Airway Management
When placing an endotracheal tube in an adult patient, approximately how deep should the tube be positioned at the teeth/lips?
What is approx 3x the diameter of the tube
Amount of air moved during one respiratory cycle.
What is tidal volume
Air entering the respiratory system that doesn't participate in gas exchange.
What is dead space?
As the concentration of hydrogen ions increases, this value decreases.
What is pH?
This condition occurs when alveoli become deflated or collapse.
What is atelectasis?
Tachycardia may indicate hypoxemia, while this heart-rate finding may indicate imminent arrest.
What is bradycardia
Two values multiplied to calculate minute volume
What is Tidal Volume & Respiratory Rate
Normal blood pH range.
What is 7.35-7.45
Partial pressure of oxygen in arterial blood measured in mmHg.
What is PaO₂
Oxygen moves from the alveoli into the blood primarily through this process
What is simple diffusion
Excessive ventilation pressure can cause barotrauma, gastric distention, regurgitation, and this complication
What is aspiration
A mechanical or neurological problem interfering with movement of air represents a problem with this process.
What is ventilation
Anatomical dead space plus alveoli that aren't participating in gas exchange.
What is physiologic dead space
Approximately 66–70% of CO₂ is transported in the blood in this form
What is bicarbonate
Pus from pneumonia, fluid from pulmonary edema, or alveolar collapse can interfere with oxygen diffusion and produce this blood-oxygen problem.
What is hypoxemia
A patient's SpO₂ remains acceptable, but their LOC is declining, tidal volume is decreasing, and EtCO₂ is rising. What is the primary physiologic problem that should drive your airway-management decision?
What is inadequate ventilation / impending ventilatory failure?
The lungs' ability to stretch and expand.
What is compliance
These receptors respond primarily to changes in CO₂ indirectly through changes in CSF pH.
What are central chemoreceptors
Inside an RBC, this enzyme rapidly facilitates the conversion of CO₂ and H₂O into carbonic acid and ultimately H⁺ and HCO₃⁻
What is carbonic anhydrase
Alveoli receive air, but inadequate blood flow prevents effective gas exchange. This is called this type of dead space
What is alveolar dead space
A patient with severe respiratory distress is still conscious and protecting their airway, but their work of breathing is increasing and they are beginning to fatigue. Before moving to an advanced airway, name TWO noninvasive interventions that could support ventilation
What are BVM with PEEP, CPAP, BiPaP
During spontaneous inspiration, respiratory muscles enlarge the thoracic cavity, lowering intrapulmonary pressure so atmospheric pressure pushes air inward. This is called this type of ventilation.
What is negative pressure?
Excessive oxygen can cause V/Q mismatch, vasoconstriction, free radicals and oxidative cellular damage
What is hyperoxemia
CO₂ rises because a patient is hypoventilating. Using the carbonic acid relationship, predict what happens to H⁺ and pH.
What is increased H⁺ and decreased pH
A patient with ARDS develops fluid-filled alveoli and atelectasis. Name two mechanisms that directly impair gas exchange.
What are increased diffusion distance and decreased surface area/atelectasis