Fundamentals of RT - Units 6,7,8 SPC
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| What is Oxidation? | Electron loss
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| Where does Oxidation occur? | Anode
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| What is reduction? | Electron gain
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| Where does reduction occur? | Cathode
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| Where are Polargraphic analyzers used? | Blood gas machines, TcO2(transcutaneous)monitors(Clark electrode), vent circuits, and O2 analyzers
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| What are the components of a P/G analyzer? | Silver anode, Platinum cathode, and KCl solution
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| What are the components of a GFC (Galvanic fuel cell)? | Lead anode, Gold cathode, hydroxyl solution(KOH, or CsOH)
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| What are the clinical applications of electrochemical analyzers? | Use Polargraphic for quick (<30 secs) response time, and GFC for slower (up to 60 secs)
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| 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
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| What are the diffusion qualites of Heliox? | Diffuse faster
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| What are special conciderations of Heliox? | 1. Deliver w/"closed" system -NRB mask, ET tube, NO HOODS 2. Aerosols get better depostion
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| Flow meter factors for He/Ox? | 80/20 mix = Flow x 1.8, 70/30 mix = Flow x 1.6
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| What are the 2 pricipals of Pulse Oximetry? | Spectrophotometry - light absortion = Spectrum, Photoplethysmograpghy - light transmission = Pulse Rate
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| Red/Infrared ratios? | Low ratio = High Sat (1/2 = SpO2 93%), High ratio = Low Sat (2/1 = SpO2 55%)
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| 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)
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| What are the Hyperinflation Pressures? | IS, IPPB, and PEP
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| What is IS? | Incentive Spirometry, (-) pleural and aveolar pressure
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| What is IPPB? | Intermittent Positive Pressure Breathing, (+) Inspiration(I) alveolar and pleural pressure
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| What is PEP? | Positive Expiratory Pressure, (+) E alveolar and pleural pressure
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| What are the Cardiovascular effects of hyperinflation? | 1. Decrease venous return, 2. Dercease C.O., 3. Increase PVR, 4. Increase ICP(IntaCranial Pressure)
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| What is the Clinical application of Hyperinflation? | Primary is Tx of atelectasis
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| What are the target populations for hyperinflation? | Neuromuscular disease pts, Post-Op/Surgery
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| Define IS? | Sustained Max Inspiraton via device for >3 secs, 5-10 breaths Q 1-2 hrs
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| Indications for IS? | Atelectasis, Vital Capacity(VC) > 10-15 ml/kg
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| Contraindication of IS? | Uncoroperative pts, VC < 10-15 ml/kg
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| Hazards of IS? | Dizzy, Tired, Hypoxemia if on Mask already
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| Monitor for IS? | Improved breathing sounds, Chest X-ray, Breath hold, V/Flow setting
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| Indications for IPPB? | Atelectasis, Delivery of aerosol meds, VC < 10-15 ml/kg, good breath sound
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| Contraindicatons of IPPB? | Untreated tension pneumothorax
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| Monitoring of IPPB? | Tidal Volume > 1/3 predicted IC(Inspiratory Capacity)
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| Calculate Vt for IPPB? | 1/3 predicted IC x 50ml/KgPatient weighs 80 Kg, Vt = 1/3 (80x50), 4000/3 = 1333ml
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| Indications for PEP? | Atelectasis, SECRETIONS, VC > 10-15 ml/Kg
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| What are HFCC devices? | High Frequency Closed Circuit. Oscillatory from 5-25Hz
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| One Hz = how many cycles per minute? | 60
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| What are the advantages of HFO (High Freq Oscillatory)? | Portable and cheap
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| What are the HFO devices? | Intrapulmonary Percussive Vents(IPV), used for Txs with aerosol, 6-14Hz
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| What is an MIE(Mechanical Insuffulaton Exsufflation) device? | Artificial Cough Machines, Peak Cough < 270 L/M,
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| What pts use MIE devices? | With Neuromuscular problems
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| Monitor for MIE? | Sputum (V and quantities), Improved breath sounds, and chest x-rays
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| What are ACBT(Airway Clearance Breathing Techniques)? | HUFF and AD(Autogenic Drainage)
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| HUFF Cough? | Blow tissue/cotton ball. Active cycle of breathing
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| AD(Autogenic Drainage)? | series of steps include, "unstick"=low lung V, "collect"=Vt, and "evacuate"=high lung V
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