Fundamentals of RT - Final Review - SPC
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| People in Respiratory Care | Priestly = Oxygen, Black = Carbon Dioxide, Beddoes = Father Inhalation Therapy
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| Organizations of RT | AARC = Professional org. , NBRC = Testing, CoARC = Program accredidation
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| Service Areas of RT | General Theraputics, Critical Care, Emergency Care, Diagnostic, Pulmonary Rehab
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| General Therapy | Aerosol, humidity therapy, Bronchial hygiene, IS, IPPB
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| Critical Care | Mechanical Vent, CPAP, pt transport, Airway care
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| Emergency Care | CPR, pt transport, Intubation
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| Diagnostic | Sputum collection, ABG, PFT, bedside monitoring
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| Pressure Conversion Formula | either multipy or divide by 1.36(from cm to mm, divide)(mm to cm, multiply)...mm to lbs = x14.7....mm to g/cm3 = x 1034
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| Boyle's Law | P1V1 = P2V2 (Temp is Constant) Think "boil" water by temp
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| Charlie's Law | V1/T1 = V2/T2 (Pressure is Constant) Think Charlie lives in VT
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| Gay's Law | P1/T1 = P2/T2 (Volume is Constant)
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| Graham's Law | Inversely proportional to sq. root
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| Henry's Law | More P = more gas dissolves in Liquid
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| Combined Gas Law | (P1V1)/T1 = (P2V2)/T2, if BTPS, remember to take out 47 from P2
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| Nasal Anatomy | Vestibular(entry), Olfactory(smell), Respiratory
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| Vestibular Region of Nose | Alae(wings), Vibrissae(hairs), Septum(seperator)
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| Respiratory Region | Where the warming occurs, Superior, Middle and Inferior Concha
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| Pharyngeal Region | Naso, Oro, and Hypo/Laryngo pharyngeals
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| Laryngeal Region | Epiglottis, Thyroid(adams apple), Cricoid. Glottis is space between vocal chords
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| Trachea | 16-20 "C" shaped cartliages. Seperates about 21-23 cm from mouth at Carina into mainstream R and L Bronchi
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| Lobar Bronchi | Right has 3 that branch into 10 segmental. Left has 2 that branch into 8 segmental.
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| Bronchioles | Thousands. the Terminal Bronchioles are the last of the Conducting Airways
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| Pulmonary Lobule | Gas exchange area. Alveolar ducts, sacs, alveoli
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| Diaphragm | Two muscles L and R hemidiaphragms innervated by the Phrenic Nerve
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| Accessory Inspiration Muscles | Think Neck/Chest. Scalenes, Sterno, Pectoralis Major
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| Accessory Expiration Muscles | Stomach muscles
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| Minute Ventilation | Tidal V x Frequency. Normal values are 500ml x 12 = 6L/M
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| Alveolar Ventilation | Take (Tidal V - body wt) x f or if given VD/VT, take Tidal V x (1 - VD/VT) x f
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| Pulmonary Shunt | Alveolar deadspace. Perfusion w/o ventilation. No gas exchange. Noted in pneumonia
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| Deadspace | Conduction Airways. Ventilation w/o perfusion
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| ABG normal values | pH 7.35-7.45, CO2 40, HCO3 24
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| ECG | P wave = atrial depolorization, QRS wave = ventricular depolorization, T wave = Ventrical repolorization
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| Cardiac Anatomy | Blood in RA thru Tricuspid to RV to Pulmonary Art return Pulm veins to LA thru Bi(Mi)to LV out Aorta
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| Oxygen Content Calculation | 1.34 x g/Hb x SaO2(sat). Then add (PaO2 x .003)to the total
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| Apnea | Stop Breathing
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| Dyspnea | SOB
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| Eupnea | Normal Breathing
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| Hypervent | blowing off CO2 <35
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| Hypovent | CO2 level up >45
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| Orthopnea | breath only in upright position
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| Hypernea | VT >10L/M
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| Hypopnea | VT <5L/M
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| Bradypnea | f <10/M
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| Tachypnea | f >20/M
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| Causes of Resp. Acidosis | Hypovent(hang on to CO2), Narc drugs, anestesia, sedative drugs, obesity
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| Causes of Resp. Alkalosis | Faster breathing, anxiety, Acute Asthma, Pulm. Vasc. disease, Hypobarism
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| Causes of Met. Acidosis | Loss BiCarb, Diarrhea, Diabetic ketoacidosis, lactic acidosis
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| Causes of Met. Alkalosis | Increase in Base, Diuretic therapy, Vomitting
