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Flashcards in End tidal Deck (32):
1

Physiologic factors causing INCREASE EtCO2?

- Increased muscular metab. (shivering)

- Malignant hyperthermia

- Increased CO (during resuscitation)

- Bicarb infusion 

- Tourniquet release

- effective treatment of bronchospasm

Decreased Minute Vent (MV)

1

What tank will be yellow?

Air - yellow tank and yellow hoses

2

Phys. Factors causing a DECREASE in EtCo2?

- decrease muscle activity (paralytics)

- Hypothermia (decreased metabolic demand)

- Decrease CO (cardiac arrest)

- Pulmonary embolism

- Bronchospasm

- Increased MV

3

Oxygen is measured by?

A. Fuel cell

B. Infrared 

C. Magnetic

A & C only!

4

Loss of Alveolar Plateau

- COPD, asthma, Bronchoconstriction, or airway obstruction

4

What do each number represent?

Waveform Example 1

PHASE I: Respiratory Baseline, CO2 free dead space air, normally 0
PHASE II: Expiratory Upstroke, rapid rise due to mixing of dead space air and alveolar air, should   be steep
PHASE III: Expiratory Plateau, exhalation of mostly alveolar air
☼: Peak Et CO2 Level , end of exhaled air, peak end tidal CO2 level, normally 35-45mmHg
PHASE IV: Inspiratory Downstroke , inhalation of CO2 free gas, quickly returns to the baseline.

4

How often are cylinders checked?

Visual inspection every 5 years

- test every 10 years - if pass pressure test requal 10 years

if residual expansion less than 10% = requal 5 years

if greater than 10% = removed from medical use!

5

How many Liters of O2 does an E-cylinder contain?

H- Cylinder?

And at what PSI

E: 660 liters/1900psig

H: 6900L/ 2200psig

6

Capnography vs Capnometry?

Capnography: displays both ETCO2 value and waveform

Capnometry: displays JUST the numeric value

7

Hyperventilation

8

Which tank is Grey?

Carbon Dioxide

9

Normal ABG CO2 vs End tidal CO2? 

Why are they different normals?

35-45 ABG vs 30-43mmHg ETCO2

end tidal lower than Arterial d/t dead space

10

Which tank is BLUE?

Nitrous Oxide - N2O

11

Curare Attack - 

Paralytics wearing off- diaphramatic breathing

12

Normal Capnography

Normal ETCO2 reading

13

Pressure required to Liquify Nitrous Oxide?

745 psig

13

Which tank is Green?

Oxygen

14

Total dead space is the sum of what? 

Anatomic deadspace (airways leading to the alveoli)

+

Alveolar deadspace (ventilated areas of lung w/out bloodflow)

+

Mechanical deadspace (artificial airway including ventilator circuit)

16

Inadequate Seal around ETT

17

What does it mean when N2O pressure gauge starts falling?

CHANGE THE TANK

- you have 250L or less remaining

18

Faulty ventilator curcuit valve

20

Causes for obstruction slope on EtCo2?

- Partially kinked or occluded artificial airway

- Presence of foreign body in the airway

-Obstruction in expiratory limb of the breathing circuit

- Bronchospasm, asthma, or COPD

21

US Dept. of Transportation Role in medical gases? 

Regulates the construction & handling of all medical compressed gas cylinders, including:

– Design, construction, testing, marking, labeling, filling, storage, handling, maintenance, transportation

 

22

Hypoventilation

Hypoventilation

24

Esophageal Intubation

25

Apnea/Loss of Waveform

Apnea/Loss of Waveform

26

What should be done Immediately if you have an airway fire??

Shut off the OXYGEN and extubate immediatley

Oxygen: Supports combustion

N2O will support combustion as well

27

Which tank is Brown?

Helium

28

Elevated Baseline

Elevated Baseline

Rebreathing CO2

29

Causes for Re-breathing?

- Faulty expiratory valve

- Inadequate inspiratory flow

- Insufficient expiratory flow

- Malfunction of CO2 absorber system

30

Causes for SUDDEN loss of EtCO2 waveform?

- Most common ===> airway disconnection - start @ pt first & work way to machine

- Apnea

- Airway Obstruction

- Dislodged airway (esophageal)

- Airway disconnection

- Ventilator malfunction

- Cardiac Arrest 

31

Hyperventilation