Mind Yours ABCDEFs
This A component of the A-F bundle emphasizes routine pain assessment using a validated tool such as the CPOT.
What is A or Assess, Prevent, and Manage Pain?
In a patient with severe opioid-induced respiratory depression progressing toward respiratory arrest, this medication is administered to reverse the cause.
What is naloxone or narcan?
During cardiac arrest, this medication is administered every 3-5 minutes during pulseless cardiac arrest to improve cardiac and cerebral perfusion.
What is epinephrine?
Current guidelines recommend maintaining this minimum arterial pressure in most patients with septic shock.
What is 65 mm Hg?
This ventilator setting helps prevent alveolar collapse at end-expiration and improve oxygenation in patients with acute respiratory failure.
What is positive end-expiratory pressure (PEEP)?
This assessment performed prior to extubation evaluates a patient's ability to maintain adequate ventilation and oxygenation while recieving minimal ventilatory support.
What is a spontaneous breathing trial?
The first-line vasoactive medciations is recommended for septic shock because of it's potent alpha-adrenergic effects that increase systemic vascular resistance.
What is norepinephrine or Levophed?
This reversible cause of cardiac arrest, one of the H's and T's, should be suspected when a patient develops sudden pulseless electrical activity after central line insertion.
What is tension pneumothorax?
This shock state is characterized by low CO, high CVP, and high SVR.
What is cardiogenic shock?
When the high airway pressure alarm is triggered, the problem is most likely caused by this.
What is secretions, coughing, or kinked ventilator tube/tubing?
Evidence suggests this commonly used sedative is associated with a higher risk of delirium compared with propofol or precedex.
What are benzodiazepines?
This medication may be added in septic shock patients requiring escalating doses of norepinephrine to help increase blood pressure.
What is vasopressin?
During high-quality CPR, compression interruptions should be limited to less that this number of seconds.
What is 10 seconds?
A patient presents with hypotension, tachycardia, low CVP, low PAWP (wedge), and increased SVR following significant blood loss. This type of shock is most likely occurring.
What is hypovolemic shock?
This method is most effective for improving CO2 elimination in a patient with hypercapnia.
What is increasing the respiratory rate?
What is early mobility and exercise?
This inotropic medication increases contractility by stimulating beta-1 receptors and is commonly used in cardiogenic shock for low cardiac output.
What is dobutamine?
This shockable rhythm is characterized by a rapid, wide-complex tachycardia without a detectale pulse that requires immediate defibrillation.
A patient has a cardiac output 3.0 L/min and a BSA 1.5 m2. This calculated value, frequently used to assess cardiac performance, equals 2.0.
What is cardiac index?
This mechanical ventilator mode provides a set number of manditory breaths per minute, but allows spontaneous assisted breaths as well.
What is assist control mode?
An intubated patient has a RASS of -5, recieves continuous benzodiazepine infusions, experiences prolonged immobility, and develops delirium. This A-F bundle element was most directly neglected.
What is C or Choice of Analgesia and Sedation?
What is peripheral tissue ischemia?
During CPR, this monitoring parameter may suddently rise from 12 mm Hg to 40 mm Hg even before a pulse check is performed.
What is EtCO2 or end-tidal carbon dioxide?
Calculate the Cardiac Output using the FICK
BSA - 1.8; SaO2 - 98%; SvO2- 68%; Hgb - 11.0
What is 5.01 l/min?
A patient with severe ARDS on PCV develops worsening hypoxemias despite max FiO2, high PEEP, and neuromuscular blockade. This advanced therapy may be indicated.
What is proning?