Week 1 - 3 Flashcards
• What are the signs of a compromised airway?
Inability to talk, snoring, gurgling, stridor, wheeze, cyanosis, reduced or no air entry, no breath sounds
• What symptoms may your patient display with a compromised airway?
Snoring, gurgling, stridor, wheeze, cyanosis, no breath sounds, anxiety level increased, altered conscious state
• What are the management strategies to be employed in airway management?
Basic airway management-(Head repositioning, head tilt jaw thrust) Airway suctioning to remove foreign material Magill Forceps to remove foreign material Oropharyngeal Airway (OPA) Nasopharyngeal Airway (NPA) Laryngeal Mask Airway (LMA) Endotracheal Intubation (ETT)
• What adjuncts are available for airway management?
Airway suctioning (Yankaur suction, Y suction catheter) Oropharyngeal Airway (OPA) Nasopharyngeal Airway (NPA) Laryngeal Mask Airway (LMA) Endotracheal Intubation (ETT)
• What are the common signs and symptoms associated with respiratory presentations?
Dyspnoea, use of accessory muscles, coughing, cyanosis, tracheal tug, adventitious breath sounds
• What are the 3 common pathophysiological concepts that influence respiratory function in critically ill patients?
hypoxaemia, inflammation and oedema.
What is the criterion for a patient to be intubated?
- inability to protect airway - loss of gag/cough reflex
- Decreased GCS lower than 8 intubate
- clinical signs indicating respiratory distress - tachpnoea, use of accessory muscles, tachycardia and hypertension
- inability to sustain adequate oxygenation - low O2 sats with suplemental O2 = 88% or less
- respiratory acidosis
- post op resp failure
- shock
- facial or inhalation burns
- unconscious
• Which conditions might you see CPAP used on a patient?
COPD
Asthma
Pulmonary oedema
• Which conditions might you see BiPAP used on a patient?
COPD
Asthma
post extubation weaning
sleep apnoea
• What are the signs and symptoms of shock in your patient?
tachycardia Altered LOC cold diaporetic skin Tachpnoea shallow resps Urine output
• What assessments are important to diagnose what type of shock your patient is in?
ABCDE incorporating BP TPR RR, SPO2, Then blood tests Lactate,U&E, ABGs Urine tests, urine output, ECG, GCS, CAP refill, Cardiovascular assessment Neurological assessment Renal function assessment
• What interventions are appropriate for cardiogenic shock
ABCDE vascular support PCI thrombolytic therapy 02 Vasodilators antiarrhytmic drugs ionotrops to increase contractility morphine for severe pain insert urinary catheter to monitor output monitor electrolytes Assess ABGs Assess for troponins and CK assess renal perfusion - BUN and creatinine
• What interventions are appropriate for distributive shock - anaphylaxis
(1)Assessment: Accurate History, Allergies, Time of onset
(2)ABCDE,
(3) remove causative agent
(4)establish and maintain airway,
(5) give epinephrine, antihistamine and Corticosteroids vasopressors, bronchodilators
give O2
• What interventions are appropriate for hypovolaemia
ABCDE (1) maximize oxygen delivery - completed by ensuring adequacy of ventilation, increasing oxygen saturation of the blood, and restoring blood flow,
(2) control further blood loss, once airway and breathing secured
(3) fluid resuscitation. crystalloid/colloid/blood/plasma to maintain agreed MAP/SBP
(4) Minimum 2 Large bore Cannulae
(5) Keep Patient Warm
(6) Prepare patient for theatre/transfer
• What interventions are appropriate for distributive shock - sepsis
(1) Assessment ABCDE
(2) Correct physiological deterioration
(3) Fluid Management
(4) Address underlying infection
(5) Administer antibiotics - Inotrope -Vasopressin
