Chap. 10,18,35,38,39
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| show | severity/cause of hypoxemia, age group, degree of consciousness and alertness, presence/abscence of tracheal airway, stability of minute ventilation and mouth vs.nose breathing pt
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| show | meet inspiratory demand, inspiratory demand equals 3*minute volume, CAN NOT deliver fixed FIO2, ordered in FIO2 while low flow devices ordered in lpm, breathing pattern irrelevant & fixed performance device
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| HAFOE(high air flow oxygen enriched) | show 🗑
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| High flow sysytems | show 🗑
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| Venturi Mask | show 🗑
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| entrainment ratio | show 🗑
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| show | need large bore tubing & nebulizer bottle, constant FIO2 to babies, flow has to be set high enough to flush out CO2, 5-10 lpm; noise pollution becomes a real problem for babies, measures FIO2 @ babies nose; not @ top of hood(care about babies mouth & nose
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| show | environmental delivery system, warms child to 35 degree Celsius, provides O2 enriched environment, humidifies, noise a problem [Red flag closes entrainment port; flag up = closed(100% FIO2)& flag down = open(40% O2)]
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| show | todays tent provide for children, oxygen enriched environment, high humidity, temperature control
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| Oxygen adder | show 🗑
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| Blender | show 🗑
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| Hyperbaric Oxygen Chamber | show 🗑
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| Monoplace Chamber | show 🗑
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| Multiplace Chamber | show 🗑
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| show | most common acute conditions are Air embolism and Carbon monoxide poisoning. Others are decompression sickness, cyanide poisoning, gangrene, anaerobic infection, skin grafts and wound healing
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| Contridictions for Hyperbaric Oxygen Therapy | show 🗑
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| Helium Oxygen Therapy | show 🗑
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| Guidelines for use of Heliox therapy | show 🗑
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| Trouble shooting and hazards of Heliox Therapy | show 🗑
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| show | physiologic control of heat-moisture exchange,nose is an effective humidifier/heater, mouth is less effective, artificial airway puts stress on the lower airway to provide heat & moisture
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| Heat-moisture exchange | show 🗑
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| show | temperature- the higher the temp of the gas the more water it can hold, surface area-affects the rate of evaporation, contact time-evaporation increases as contact time increases
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| show | is a device that adds molecular water to gas & this occurs by evaporation of water from a surface
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| show | administration of dry medical gases @ flows greater than /equal to 4Lpm, following intubation of the patient, managing hypothermia & treating bronchospasm caused by cold air
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| show | Temperature is the primary factor influencing evaporation; warmer the air the more H2O vapor it can hold
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| show | difference between the amount of water vapor in alveolus air and inspired air
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| show | impairment of cillia, decreased mucus movement, retained secretions, bacterial infiltration, atelectasis & pneumonia
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| insensible body deficits | show 🗑
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| sensible body deficits | show 🗑
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| additive deficits | show 🗑
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| show | ensure water vapor content is sufficient to meet patient physiologic need, increase water vapor content of dry therapeutic gases to approximate ambient conditions, provide inspired gas near BTPS for patient with artificial airway
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| Rationale for using humidity | show 🗑
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| show | alternation of normal heat and water exchange caution should be used in using heat humidifiers for pt w/fever, fluid retention. pediatric & neonatal care very sensitive because heat and water exchange more easily disrupted infection primarily w/aerosol
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| humidifier that produce aerosol | show 🗑
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| bubble humidifier | show 🗑
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| Passover Humidifier | show 🗑
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| Cascade Humidifier function | show 🗑
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| Wick humidifier | show 🗑
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| show | saturation @ high flow & less resistance to flow
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| Heat- Moisture Exchanger | show 🗑
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| Things to think about w/ HME | show 🗑
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| show | heated humidifiers can evaporate more than 1L/day to avoid constant refilling, the devices use large water reservior and/or gravity feed system
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| show | consists of liquid particles suspeneded in a gas(oxygen or air), a variety of liquids may be used, sterile water(entrain water into oxygen)& sterile saline( hypotonic,isotonic, hypertonic)
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| pulmonary circulation | show 🗑
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| show | gas exchange @ the alveolar- capillary membrane(primary function), pick up O2 and drop off CO2, Alveolar -Capillary membrane controls fluid exchange in lungs. production, processing and clearance of variety of chemicals and blood clots
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| show | movement of gas into and out of lungs
