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1internyearprep > Intern Prep Class - 2/29 > Flashcards

Intern Prep Class - 2/29 Flashcards

(53 cards)

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1
Q

Mallampati Class I and II

A
  1. complete visualization of soft palate

2. complete visualization of the uvula

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2
Q

Mallampati Class 3 and 4

A
  1. Visualization of base of uvula only

4. soft palate not visible at all

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3
Q

Thyromental distance

A

tip of mentum to thyroid cartilage
should be around 6 inches (3 fingers)
less is not good

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4
Q

RF for difficult ventilation

A 
obesity, snoring
age>55 years, lack of teeth
presence of a beard
mallampati 3 or 4
abnormal mandibular protrusion test
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5
Q

Reasons down syndrome pts are difficult to intubate

A

c1/c2 instability
macroglossia
small mouth opening
short, thick neck

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6
Q

Adequate oxygenation

A

spo2 more than 90

pao2 more than 60

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7
Q

Appropriate oxygenation

A

estimate Pao2 with Fio2 x 5

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8
Q

fio2 from 1L o2

A

2%

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9
Q

A-a gradient

A

difference between calculated alveolar oxygen partial pressure and measured arterial oxygen partial pressure

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10
Q

A-a gradient value based on

A

fio2
Room air ~10mm difference
100% fio2 ~100mmhg

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11
Q

BIPAP, support to

A

both ventilation and oxygenation

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12
Q

BIPAP, ventilation

A

IPAP

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13
Q

BIPAP, oxygenation

A

EPAP (functionally similar to PEEP?)

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14
Q

BIPAP and CPAP contraindications

A

mental status issues

risk of emesis

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15
Q

CPAP, support to

A

oxygenation

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16
Q

condition that may require CPAP only

A

cardiogenic pulmonary edema

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17
Q

Pressure Control - constants and variables

A

constant: Paw, Palv
variable: Vt, peak flow
Flow: decelearting

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18
Q

Volume Control - constants and variable

A

Variable: Paw, Palv
Constant: vt, peak flow
preset flow pattern

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19
Q

peak inspiratory pressure

A

pressure required to deliver the tidal volume

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20
Q

plateau pressure

A

pressure required to distend the lung

compliance

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21
Q

peak inspiratory flow

A

greatest flow used to deliver the tidal volume

resistance and compliance

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22
Q

mean airway pressure

Study These Flashcards
A

time weighted average airway pressure measured during entire cycle

23
Q

PEEP

Study These Flashcards
A

increase mean airway pressure
increase recruitment of collapsed alveoli
prevent de-recruitment of easily collapsible alveoli

24
Q

PEEP and worsening oxygenation

Study These Flashcards
A

over-distended alveoli

25
PEEP and worsening hypoventilation
deadspace ventilation is increased
26
PEEP and hypovolemic pt
causes hypotension | give fluids or turn off peep
27
Control Mandatory Ventilation
OR | machine triggered, no ability to sense pts
28
Assist Control Ventilation
constant TV, rate | trigger breaths with machine + pt spontaneous effort (neg pressure)
29
AC Ventilation - issues
develop mild resp alkalosis
30
Norepinephrine receptors
alpha one | beta one
31
Norepinephrine uses and considerations
first line for septic shock (increase SVR) | but can cause cardiac dysrhythmias
32
Phenylephrine Receptors
alpha one
33
Epinephrine Receptors
B1, B2 low dose | alpha1 high dose
34
Epinephrine Considerations
can elevate lactate during initial administration
35
B1 receptor & SVR
initially decreases VR
36
Dopamine receptors
d1, b1, alpha one
37
Vasopressin works by
vasoconstricting, increases SVR
38
caveat for vasopressin
decreases UOP at high doses
39
Treatment for local extravasation
phentolamine alpha1 blocker, SQ
40
Vasopressor complications
dysrhythmias, hyperglycemia from inhibition of insulin secretion, local extravasation
41
Dobutamine receptors
B1 and B2 | getting vasodilation and afterload reduction
42
Dobutamine major AE
hypotension, dysrhytmias
43
Milirinone mechanism
PDE III inhibitor | increases CO, contractility, profound vasodilation
44
Milirinone metablized in
kidneys
45
Milirinone better suited for...
right sided HF from pulm HTN
46
How do we treat flash pulmonary edema?
Afterload reduction, hypertensives. Not necessarily diuretics.
47
NIPPV - decreases mortality w/
COPD and CHF
48
NIPPV - don't use w/
AMS, emesis
49
What is CPAP to start at?
5. Titrate 2-5 q15min. Max is 20. (why?)
50
BIPAP setting to start with
10/5
51
Epi pen IM dosing
0.3 mg of 1 in 1000
52
Epi IV bolus dose
0.1mg (1/10000) over 5-10min
53
Epi IV drip dose
1 mg of 1/1000 added to 250ml D5w

1internyearprep (9 decks)

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