Treatment for Hypoxia Diagnosis

Question 1

For a Pneumothorax, where are your landmarks for needle decompression?

Answer 1

2nd intercostal space, mid-clavicular line

Question 2

For a Pneumothorax, where are your landmarks for chest tube?

Answer 2

5th intercostal space in the mid-axillary line

Question 3

For a Pneumothorax, what equipment is needed for a chest tube?

Answer 3

36-40 French tube

Question 4

When do you need to explore a chest tube for hemothorax?

Answer 4

200cc/hour

Question 5

What is the treatment for aspiration pneumonia?

Answer 5

1. Suction airway
2. Increase FiO2 if oxygenation low
3. Tube and Vent if needed
4. PEEP for PaO2 / FiO2 < 250

Question 6

What are two things that you should NOT do or give for aspiration pneumonia?

Answer 6

1. Prophylaxis Steroids

2. Antibiotics

Question 7

What procedure should you NOT do for aspiration pneumonia?

Answer 7

Bronchopulmonary Lavage

Question 8

You diagnose a venous air embolism, what is the next steps?

Answer 8

1. Surgeon to flood the field
2. Place surgical site below the heart
3. D/C Nitrous oxide
4. Fluid bolus to increase CVP
5. Aspirate through the central venous catheter

Question 9

You diagnose carboxyhemoglobinemia, what are your steps to treat?

Answer 9

1. Don’t rely on pulse ox
2. FiO2 to 1.0
3. Increase minute volume up to 6 fold
4. Add CO2 to maintain normocarbia
5. Hyperbaric oxygen

Question 10

What is the treatment for methemoglobinemia?

Give drug, dose and route.

Answer 10

Methylene Blue 1-2 mg/kg IV over 5 minutes

Question 11

What are the initial management steps in Bronchospasm?

Answer 11

1. 100% oxygen
2. If Apnea –> PPV
3. If unconscious –> Tube

Question 12

What are the first line therapies and doses/routes of bronchospasm?

Answer 12

First, turn up your gas agent

1. Beta 2 Agonism
     Albuterol 10 puffs
2. Epinephrine
     1-10 mcg/kg IV
     0.1 mg/kg SQ
     Racemin Epi (0.25 - 0.5mL of 2.25% in 3cc NS every 60 minutes)
3. Terbutaline
    0.25 mg SC q15-30 min
4. Ketamine 0.5-1.0 mg/kg IV
5. Atropine 0.02 mg/kg IV q1-5 min
6. Lidocaine 1-2 mg/kg
7. Sodium Thiopental 1-2 mg/kg IV

Question 13

What are the treatments for laryngospasm?

Answer 13

100% oxygen
Suction debris and secretions
Remove Artificial airways except for ETT
Jaw Thrust
Gentle PPV
Succinylcholine 0.5 mg/kg IV
if Unavailable 3-4 mg/kg IM