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EM - Exam 1 > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

Define pulse oximetry

A
  • Transcutaneous measurement of light wavelengths to calculate arterial oxygen saturation
  • Oxygenated and deoxy blood have differing absorption of light spectra
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2
Q

Define capnography

A
  • Monitoring of CO2 levels via nasal cannula (normal is 35-37 mm Hg)
  • Frequently used during moderate sedation
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3
Q

Proper size of nasopharyngeal airway?

A

Tip of nose to tragus of ear

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4
Q

Proper size of oropharyngeal airway?

A

Corner of mouth to angle of mandible

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5
Q

When is a nasal cannula indicated?

A 
Mild hypoxia (91-94%) 
(delivers 1-6 L/min)
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6
Q

When is a non-rebreather mask indicated?

A 
Moderate hypoxia (86-91%)
(delivers up to 15 L/min)
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7
Q

Advantages of non-rebreather mask

A

Able to deliver high volume of O2 without risk of rebreathing patient’s own CO2

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8
Q

When is a Venturi mask indicated?

A

COPD patients

PO2 86-91%

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9
Q

Advantages of Venturi mask

A

Able to fix a concentration of oxygen

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10
Q

What is non-invasive ventilation?

A
  • BiPAP and CPAP

- Pressurized oxygen delivery devices which provide support in early respiratory failure

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11
Q

Describe BiPAP

A
  • Cycles b/w a targeted peak inspiratory pressure and a lower expiratory pressure
  • Ventilation varies with patient effort
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12
Q

Indications for BiPAP

A

COPD, asthma, CF, PNA, sleep apnea

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13
Q

Describe CPAP

A

Delivers a static airway pressure maintained throughout inspiratory and expiratory cycle

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14
Q

Indications for CPAP

A

Same as BiPAP but PREFERRED for CHF and sleep apnea

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15
Q

Describe intubation

A

Placement of endotracheal tube orally for direct ventilation

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16
Q

Define rapid sequence intubation (RSI)

A

Intubation including sedation and paralysis

17
Q

Indications for intubation

A
  • Inability of pt to protect own airway
  • Failure to oxygenate
  • High potential for deterioration
  • Pt/staff safety
18
Q

MC meds used in intubation

A
  • Etomidate (sedative)

- Succinylcholine (paralytic)

19
Q

Describe hyperbaric oxygen therapy

A

Administration of 100% oxygen under pressure, usually 2.5x higher than normal atmospheric pressure

20
Q

Purpose of hyperbaric oxygen therapy

A
  • Blood can be hyperoxygenated by dissolving O2 within the plasma
  • O2 carried to areas where circulation is diminished/blocked
21
Q

What readings are WNL for pulse oximetry?

A

95-100% (with a good waveform)

22
Q

Uses of nasopharyngeal airway

A
  • Diminished gag
  • Trismus
  • Oral injuries
  • Intoxication
23
Q

When is an oropharyngeal airway used?

A

Spontaneous breathing but no gag

24
Q

What does an oropharyngeal airway do?

A
  • Holds tongue off posterior pharyngeal wall

- Provides opening for air/suction

25
Q

What is applied after insertion of oropharyngeal airway?

A

O2 mask

26
Q

Advantages of nasal cannula

A
  • Talk, eat, drink w/o removing cannula

- Mouth breathing is possible w/o affecting function

27
Q

Disadvantages of nasal cannula

A

Irritation to nasal mucosa both by dry oxygen and physical abrasion (causing epistaxis or rhinitis)

28
Q

What does a non-rebreather mask contain?

A

Oxygen reservoir with one way CO2 valve

29
Q

Disadvantages of non-rebreather mask

A
  • Claustrophobia

- Difficulty speaking/eating

30
Q

Adverse effects of non-invasive ventilation

A
  • Anxiety (pt may strain and increase work of breathing)
  • Decreased CO (d/t increased intrathoracic pressure)
  • Barotrauma
  • Gastric distention
31
Q

Importance of pre-procedure passive oxygenation?

A

Extends duration of safe apnea via de-nitrogenating the residual capacity of the lungs (which maximizes O2 storage within the lungs)

32
Q

Define safe apnea

A

Time until a patient reaches a saturation level of 88-90%

33
Q

How should a pt be positioned for pre-procedure passive oxygenation?

A

External auditory meatus on same horizontal plane as sternal notch (approx 20 degrees from horizontal)
(OR reverse Trendelenburg)

EM - Exam 1 (5 decks)

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