Week 13 - 14

Question 1

What is the ALS algorithm

Answer 1

• Start CPR 30 and 2• Attach defib/monitor • Assess rhythm• Shockable – shock – CPR • Non shockable – CPR
Return of Spontaneous circulation?
Post Resus care.

Question 2

What are the DRUGS on resus trolley

Answer 2

• Adrenaline (Epinephrine) • Amiodorone • Calcium • Lignocaine • Magnesium • Potassium • Sodium Bicarbonate

Question 3

What was multiple organ dysfunction syndrome previously know as?

Answer 3

multiple organ failure (MOF)

Question 4

Describe the clinical manifestations of multiple organ dysfunction syndrome

Answer 4

Systemic inflammatory response syndrome must be diagnosed by finding at least any two of the following:
Temperature 38.5 degrees
Heart Rate >90
Tachypnoea RR >20 
WCC – significantly low or elevated
Second, SEPSIS
Third, signs of end-organ dysfunction

Question 5

What are the nursing interventions for patients with multiple organ dysfunction syndrome ?

Answer 5

Volume resuscitation
maintain tissue perfusion - O2
Early antibiotic administration
Early goal directed therapy
Rapid source identification and control.
Support of major organ dysfunction.

Question 6

What effects does critical illness have on patients?

Answer 6

6 months for functional recovery at home
Physical deconditioning
Neuromuscular dysfunction
Psychological issues

Question 7

• What constitutes a safe patient transfer?

Answer 7

a

Question 8

• What rehabilitation may patients require?

Answer 8

muscle reconditioning
psychological - diaries
PTSD depression

Question 9

What is lactate indicative of and what are normal values

Answer 9

Lactate
(Lactic Acid)
When cells no longer have enough O2 for
‘normal’ aerobic metabolism (cell hypoxia)
Anaerobic metabolism takes over resulting
in lactate production, leading to lactic acidosis
0.5 - 2.0mmol/L

Question 10

what are normal PO2 values and what does this represent

Answer 10

paO2 Arterial oxygen tension. In other words
how well the lungs are able to pick up
oxygen, i.e. supply, but not demand (this
is shown in a mixed venous gas, discussed
later).
75-100mmhg

Question 11

what are the normal values for haemoglobin in the blood

Answer 11

Hb
(Haemoglobin)
Amount of haemoglobin in blood possibly
capable of carrying oxygen.
135 - 180g/L

Question 12

What causes METABOLIC ACIDOSIS

Answer 12

Can be caused by either an increase in circulating acids and or a loss of base (HCO3-
). These include:
• Renal failure (unable to excrete acids or H+)
• Lactic acidosis (increase in circulating acids)
• Keto - acidosis (increase in circulating acids)
• Diarrhoea (HCO3-
loss)

Question 13

What causes METABOLIC ALKOLOSIS

Answer 13

Can be caused by an increase in HCO3-
or loss of metabolic acids. These include:
• Prolonged vomiting (acid loss)
• GI suctioning (acid loss)
• Hypokalaemia (H+ (an acid) excreted to maintain electrolyte balance)

Question 14

What causes RESPIRATORY ACIDOSIS

Answer 14

Caused by increased CO2 levels which is then converted to an acid (H+) as the body tries compensate by excreting acids via the
kidneys. These include:
• Hypoventilation:
 - sedatives/sedation/opiates
• Depression of respiratory centre in brain stem via trauma
• Pneumonia
• Pulmonary oedema
• Asthma

Question 15

What causes RESPIRATORY ALKALOSIS

Answer 15

Caused by a hyperventilation, the body getting rid of too much CO2, for example:
• Anxiety
• Hypoxaemia (caused by heart failure)

Question 16

What is the OXYHAEMOGLOBIN

DISSOCATION CURVE

Answer 16

• The ODC looks at the relationship between oxygen tension (pressure) and oxygen saturation. It helps us better understand how our blood interacts with oxygen, i.e. how and why it picks up and lets oxygen go.
• The S shape tells us that after an amount of oxygen has accumulated inthe blood, there isn’t room for any more, no matter how much oxygen you throw at the haemoglobin molecule, it wont change
• Affinity basically means how much we (or blood) are attracted to someone (oxygen). The ODC shows us what changes the affinity of blood for oxygen.