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Fundamentals of RT
Fundamentals of RT - Units 6,7,8 SPC
Question | Answer |
---|---|
What is Oxidation? | Electron loss |
Where does Oxidation occur? | Anode |
What is reduction? | Electron gain |
Where does reduction occur? | Cathode |
Where are Polargraphic analyzers used? | Blood gas machines, TcO2(transcutaneous)monitors(Clark electrode), vent circuits, and O2 analyzers |
What are the components of a P/G analyzer? | Silver anode, Platinum cathode, and KCl solution |
What are the components of a GFC (Galvanic fuel cell)? | Lead anode, Gold cathode, hydroxyl solution(KOH, or CsOH) |
What are the clinical applications of electrochemical analyzers? | Use Polargraphic for quick (<30 secs) response time, and GFC for slower (up to 60 secs) |
What are theraputic applications of Helium? | Lower density gas will decrese turbulence and WOB. Stridor(post extubation), Croup, Foreign body aspiration, and Upper airway masses |
What are the diffusion qualites of Heliox? | Diffuse faster |
What are special conciderations of Heliox? | 1. Deliver w/"closed" system -NRB mask, ET tube, NO HOODS 2. Aerosols get better depostion |
Flow meter factors for He/Ox? | 80/20 mix = Flow x 1.8, 70/30 mix = Flow x 1.6 |
What are the 2 pricipals of Pulse Oximetry? | Spectrophotometry - light absortion = Spectrum, Photoplethysmograpghy - light transmission = Pulse Rate |
Red/Infrared ratios? | Low ratio = High Sat (1/2 = SpO2 93%), High ratio = Low Sat (2/1 = SpO2 55%) |
What are the technical limitations of Pulse Ox? | False highs. HbCO (Firemen)carboxy hemoglobin, MHb reads R/IR 1.0 85%SpO2 Both don't allow Hb to release O2, Nail Polish, Flourescent Lights(babies) |
What are the Hyperinflation Pressures? | IS, IPPB, and PEP |
What is IS? | Incentive Spirometry, (-) pleural and aveolar pressure |
What is IPPB? | Intermittent Positive Pressure Breathing, (+) Inspiration(I) alveolar and pleural pressure |
What is PEP? | Positive Expiratory Pressure, (+) E alveolar and pleural pressure |
What are the Cardiovascular effects of hyperinflation? | 1. Decrease venous return, 2. Dercease C.O., 3. Increase PVR, 4. Increase ICP(IntaCranial Pressure) |
What is the Clinical application of Hyperinflation? | Primary is Tx of atelectasis |
What are the target populations for hyperinflation? | Neuromuscular disease pts, Post-Op/Surgery |
Define IS? | Sustained Max Inspiraton via device for >3 secs, 5-10 breaths Q 1-2 hrs |
Indications for IS? | Atelectasis, Vital Capacity(VC) > 10-15 ml/kg |
Contraindication of IS? | Uncoroperative pts, VC < 10-15 ml/kg |
Hazards of IS? | Dizzy, Tired, Hypoxemia if on Mask already |
Monitor for IS? | Improved breathing sounds, Chest X-ray, Breath hold, V/Flow setting |
Indications for IPPB? | Atelectasis, Delivery of aerosol meds, VC < 10-15 ml/kg, good breath sound |
Contraindicatons of IPPB? | Untreated tension pneumothorax |
Monitoring of IPPB? | Tidal Volume > 1/3 predicted IC(Inspiratory Capacity) |
Calculate Vt for IPPB? | 1/3 predicted IC x 50ml/KgPatient weighs 80 Kg, Vt = 1/3 (80x50), 4000/3 = 1333ml |
Indications for PEP? | Atelectasis, SECRETIONS, VC > 10-15 ml/Kg |
What are HFCC devices? | High Frequency Closed Circuit. Oscillatory from 5-25Hz |
One Hz = how many cycles per minute? | 60 |
What are the advantages of HFO (High Freq Oscillatory)? | Portable and cheap |
What are the HFO devices? | Intrapulmonary Percussive Vents(IPV), used for Txs with aerosol, 6-14Hz |
What is an MIE(Mechanical Insuffulaton Exsufflation) device? | Artificial Cough Machines, Peak Cough < 270 L/M, |
What pts use MIE devices? | With Neuromuscular problems |
Monitor for MIE? | Sputum (V and quantities), Improved breath sounds, and chest x-rays |
What are ACBT(Airway Clearance Breathing Techniques)? | HUFF and AD(Autogenic Drainage) |
HUFF Cough? | Blow tissue/cotton ball. Active cycle of breathing |
AD(Autogenic Drainage)? | series of steps include, "unstick"=low lung V, "collect"=Vt, and "evacuate"=high lung V |