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ACCS RT
RT critical care
Question | Answer |
---|---|
BNP | 100 and below, no <3 failure 100-300 mild MI 300-600 moderate MI |
Cardiac output | 4-8 normal range |
Vd | Dead space = 1ml per lb of IBW |
Rales/crackles vs rhonchi | Rales, mobilize secretions Rhonchi can be suctioned. |
AEC | Airway exchange catheters Superior to bougie |
Platelets | Transfuse only when less than 10,000 for coagulation |
5 types of shock | Volume Cardiac Anaphylaxic Septic Neurogenic kdrugs) |
Bronchoscopy | 7.0.ETT or bigger |
NIPPV Initial settings | 12/6 |
Vent weaning | SBT is preferred |
P/F Ratio | Pao2/fio2 as a decimal |
How to use P/F ratio | <300 ALI <200 ARDS |
4 ARDS lung protective modes | APRV (bilevel) PC PRVC HFOV |
Indications for APRV | ALI ARDS extensive atelectasis Difuse PNA TE fistula |
APRV contraindications | Cerebral edema (increased ICP) Status epileticus Neuromuscular disease COPD / asthma |
APRV Weaning | Drop & stretch Drop pHi 1-2 cm q2 Drop tHi ,5 for every 1cm drop pHi @pHi 10 switch ro cpap |
Resistance = | Delta p/delta f |
Compliance = | Delta v / delta p |
HFOV Initial Settings | Paw is 5 above Paw on CMV Fio2 100% Hertz 5-6 Power 4 I time 33% Bias flow 40 lpm |
Carboxyhemoglobin threshold | 20% or greater |
Myesthenia Gravis Tensilon challenge | If pt improves w tensilon, a MG crisis is happening |
Keys to monitoring MG | Monitor Vt, MIP, VC |
Guillan Barre | Can come on slowly, will run its course. Intubate when VC is less than 1.0 L |
PEs (dead space disease) | V/Q scan to dx |
Anti coagulants | Heparin, coumadin Clot-buster is streptokinase or heparin bolus |
Pneumocystic carinii | Common in AIDS patients |
Test for HIV | Elisa |
CF | Sweat chloride above 60 mEq/L |
Inhaled meds for CF | Tobrimyacin, Pulmozyme (dornase alpha) |
Methemoglobinemia | Caused by drug use Treat w methylene blue |
Gram + | Mostly cocci Treat w penacillin and other cillins |
Gram negative | Not the coccis Treat w myacins |
R!pod Sequence Intubation | 10 mg etomodate 30 mg rocuronium |
6altitude sickness (Induced PHTN) | Sildenafil citrate (viagra) |
Analgesics | Toradol Fentanyl Dilaudid Morphine (vasodilator) |
Anesthetic | Ketamine |
Anxiety control | Versed Valium Ativan (benzo) |
Reverses benzodiazapines | Romazicon |
Adenosine | For SVT |
Nitroglycerine | Vasodilator Relaxes smooth muscle |
Epi | Increases cardiac contraction |
Atropine | Treats bradycardia |
Paralytics | Succs (anectine) Vecuronium Pancuronium |
Resp stimulants | Dopram Duapram. Tx central sleep apnea |
Pulm vasodilators | Viagra iNo Nitroprusside Hydrolazine diuretic Flolan Beta I blockers |
Sedation | Propofol Presedex Phenobarbitol (tx high ICP &anticonvulsant) Haldol Etomidate |
Siezure control | Dilantin |
Vasodilators | Prostacyclin Dobutamine |
Dopamine | Vasoconstrictor good for shock Levophed also good if dopamine doesnt work |
SUDDEN rise in PIP is caused by | Bronchospasm |
If Pplat increases it means | Atelectasis (Lungs, not airway) |
Electrolyte imbalance | Angry, irradic behavior |