q

Define tidal volume:

A

Average volume of gas inhaled or exhaled in one respiratory cycle.

57
Q

Explain respiratory rate:

A

The number of times a person breathes in one minute

58
Q

Identify the purpose and indications of CPR

A

The purpose of CPR is to restore partial flow of oxygenated blood to the brain and heart. Objective is to delay tissue death. The indications for CPR are no pulse and no breathing/irregular/ineffective breathing.

59
Q

List steps for administering CPR

A

Assess ABC’s, if B and C are not present begin chest compressions, after 30 chest compressions apply 2 breaths, repeat for 2 mins (5 cycles) then reassess pulse for no more than 10 seconds, continue if no pulse present. Witnessed arrest = apply defibrillator ASAP. Unwitnessed arrest = apply defibrillator after 2 minutes CPR.

60
Q

CPR potential complications include:

A

Rib fractures, sterna fractures, bleeding in anterior mediastinum, heart contusion, hemopericardium

61
Q

Identify the purpose of and indications for hemorrhage:

A

Control through the use of direct pressure and patient positioning. Purpose – to control uncontrolled bleeding. Indications – uncontrolled bleeding

62
Q

Complications of using direct pressure and patient positioning for hemorrhage control:

A

Decreased tissue perfusion to the distal area. Pain in the affected area.

PANB (6 decks)

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