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)
What tank will be yellow?
Air - yellow tank and yellow hoses
Phys. Factors causing a DECREASE in EtCo2?
- decrease muscle activity (paralytics)
- Hypothermia (decreased metabolic demand)
- Decrease CO (cardiac arrest)
- Pulmonary embolism
- Increased MV
Oxygen is measured by?
A. Fuel cell
A & C only!
Loss of Alveolar Plateau
- COPD, asthma, Bronchoconstriction, or airway obstruction
What do each number represent?
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.
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!
How many Liters of O2 does an E-cylinder contain?
And at what PSI
E: 660 liters/1900psig
H: 6900L/ 2200psig
Capnography vs Capnometry?
Capnography: displays both ETCO2 value and waveform
Capnometry: displays JUST the numeric value
Which tank is Grey?
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
Which tank is BLUE?
Nitrous Oxide - N2O
Curare Attack -
Paralytics wearing off- diaphramatic breathing
Normal ETCO2 reading
Pressure required to Liquify Nitrous Oxide?
Which tank is Green?
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)
Inadequate Seal around ETT
What does it mean when N2O pressure gauge starts falling?
CHANGE THE TANK
- you have 250L or less remaining
Faulty ventilator curcuit valve
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
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
Apnea/Loss of Waveform
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
Which tank is Brown?
Causes for Re-breathing?
- Faulty expiratory valve
- Inadequate inspiratory flow
- Insufficient expiratory flow
- Malfunction of CO2 absorber system
Causes for SUDDEN loss of EtCO2 waveform?
- Most common ===> airway disconnection - start @ pt first & work way to machine
- Airway Obstruction
- Dislodged airway (esophageal)
- Airway disconnection
- Ventilator malfunction
- Cardiac Arrest