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Flight Paramedic Certification > Respiratory > Flashcards

Respiratory Flashcards

1
Q

What are critical blood gas results?

A

Ph less than 7.2, Paco2 >55, Pa02 <60

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2
Q

Calculate minute volume

A

Minute Volume (Ve) = Tidal Volume (Vt) x Rate (f)

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3
Q

S/S of Acute Resp Distress?

A

Rapid, shallow breathing, accessory muscle use, tripod, decrease minute volume, critical ABG results, changing breath sounds

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4
Q

What is a shunt?

A

No perfusion of alveolar beds causing no gas exchange

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5
Q

Classic Pulmonary Embolism patients

A

Smokers, birth control, surgery, cancer, pregnant, obese

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6
Q

Treatment of P.E.

A

High flow 02, Lovenox/Heparin, Fibrinolysis (TPA), Surgery

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7
Q

Signs of P.E.

A

Acute Resp Distress, Spo2 not responding to high flow 02. Elevated D-Dimer.

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8
Q

S/S of COPD/Asthma/Bronchitis

A

Bronchoconstriction, Hypersecretion and edema, Trouble breathing OUT

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9
Q

Treatment of COPD/Asthma/Bronchitis

A

Albuterol, Atrovent, Magnesium sulfate, Steroids. Ketamine for induction agent (bronchodilator)
Increase I:E ratio to 1:3 or 1:4

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10
Q

Causes of Pneumonia

A

Ventilator acquired VS Community acquired. Can be viral, bacterial, or fungal.

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11
Q

Treatment of Pneumonia

A

O2, IV antibiotics, HOB elevation of 30*, Suction mouth and upper airway PRN, Supportive treatment.

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12
Q

Define Adult Respiratory Distress Syndrome (ARDS)

A

Hyperpermeable pulmonary capillaries causing interstitial fluid build up causing separation of alveoli and capillary bed (shunt forms).

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13
Q

Treatment of ARDS

A

PEEP of 5-20, Recruit alveoli and provide O2, Monitor PIP, Vt, and Pplat.

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14
Q

What is normal tidal volume for the obstructive approach to ventilator management?

A

6-10 ml/kg

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15
Q

Clinical signs of Pneumothorax

A

SOB, Absent lung sounds on one side, JVD, hypotension, tachycardia.

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16
Q

Treatment of Pneumothorax

A

Remove from Vent / PPV! Needle chest decompression or chest tube.

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17
Q

Criteria for Intubation

A

Current airway patency (trauma, unable to swallow)
Oxygenation or Ventilation failure (pH <7.2, Co2>55, PaO2 <60)
Expected clinical course
Gcs<8

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18
Q

Ventilator CMV mode

A

Delivers Vt or PIP at preset rate. Cannot initiate breaths.

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19
Q

Ventilator AC mode

A

Delivers preset Vt or PIP. Able to trigger full breaths. Can cause breath stacking or autopeep.

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20
Q

Ventilator IMV mode

A

Provides preset Vt or PIP while allowing patient to take own breath and volume without delivering full breath.

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21
Q

Ventilator SIMV mode

A

Considered safest mode. Allows for variation of support from complete support to spontaneous breathing.

22
Q

Ventilator High Pressure alarm troubleshooting

A

Suction tube/patient, Connections secured and not kinked, check for obstructions, pneumothorax, ETT displacement (main stem).

23
Q

Ventilator Low Pressure alarm troubleshooting

A

Think disconnect! Check all connections starting at patient and working back. Check O2 delivery/supply, Check for leaks in vent circuit, ETT displacement (dislodged)

24
Q

Ventilator Low Spo2 alarm troubleshooting

A

Appropriate Vt set? Appropriate rate? Appropriate I:E ratio? Consider PEEP/O2, suctioning, pneumothorax, ETT placement, P.E.

25
Q

VA = (Vt-VD) x f

A

Alveolar minute volume = (tidal volume - dead space) x rate

26
Q

Ve = Vt x f

A

Minute volume = tidal volume x rate

27
Q

Normal VD

A

Normal dead space = 1/3 Vt or 1 ml/lb IBW

28
Q

Normal Ve

A

Normal minute volume is 6.0 L/min

29
Q

Normal Vt for injury approach in ventilator management?

A

4-8 ml/kg

30
Q

To blow off CO2 increase __ first then __.

A

Volume first then rate

31
Q

To protect injured lungs on a vent, use lower __ and higher __.

A

Tidal volume

Rate

32
Q

Cheyne-Stokes respirations

A

Alternating periods of increased and decreased rate and depth with brief periods of apnea.

33
Q

Causes of Cheyne-Stokes

A

Associated with Decorticate posturing

Cushing’s triad, brainstem herniation

34
Q

Biot’s respirations

A

Quick, shallow, inspirations followed by apnea

35
Q

Causes of Biot’s

A

Meningitis
Increased ICP
Damage to medulla by stroke or trauma

36
Q

Kussmaul’s respirations

A

Deep and fast breathing without apnea

37
Q

Causes of Kussmaul’s

A 
Metabolic acidosis
Renal failure
DKA
Salicylates
Toxins
38
Q

Apneustic respirations

A

Long gasping inspiration followed by short expiration causing chest hyperinflation and hypoxia

39
Q

Causes of Apneustic respirations

A

Brain lesion

Common is decerebrate posturing

40
Q

Central Neurogenic Hyperventilation

A

Very deep, rapid respiration rate >25 bpm causing alkalosis

41
Q

Causes of central neurogenic hyperventilation

A

Increased ICP
Stroke
Lesion to brainstem
Head injury

42
Q

Desired minute volume for an intubated patient

A

120ml/kg/min

43
Q

Desired minute volume for intubated metabolic acidosis patient

A

240ml/kg/min

44
Q

Ataxic respirations

A

Complete irregularity of breathing “A-Fib of breathing”

45
Q

Gold standard for oxygenation

A

SpO2

46
Q

Gold standard for ventilation

A

ETCO2

47
Q

1 cause of iatrogenic death in the US

A

Ventilator Acquired Pneumonia

48
Q

Gold standard for ET tube placement

A

Chest X-Ray

49
Q

Curare Cleft on ETCO2 represents?

A

Patient needs resedated / paralyzed

50
Q

Preoxygenation is required in what patients?

A

Obese patients
Pregnant patients
Pediatric patients

(10 lpm via NRB for 15 minutes)

Flight Paramedic Certification (15 decks)

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