Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
34 Cards in this Set
- Front
- Back
|
What is the watchword of the ASA????
|
Vigilance
|
|
|
Name 4 ways of monitoring per lecture notes.
|
1. observation and vigilance
2. instrumentation 3. interpretation of data 4. corrective therapy |
|
|
Name 3 major uses of capnography
|
1. confirming ETT placement
2. detection of circuit d/c 3. detection of vent failure |
|
|
prior to capnography what was the major cause of unexpected cardiac arrest in the OR?
|
circuit disconnect
|
|
|
What is the normal PaCO2
|
44 mmHg
|
|
|
What is the normal difference b/w arterial co2 and alveolar co2?
how about under GA? |
normal - 2-5mmHg
GA - 5-10mmHg (increase anatomic dead space, increase physiologic shunt - altered V/Q mismatch) |
|
|
What are the effects of resp acidosis/alkalosis per lecture notes?
|
1.electrolyte shifts (K, Cl)
2.change in cerebral/CV circulation 3.post-op resp distress with high PaCO2 4.post-op apnea due to low PaCO2 5.exacerbation of intra-op hypotension with low PaCO2 |
|
|
How much sampling gas does the sidestream monitor use?
|
200cc/min (caution with peds, low flows)
|
|
|
Name 7 other uses for capnography
|
1.determination of adequacy of ventilation
2.evaluation of depth of anesthesia during spontaneous ventilation 3.determination of airway obstruction 4.Early warning for MH 5.Adequacy of CO2 absorption 6.monitor for gas emboli 7.monitor for significant change in CO |
|
|
explain the 1st phase of exhalation
|
deadpace gas leaving the lung (no CO2)
|
|
|
explain the 2nd phase of exhalation
|
includes deadspace gas and gas from the alveoli mixing, which causes a rapid rise in CO2
|
|
|
explain the 3rd phase of exhalation
|
all deadspace gas is out.
CO2 slowly rises (dependant on V/Q ratio) |
|
|
Explain the 4th phase of exhalation
|
peak ETCO2 which is the highest level exhaled CO2 during respiration (plateau)
|
|
|
This measures the partial pressure of CO2 sampled from the patients exhaled gas and measure at a wavelength of 4.28
|
infrared analyzer
|
|
|
What will you see on your ETCO2 monitor if there is an air emboli?
CO2 emboli? |
air - sudden drop in ETCO2
CO2 - rise in ETCO2 |
|
|
Increased baseline on ETCO2 waveform
|
CO2 rebreathing - check absorber, incompetent inspir/expir valves, d/c on inspiratory limb
|
|
|
Cleft on alveolar plateau on ETCO2 waveform
|
spontaneous respiration
|
|
|
Steep plateau on ETCO2 waveform
|
obstruction - can be COPD or asthma
|
|
|
Cardiogenic oscillations on ETCO2 waveform
|
interference from heart or aorta pulsation
|
|
|
flattening of CO2 rise on ETCO2 waveform
|
kinked tubing
|
|
|
Hypoventilation
|
Increased CO2
|
|
|
sodium bicarb administration
|
Increased CO2
|
|
|
CO2 insufflation during laproscopic procedure causes?
|
Increased CO2
|
|
|
hyperthermia
|
Increased CO2
|
|
|
inproved blood flow (CO)
|
Increased CO2
|
|
|
water in capnograph head
|
Increased CO2
|
|
|
tourniquet release
|
Increased CO2
|
|
|
release of clamp during vascular surgery
|
Increased CO2
|
|
|
hyperventilation
|
Decreased CO2
|
|
|
circuit disconnect
|
Decreased CO2
|
|
|
hypothermia
|
Decreased CO2
|
|
|
PE
|
Decreased CO2
|
|
|
air embolism
|
Decreased CO2
|
|
|
decreased CO
|
Decreased CO2
|
