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TMC

Tutoring TMC

QuestionAnswer
Levophep Vasopressor, increases B/P Decreases Pressures First RT has to establish a CVP to administer
Norepinephrine Decreases B/P
CVP 2-6 mmHG Measures RA pressure Increased Cor Pul decreased Vaso dilation
Plat <30 Alveoli Compliance drops PLAT would increases Measured at end Inspiration
PIP <40 Upper Airway + Alveoli Compliance Drops PIP would increases
Low Pressure Alarms Leak, Low Vt, Rupture in ETT or Cuff Withdraw of ETT
High Pressure Alarms Bitting ETT, Kinking , Secretions, Mucus plug, Pnemo Right mainstem, Increased/too much Vt due to decreased compliance
Pneumothorax B/P decrease's Radiolucent-black Hyperlucency-Black Tracheal Deviation to opposite side from affected side Tympanic/Hyyperreasonce Unequal breath sounds Unstable- Needle Depression Midclavicular 2-3 Stable- Chest Tube
Continuous Bubbling only acceptable in Drainage seal In-active Inhalation and exhalation
If there is continuous bubbling Replace Tubing Notify Physician
SBT Ps/CPAP -30min- 2hrs HR. RR, WOB, B/P, signs of resp distress RR >35 for 5 mins (D/C SBT) HR >130/20% increase for 5 mins or (D/C SBT)
RAW 0.6-2.4 cmH20 (up to 6 for vented pts) Secretions/Bronchoconstriction Pip-Plat/Flow (L/S) Secretions- SXN Bronchoconstriction- Bronchodilator If effective PIPS would decrease
Pre/Post Bronchodilator Test Assess for revisability of disease 1st- Get baseline 2nd- Get post measurement assess increase of 12% in FEV1 & FVC 200 ml
Flow loops if they don't get back to baseline -Airdropping/Obstruction/Decreased Exhalation
Secretions Course crackles BS Flow wave form (Snake) Increased PIP Vibrations in the chest Q4 CPT
Pul. E Sudden Desat Young Kids Long bone fracture Rib Fractures Chest pain Post Ob pt in long periods of bed rest Cough Nonproductive if productive it would be hemoptysis Cyanotic
ARDS P/f ratio <200 Increased PLAT Refectory Hypoxemia Ground glass / Honey combing Increase PEEP Low VT ARDS net Low Fio2 at 60% and High PEEP
when weaning off ARDs net Drop first FIO2 then Drop PEEP
Normal PEEP PEEP 4-6 ml/Kg
VC Pressure is SET MG/GB
PC Volume is SET ARDS
Insp Flow Increased insp flow it fix air trapping (autoPEEP) and air hunger it will then Decreased i-Time
Increase PIP Increase VT
Decrease MAP Decrease itime, and Increase PIP (improves Oxygenation and Improves Distribution of ventilation)
IPV Hyperinflation/High freq pulse delivery Improves ventilation, Mobilize secretions Promoter Bronchial Hygiene Vent Patients (Unconscious Patients) But if they are in floors they don't qualify ( Unconscious patient)
IPPB Correct Atelectasis Improves & promotes Cough Mechanism Follow commands Surgical Patients
Cd 40-60 cmH20 Measured at Inspiratory Hold and Expriatory
Cs 60-100 cmH20 Measured at Inspiratory Hold
ICP 5-10 to Decease ICP hyperventilate
CBC Hb, Hct, RBC, Platelets
Auscultation of the chest Asses for breathrng Pattern SOB, Increased RR Fever
Blood Cult Asses for sepis
Confirm ETT EZ-Cap 5% yellow
Position ETT
Placement ETT
Chest Xray findings Broken Ribs, Diseases,
Toxicology Screen Overdose/Alcohol Use/Pt fall down-Unresponsive
LOC Mental Status Orientation Can they Follow commands GCS >9
Integrity of ET and Airway To asses patency Increase PIP, Decrease PIP -Proper placement
Nasal SX Weak/nonproductive cough IF they are desating and large of continuous of secretion consider Intubation
Patient on 3L NC smoking leads to fire brought in brought by ambulant NRB Co-ximetry /hemoximeterr Pink Cherry Red Sp02 100% inaccurate
12 ECG Chest Pain Increased HR Cardiac Arrthtymias
Check electrolytes in what type of patients Weak patients /nuromuscular disorders
If PIPs are high what do you give Bronchodilator
Created by: Fabian.559
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