Respiratory Flashcards
(24 cards)
How quickly should albuterol take into effect?
20 minutes
how much albuterol should be administered before switching treatment options?
at least 15-20mg
what is the standard dose of albuterol?
2.5mg in 3 mL
terbutaline (beta agonist)
more effective in respiratory distress than epi
why do we give dexamethasone?
we only need to give one dose as opposed to the 2-3 doses of prednisolone
what are the options for positive pressure?
High flow nasal cannula, BIPAP, CPAP
What is the medication of choice for RSI medication in asthma and why?
ketamine because it is a bronchodilator, and works well for sedation.
why is the use a of a paralytic so important when intubating athsmatics?
the paralytic helps to relax muscles and ensure that patients can exhale. if not you would be force air in and it wouldn’t be able to come out.
when using NEO TEE start at __ LPM
10 LPM leave red cap in place
how do you give breaths with NEO TEE
Occlude the PEEP knob at the end of the neotee
Prime inhaler (ventolin) ____ times before the first use
4 times
Best practices for using inhaler
Rinse mouth with water after full dose, clean inhaler mouthpiece at least weekly with warm water, always use spacer with pediatric patients.
Sizing nasal cannula high flow
80% occluded by nasal cannula, 20% open to air.
Cardiac patients
Don’t over oxygenate pts with cardiac history.
Titrating high flow
Titrate up flow for no improvement in work of breathing.
Albuterol absorption
How you administer albuterol determines how much is absorbed, only 10% absorbed with high flow.
Ideal setting for suction neosuction
Start at 80 mmhg
Deep suction
You are suctioning oropharynx. Max of 15 seconds of suctioning. Stay at pockets where you are getting phlegm for a few seconds. Suction one time really well, then reassess.
Ram cannula
Use the 80 20 rule, creates back pressure, nimv will give you faulty values. 5 kilos and below needs ram cannula. Assess for chest rise. Consider og/ng tube.
CPAP
Greater than 5 kilos. Nasal cpap, pt expires through mouth. Ev300 setting.
Peep, psv, cpap
All the same thing.
Tidal volume
6-8cc per kilo ideal setting
Intubation
Removes drive to breath, you are breathing for the patient. 1. Set respiratory rate. 2. Set volume vs pressure control. 3. Set peep to ensure lungs stay open 5-7 to keep lungs open. 4. Set Fio2 start at 100%. Consider medication for continued sedation. If the ventilator fails, bag the patient. Ambu bag is most important and most dangerous. If you are doing it IT IS YOUR 1 AND ONLY JOB!
End Tidal CO2
Look to see if patient has an end tidal if you suspect pt is extubated.
