Hypercarbia

Question 1

What is hypercarbia?

Answer 1

Abnormally high levels of carbon dioxide in the blood, usually defined as PaCO2>45 mmHg

Question 2

What does a patient look like if hypercarbic?

Answer 2

flushed skin, sweating, headache, confusion, lethargy

Question 3

what kind of vitals would you see in a patient with hypercarbia?
what about if they are spontaneously breathing? mechanically ventilated?

Answer 3

tachycardia
HTN
dysrhythmias
If spontaneously breating-dyspnea and tachypnea
mechanically ventilated-pt may attempt to overbreathe

Question 4

DDx for hypercarbia?

Answer 4

fever, sepsis, TPN with high carbohydrate load, CO2 pneumoperitoneum

Question 5

How do you manage hypercarbia? If pt is spontaneously breathing? Confirm and treat-but how?

Answer 5

Establish/maintain a patent airway, ensure adequate oxygenation and ventilation. If pt is spontaneously breathing-consider assisting with CPAP.
evaluate for presence of residual anesthetics, opioids, NM blockers. Check temp, presence of muscle rigidity (MH). check for syringe swap (accidental opioid or NM blocker)