Let's Get Medications
Before giving Mucomyst or hypertonic saline, what do we administer and why?
Bronchodilator because they can cause bronchospasm
An AHI of 20 means?
Moderate sleep apnea
An ETT should ideally be positioned?
3-5cm above the carina
What 3 substances do we see trach cuff filled with?
Air, sterile water, foam.
What is the suction pressure range for an infant?
-80 to -100 mmHg
What are the two ingredients in Advair?
Fluticasone and salmterol
A patient with central sleep apnea and hypercarbia will likely need?
BIPAP
What ETT size is appropriate for a 2 year old child?
4.5
After how many days intubated do we consider placing a trach?
10-14 days.
A 2Kg infant is intubated witha 3.5 uncuffed ETT, what should the initially tube depth be?
8cm at the gums
When nebulized for post extubation stridor, what effect of epinephrine is most important?
Alpha 1 agonist/vasoconstriction
PSG is short for?
Polysomnogram
What is the safe pressure range for ETT and trach cuffs? (include units!)
20-30cmH2O
Before placing a speaking valve or trach cap, what must the RT do first?
Deflate the cuff.
Which form of lung expansion is good for preventing atelectasis but not reversing it?
Incentive spirometer
A patient with a drip of vasopressin is likely suffering from:
Hypotension/shock
Besides CPAP, name two other treatments for OSA.
Surgery, oral appliances, weight loss, oxygen therapy, position (kind of), medications, BIPAP
This type of ETT can be placed to ventilate a single lung:
Dual lumen
What should you do prior to suctioning a trach?
Hyperoxygenate/hyperinflate
What is the term for high FiO2 causing atelctasis?
This medication is also a SABA and an isomer of albuterol:
Levalbuterol/xopenex
How long can sleep cycles range?
70-120 minutes
Name three methods we can use to determine ETT placement.
CXR, capnography, breath sounds, lack of epigastric sounds, chest rise, condensation in ETT, improving SpO2
If a trach appears to be occluded with secretions and the suction catheter will not pass, what should the RT do?
Change the inner cannula for adults, change trach for peds
What are 3 major contraindications to most forms of ACT/lung expansion?
Untreated PTX, hemodynamic instability, ICP greater than 20mmHg