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ACCS RT

RT critical care

QuestionAnswer
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
Created by: Clohkamp