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| show | force per unit area
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| show | volume per unit time
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| show | impedance to flow
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| show | ability of object to return to original shape after having been distorted by some external force
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| compliance | show 🗑
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| airway resistance | show 🗑
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| show | pressure difference between airway opening and alveoli
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| pressure gradient | show 🗑
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| transpulmonary pressure | show 🗑
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| show | pressure difference between alveolus and pleural sapce
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| show | pressure required to inflate/deflate the lungs and chest wall
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| surface tension | show 🗑
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| Formula for surface tension | show 🗑
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| show | when you exhale it is ability of lungs to return to original shape
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| show | when you inhale it is ease with which lungs can be distorted; measured as change in volume/change in pressure. measure of inflation of lung, expressed as L/cmH20 or mL/cmH20. decreased lung compliance = increased elasticity
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| elaticity | show 🗑
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| FRC(functional residual capacity) | show 🗑
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| show | measure of compliance obtained while breathing(change in volume/ change in pressure)
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| static compliance | show 🗑
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| show | (VE) normal 5-10L/min total volumne moved in and out per minute VE=RR*VT VE driven by CO2 production and subject size
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| alveolar ventilation | show 🗑
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| Dead space Ventilation | show 🗑
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| Lung volumes | show 🗑
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| lung capacity | show 🗑
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| show | volume of air inhaled/exhaled @ rest 500mL
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| inspiratory reserve volume | show 🗑
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| show | amount of gas exhaled from lungs after resting exhalation 1000mL
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| residual volume | show 🗑
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| show | maxium amount of air inhaled from resting exhalation 3500mL
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| vital capacity | show 🗑
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| show | amount of gas left in lungs after normal exhalation 2500mL
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| total lung capacity | show 🗑
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| show | correct documented/suspected acute hypoxemia, decrease the symptom associated w/ chronic hypoxemia, decrease the workload hypoxemia impose on the cadiopulmonary system
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| show | laboratory documentation(PaO2,SaO2),specific clinical problem(pt suspected of carbon monoxide poising)& clinical findings @ the bedside(tachypnea,tachycardia,confusion,etc)
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| Precautions & hazards of Supplemental O2 | show 🗑
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| hypoxemia | show 🗑
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| hypoxia | show 🗑
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| Hypoxia occurs when | show 🗑
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| show | hypoxic, anemic, stagnant & histotoxic
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| show | 2types, absolute anemia & relative anemia
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| show | reduction in blood Hb concentration caused by hemorrahage/poor erythropoiesis
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| show | does not make rbc adequately/fast enough
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| relative anemia | show 🗑
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| Stagnant hypoxia | show 🗑
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| Ischemia | show 🗑
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| show | oxygen is ther but tissues can not use it. cellular use of O2 is abnormal like w/ cyanide poison. Hb is ok but tissue is bad
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| physiologic effects of hypoxia | show 🗑
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| show | common after surgery involving the upper abdomen/thorax, complications include atelectasis, pneumonia, and acute respiratory failure
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| lung expansion therapy | show 🗑
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| show | occurs when mucus plugs block ventilation to selected regions of the lung; gas distal to the obstruction is absorbed by the passing blood
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| show | is caused by persistent breathing w/ small tidal volumes
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| show | obesity, neuromuscular disorders, heavy sedation, history of lung disease, surgery near the diaphragm, bed rest & poor cough
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| show | history of recent major surgery, tachycardia, tachypnea, fine/late-inspiratory crackles, bronchial/diminished breath sounds, increased density & signs of volume loss on chest x-ray
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| incentive spirometry | show 🗑
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| show | simple, portable and inexpensive. Are either flow/volume oriented; flow-oriented are more popular because they are smaller
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| show | determined by careful patient assessment( high-risk patient)
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| effective patient teaching | show 🗑