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| Gas Cylinder Volumes | E= 22, G= 187, H= 244, K= 275
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| Cylinder Factors | E= .28, G= 2.41, H= 3.14
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| Cylinder Calculation/Duration of Flow | (PSIG x Factor)/Flow
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| Liquid to Gas Conversion | 1LB of Liquid O2 = 344L Gaseous O2
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| Cubic Feet to Liters | 1Cu foot of Gaseous O2 = 28.3L of Gas
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| NFPA | Regulates storage and Handling of cylinders as well as central supply gas and piping
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| DOT | Regulates cylinder construction, testing and transport
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| CGA | Sets all safety standards...ASSS, PISS, DISS
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| FDA | Sets medical gas purity standards
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| Thorpes Tubes Flowmeter | COMPENSATED, will jump, needle distal to valve, reads accurately in back pressure
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| Oxygen Concentrators | Electrically powered, use molecular sieves containing ZEOLITE to absorb N2 as well as H2O and CO2 from air. <6L/M = 92-96% delivered
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| Alveolar Air Equation | Quick and dirty 7 x FiO2 - CO2 from Bl. gas
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| Clinical Manifestations of Hypoxemia | Tachycardia, Tachypnea, Cyanosis, Pulmonary Hypertention, Restlessness/Confusion
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| Refractory Hypoxemia | Minimal response w/ increase FiO2. Due to Shunting. Use PEEP or CPAP
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| Responsive Hypoxia | Significant increase in PaO2 w/increase in FiO2. Due to V/Q mismatch or diffusion defect. Use Hi or Low flow device
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| Total Flow | Remember Magic Box from Clinicals100 Percent20Then cross substact, add then x flow
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| AARC CPGs for Hypoxemia | Documented = PaO2 < 60mmHg, SaO2 <90%. Suspected = Acute M/I, Severe Trauma
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| Low Flow Systems Under 15L | NC= 2-4L, Transtracheal O2 Cath, Simple= 6-10L, Partial and Non-Rebreathing Masks= 12-15L
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| High Flow Systems | Will meet pts peak Insp. needs. AEM <.40/Venti, AE Nebs - High Flow <.40
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| Oxygen Analyzers | Polargraphic and Galvanic Fuel Cell
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| Polargraphic | Used in Bl. Gas machines, Clark electrode, vent circuits, O2 analyzers. Fast because of Battery. Under 30 secs. Silver Anode, Platinum Cathode KCl solution
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| Galvanic Fuel Cell | No Voltage. Found Vent circuits O2 analyzers. Lead Anode, Gold Cathode, teflon membrane, SLOWER
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| HeOx Therapy | Decrease turbulence and WOB, Stidor(post extubation), Croup, Foreign body aspiration, Upper airway masses, Diffuses faster than O2 or air
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| Pulse Ox | Spectro= light, S= spectrum.Photo= Pulse
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| Hyperinflation Calculation` | VC= ml/kg. If VC >10-15 and clear= ISVC >10-15 w/secrections PEP, VC <10-15 and clear= IPPB
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| Bronchial Hygiene Devices | Oscillation, HFCC(Hi Freq Closed Chest), HFO(Flutter Valve)= CHEAP, IPV(used for tx w/hygiene therapy), MIE(mechanical couch), HUFF(Forced Ex. Techniques), Autogenic Drainage(AD) uses series of steps
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| Categories of Nebs | Pneumatic(powered by gas) include Jet,SVN, LVN(SPAG for Ribavirin and HEART for continuous Broncho Di), MDI, DPI. Electric- ultrasonic
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| Percent Drug Solution | divide mg/ml/10 for % solution or % solution x 10= mg/ml
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| What are Adrenergics? | Sympathetic. Receptor sensitive to norepinephrine. Increase HR and contraction, bronchodilate, Vasoconstriction
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| Adrenergic Drugs | Catecholamines - Racemic(All receptors), Noncatecholamines - Alupent, Albuterol, Levalbuterol, Salmeterol, Formoterol, Brovana, Tornalate, Maxair
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| What are Anticholinergics? | Block Parasympathetic receptor sensitive to acetylcholine. Broncho Di, Increase HR, Dry secretions. Atrovent and Spiriva(Tiotropium BR) DPI
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| What are Asthma Maintenance Drugs? | Glucocorticosteroids= Prednisone(Tab) and Pulmicort(MDI/DPI. Also Mast cell stabilizers Intal and Tilade. And Leukotriene blockers Accolate, Zyflo and Singulair. Fight all inflammation.
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| Proteolytic Agent | Dornase Alpha(Pulmozyme) NEB, infectious secretions, digest DNA
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| Wetting Agents | Use Ultrasonic Neb, Iso and Hypo both Thin secretions and Hyper induces sputum
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| Biological Indicators | Spore strips used to determine sterilization
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| Chemical Indicators | ETO exposure
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| Disinfectants | Low-level in Home Acetic Acid(Vinegar), Glutaraldehyde (sterilizing agent for vent tubes, scopes, bags), Auto- claving(true sterilization process in central supply, damages rubber and plastic), Ionizing(High cost, long time), Ethylene(heat sensitive),
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