Flashcards in Chest treatment in Critical Care Deck (58)
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1
Donning PPE order?
1. hand hygiene
2. gown
3. mask / respirator
4. eye protection
5. gloves
2
Doffing PPE order?
1. ensure you are 2 m away from pt before beginning
2. gloves
3. hand hygiene
4. gown
5. hand hygiene
6. eye protection
7. hand hygiene
8. mask / respirator
9. hand hygiene
3
3 components of resp ax?
1. pt history
2. physical examination
3. lab tests and investigations
4
In normal lung, ventilation is best is _______ region
dependent
5
For pt on mechanical ventilation, ventilation is best in ________ region of lungs
non-dependent (air follows path of least resistance)
6
Perfusion in normal lung is a _____ pressure system and therefore responds more to _____
low; gravity
7
________ is our best position for V/Q match as it improves overall ventilation
upright
8
Mechanical ventilation can limit _______ due to high pressures in thorax
perfusion
9
______ zone of lung has best V/Q matching
middle
10
Generally place bad lung ___
up (non-dependent position)
11
When someone has and epidural, be aware of ___ changes
BP
12
Who do we prone ?
ARDS or ALI pts
13
Why we prone: 75% of ARDS pt's have decrease in ____ and increase in PaO2
shunt
14
Why we prone: generally allows for decrease in ___ and ______ levels
FiO2; PEEP
15
Why we prone: generally allows for decrease in ______
PaCO2
16
4 precautions to proning?
1. hemodynamic instability
2. active intra abdominal process
3. facial or ocular injuries
4. recent sternotomy or abdominal incisions
17
3 CI's to proning?
1. unstable spina injury
2.uncontrolled cerebral hypertension
3. facial trauma / burns / open chest or abdomen
18
When proning, head and arm position change every ___ hours, and pt is prone for __-___ hours
2; 2-18
19
Lung volume recruitment techniques produce an ____ breath that is larger than the pt or ventilator delivered TV
inspiritory
20
3 indications to perform lung volume recruitment technique?
1. acute lobar collapse
2. sputum clearance
3. maintenance lung compliance and thoracic mobility
21
Lung volume recruitment techniques can be performed only with non-ventilated pts (T/F)
FALSE; ventilated and non ventilated
22
4 lung volume recruitment technique examples ?
1. breath stacking with an ambu bag +/- a one way valve
2. manual hyperinflation
3. mechanical insufflation / exsufflation machine
4. ventilator hyperinflation
23
5 CI's to lung volume recruitment techniques?
1. undrained pneumothorax
2. proximal tumor / obstruction
3. unstable head injury
4. HFOV
5. recent thoracic sx (unless you have surgeons permission)
24
Manual hyperinflation is also known as ______
bagging
25
_____ ______ is usually performed on an intubated / ventilated pt to improve lung volumes and assist with secretion clearance
manual hyperinflation
26
Manual hyperinflation consists of slow _____ phase and a week release stimulating a ____/___
inspiration; cough/huff
27
With MHI, O2 flow rate of __-__ L/min is required to prevent rebreathing of CO2
14-15
28
When doing MHI, pt's PEEP on the ventilator should be at __ or below, otherwise opening the circuit could cause excessive de-recruitment
10
29
4 pieces of equipment needed for MHI?
1. ambu-bag
2. O2 tubing
3. PEEP value
4. Pressure manometer in the circuit for safety
30