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| IPPB means | show 🗑
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| IPPB | show 🗑
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| indications for IPPB | show 🗑
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| show | tension pneumothorax, tracheoesophagueal fistula, esophageal surgery, ICP>15mmHg, hemodynamic instability, active/untreated TB & active hemoptysis
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| show | preliminary planning and implementation
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| show | therapeutic outcomes set, evaluate alternatives and baseline assessment of the patient
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| show | equipment prep, patient orientation, patient positioning, adjusting parameter, flow & pressure
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| selecting an approach | show 🗑
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| The respiratory therapist should evaluate the following before choosing a specific modality | show 🗑
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| show | measurements of fluids/tissue that must be removed from the body, measurements made w/ an analyzer, monitoring is an ongoing process by clinicians where they obtain & evaluate physiological process; done w/ a monitor
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| Invasive procedures | show 🗑
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| Noninvasive procedures | show 🗑
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| In general, invasive procedures | show 🗑
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| show | All data must be evaluated in context of overall clinical presentation, instrument inaccuracy- recalibrate, artifacts, factitious results-true but temporary(cough), treat the pathology, not the errant number
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| All values monitored must be... | show 🗑
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| show | the measurement of Co2 in respiratory gases, graphic display of Co2 levels as they change during breathing, used in patients undergoing general anesthesia/mechanical ventilation
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| capnometer | show 🗑
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| show | places an analysis chamber in the patients breathing circuit
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| side stream technique | show 🗑
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| show | shows an PCO2 of ZERO at the start of the expiratory breath, soon afterwards, the PCo2 level rises sharply and plateaus as alveolar gas is exhaled
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| end-tidal PCo2(PETCO2) | show 🗑
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| show | works on "pauling" principle
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| O2 is.. | show 🗑
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| show | anything that is attracted by the poles of a magnet and becomes parallel to the lives of the magnetic force
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| diamagnetic | show 🗑
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| pauling | show 🗑
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| show | less resistant to flow of electrons & greater the current passing through the wire
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| show | has 2 reference chambers on one side that contain room air. A constant cooling by room air maintains current at constant level. Other side is a measuring chamber & a calibrating polentiometer, 2 sides connected in middle by voltmeter
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| potential difference is | show 🗑
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| chemical analyzers | show 🗑
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| show | for measuring FIO2, most bedside systems to measure use electrochemical principles
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| The two most common O2 analyzers | show 🗑
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| show | 10-30seconds
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| show | 60seconds
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| a gold cathode in the presence of O2 will produce the following reaction | show 🗑
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| galvanic fuel cell | show 🗑
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| show | faster than galvanic, uses battery to polarize electrode, has improved response, time w/ same chemical reaction, composed of 2 electrodes immersed in a potassium chloride electrolyte solution
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| how does current occur with polargraphic electrode | show 🗑
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| show | the greater the current produced
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| show | ABC machines & must be calibrated at different altitudes because measures partial pressure
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| show | low batteries, sensor depletion, or electronic failure
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| show | provides noninvasive measurement of SaO2(referred to as SPO2), monitors only oxygen; NOT ventilation & significant limitations
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| tissue oxygenation depends on | show 🗑
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| troubleshooting O2 analyzers | show 🗑
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| increase the flow and you | show 🗑
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| the LOWER the FIO2 the MORE air you entrain; therefore the MORE parts you have... | show 🗑
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| when the upper airway is bypassed the humidity is provided by | show 🗑
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| must have water vapor, it adds with pink silica gel crystal to RH 100%, and electric circuitry is flammable so not used | show 🗑
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| what covers the tip of a Clarke electrode | show 🗑
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| oximetry | show 🗑
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| pulse oximetry | show 🗑
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| show | 40mmHg; 35-45mmHg
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| acidotic | show 🗑
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| show | 35/above
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Popular Respiratory Therapy sets