| 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 |