Respiratory Procedures| Unit 3a and 3b

Monitoring gas exchange

what are the levels of hypoxemia

normal

mild

moderate

severe

refractory

hypoxemia

abnormal deficiency of O2 in the arterial blood

what is the range of normal hypoxemia

80-100 mmHg

what is the range of mild hypoxemia

60-79 mmHg

what is the range of moderate hypoxemia

40-59 mmHg

what is the range of severe hypoxemia

below 40 mmHg

refractory hypoxemia

severe hypoxemia that is unresponsive to increased levels of O2

Hazards associated with Oxygen Therapy

retinopathy of prematurity

oxygen toxicity

retinopathy of prematurity

PaO2 greater than 80mmhg may lead to disorganized growth in retinal blood vessles.

what can retinopathy of prematurity result to

scarring and retinal detachment which can lead to blindness

oxygen toxicity

high PaO2 that damages capillary endothelium, damages the cells that create new tissue and causes an inflammatory response

What does an Oxygen Blender do

has precise control over both FiO2 and total flow output, and mixes gas manually

what is the Polarographic Fuel Cell Analyzer also known as

Clark electrode

galvanic fuel cell analyzer

relies on a self-generated electrical potential to measure oxygen concentration. _________is "self-powered" and are generally considered less accurate but longer-lasting

polarographic fuel cell analyzer

requires an applied voltage to the electrodes to measure oxygen. ________sensor needs an external power source to operate effectively and offer faster response times and higher accuracy

What does an Oxygen Analyzer 2-point calibration consist of

21% FiO2 and 100%FiO2

What does an Oxygen Analyzer do

measures the amount of oxygen in a given environment

What is a Pulse Oximeter

a noninvasive monitoring technique performed at bedside

how does a Pulse Oximeter work

It uses light absorption patterns to indicate saturation levels of “pulsed” blood

Things that can provide an erroneous reading with Pulse Oximetry

motion artifact

abnormal hemoglobins

intravascular dyes

low perfusion states

thick nails

nail polish/artificial nails

skin pigmentation

Contraindications of Pulse Oximetry

ongoing need for actual measurements of pH, PaCO2, total hemoglobin, and abnormal hemoglobins

Accuracy of a pulse oximeter

within + 2%-4%

Tissue Oximetry

noninvasive or invasive method of measuring saturation of hemoglobin at tissue level

which Capnography waveform is this

Normal

which Capnography waveform is this

Shark fin

which Capnography waveform is this

Hypoventilation

which Capnography waveform is this

Hyperventilation

which Capnography waveform is this

Rebreathing

which Capnography waveform is this

Mechanically ventilated

which Capnography waveform is this

Cardiac arrest

which Capnography waveform is this

Return of spontaneous circulation

Capnometry

Co2 levels measures provided in a numeric display

capnography

graphic display of CO2 levels as they change during breathing(shown in a waveform)

Mainstream capnometry

placed directly in the breathing circuit directly at the airway

sidestream capnometry

uses small bore tubing to aspirate gas from or adjacent to the airway, which is then delivered to a remote measuring chamber for analysis

what are the advantages of mainstream capnometry

best suited for those with artificial airways

minimal deadspace added to circuit

lightweight

durable

what are the disadvantages of mainstream capnometry

accumulation of moisture/secretion

adds deadspace

what are the advantages of sidestream capnometry

can be used in patients that do not have an artificial airway

what are the disadvantages of sidestream capnometry

sensitive to moisture and secretions

delay in analyzation

What phase of capnography is the actual measurement obtained

at the peak of end-exhalation(ETCO2)

What will increase ETCO2

increased Co2 production

decreased alveolar ventilation

equipment malfunction

what are examples of CO2 production

fever

sepsis

increased metabolic rate

seizures

what are examples of decreased alveolar ventilation

COPD

respiratory center depression

muscle paralysis

hypoventilation

what are examples of equipment malfuction

rebreathing

exhausted CO2 absorber

leak in ventilation circuit

which delivery device is this

nasal cannula

which delivery device is this

nasal catheter

which delivery device is this

transtracheal catheter

which delivery device is this

reservoir cannula

which delivery device is this

pendant reservoir cannula

which delivery device is this

simple mask

which delivery device is this

partial rebreather

which delivery device is this

non-rebreather

which delivery device is this

venturi(AEM) mask

which delivery device is this

high flow nasal cannula

what type of flow device is the nasal cannula

low flow

what is the flow range of the nasal cannula

0.25-6 lpm

what is the FiO2 range of the nasal cannula

24%-44%

what type of flow device is the nasal catheter

low flow

what is the flow range of the nasal catheter

0.25-5 lpm

what is the FiO2 range of the nasal catheter

22%-45%

what type of flow device is the transtracheal catheter

low flow

what is the flow range of the transtracheal catheter

0.25-4 lpm

what is the FiO2 range of the transtracheal catheter

22%-35%

what type of flow device is the simple mask

reservoir

what is the flow range of the simple mask

5-10 lpm

what is the FiO2 range of the simple mask

35%-50%

what type of flow device is the partial rebreather mask

reservoir

what is the flow range of the partial rebreather mask

10-15 lpm

what is the FiO2 range of the partial rebreather mask

40%-70%

what type of flow device is the reservoir cannulas

reservoir

what is the flow range of the reservoir cannulas

0.25-4 lpm

what is the FiO2 range of the reservoir cannulas

22%-35%

what type of flow device is the non-rebreather mask

reservoir

what is the flow range of the non-rebreather mask

10-15 lpm

what is the FiO2 range of the non-rebreather mask

60%-80%

what type of flow device is the venturi(AEM) mask

high flow

what is the flow range of the venturi(AEM) mask

>60 lpm

what is the FiO2 range of the venturi(AEM) mask

24%-50%

what type of flow device is the high flow nasal cannula

high flow

what is the flow range of the high flow nasal cannula

output flow up to 60 lpm or more

what is the FiO2 range of the high flow nasal cannula

35%-100%