Advanced Airways
What is the equation to determine the proper suction catheter size?
ID/2=____*3
Example ID of 8/2=4; 4*3=12
What is the calculation used to calculate MAP?
MAP=systolic+2(diastolic)/3
What is the normal range for ICP?
5-10 mmHg
What are the 3 types of flexible bronchoscopy?
Hybrid, video, and fiberoptic
What does continuous bubbling in the water seal represent?
A leak in the system
Why would we use fiberoptic laryngoscopy after an oral intubation?
To absolutely confirm endotracheal tube placement
What kind of hemodynamic values would a patient with hypovolemia have?
QT < 4 L/M
HR < 60
CVP <2
PAP < 15/8
PCWP < 4
What factor determines the respiratory manifestations of spinal cord injuries?
The extent of the damage and the level of injury
What are the 2 directions the distal tip of a flexible bronchoscope can be flexed?
180 anteflexion and 130 retroflexion
What is the hazard of having less than 2 cmH20 in the water seal chamber?
Increases the risk of entry of atmospheric air into the patient’s thoracic cavity
Herniated cuff, mucus plug, excessive secretions, and impedance on the tracheal wall are all signs of a tracheal _________
Tracheal Obstruction
Septic, anaphylactic, and neurogenic shock are all types of what type of shock.
Distributive
Survival in patients with severe burns is associated with what?
The development of multidisciplinary teams.
Under what type(s) of bronchoscopy can metallic stents be placed?
Flexible bronchoscopy
What is the part that acts like a one-way valve that allows air to escape from the pleural or mediastinal space but does not allow it to enter?
Water seal chamber
What are some advantages of nasotracheal intubation?
Less retching and gagging, less risk of accidental extubation, better oral care, and better for long term comfort
Medical shock includes what types of shock?
Cardiogenic, obstructive, and distributive
What are the ventilation strategies for a trauma patient?
PC/AC
VT <8 ml/kg
Plat < 28 cmH2o
Bronchial washings are usually obtained in which portion of the airway?
Large airways
What types of medications are used to help the patient relax during chest tube insertion?
Benzos
What is the purpose of the inner cannula on a trach?
Helps with routine cleaning and provides a patent airway
You have a pt who arrived at the ER with suspected cardiogenic shock. RR 26, HR 122, BS bilateral course crackles, and has a dull percussive note. After placing a flow-directed balloon-tipped catheter, you get the following readings: CVP 15, PCWP 22, PAP 16, and CI 1.8. Based on this information, what is your treatment of choice?
Lasix
What are the clinical manifestations of carbon monoxide poisoning?
Anxiety, headache, and confustion
When would you perform an endobronchial biopsy?
To obtain a tissue sample from a visible endobronchial lesion.
How can you tell if there is a leak in the chest tube system or the patient?
Clamp the tubing; if bubbling stops it is in the patient and if it continues it is in the system