High AG metabolic acidosis AG > 15 mEq/L Management treatment
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stop or limit G.I. Carbonate losses.
Consider Methanol or ethylene glycol aspirin poisoning an alcoholic
ketosis
DKA intravenous normal Saline and insulin infusions
Lactic acid maintain tissue perfusion normal salinee is more effective than
normal Na plus bicarb
Treatment protocols for patients with ARDS C. Breathing: Institute mechanical
ventilation
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. 1. If work of breathing is not being met, as evidenced by the following: 2.
Patient fatigue 3. Elevated PaCO2 (partial pressure of carbon dioxide in
, arterial blood)
Noninvasive bilevel positive airway pressure (BiPAP).
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Primarily for those with hypoxemia and hypercapnia (i.e., COPD
exacerbation)
COPD nicotine i. The first-line medications include the following:
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bupropion SR, nicotine gum, nicotine inhaler, nicotine lozenge, nicotine
nasal spray, nicotine patch, and varenicline.
C. Low-volume alarms when volume returned to the ventilator is less than the set limit
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May result from disconnecting tubing, or from ETT cuff leak 2. May result
from decreased patient tidal volumes (shallow breaths)
Describe static and plateau pressures on a ventilator
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Persistent breath-to-breath peak pressures greater than 45 cm H2O are a
risk factor for barotrauma. When a ventilator mode uses a target tidal
volume in adults, the settings should be in the range of 6-8 ml/kg ideal
body weight in adults. (The goal is to not exceed the plateau pressure of
30 cm of H2O in order to prevent barotrauma.)
D. Typical PEEP settings range from 5 to 10 cm H2O.
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1. "Higher" PEEP (up to 10-20 cm H2 O) may be used with lowcompliance
conditions such as acute respiratory distress syndrome.
2. Additional factors to consider before attempting weaning:
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a. Physical ability i. Respiratory rate < 30 breaths per minute ii. Minute
ventilation < 12 L/minute b. Mechanical efficiency i. Vital capacity 10-15
ml/kg ii. Negative inspiratory force > 20 cm H2O c.
Causes of atelectasis
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, C. Type 3: Owing to increased atelectasis due to low functional residual
capacity (FRC). Causes include: 1. General anesthesia 2. Upper abdominal
surgery 3. Obesity 4. Smoking
D. Low FIO2 alarms if below set FIO2
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1. Interruption in oxygen supply E. Apnea alarms if no spontaneous or
mechanical breath detected within set time frame 1. Patient apnea 2.
Mechanical failure
Treatment protocols for patients with ARDS 12.d. Permissive hypercapnia,
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with bicarbonate repletion to avoid excessive acidosis (severe ARDS) 4.
The patient should be sedated for comfort
Asthma - Mild persistent
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Symptoms > 2 days/week but not daily, 3-4 nighttime awakenings/month, >
2 days/week but not daily and not more than 1 time per day use of a SABA
for symptom relief, minor limitation with normal activity, FEV1 > 80%
predicted, and normal FEV1 /FVC
Give this one a try later!
stop or limit G.I. Carbonate losses.
Consider Methanol or ethylene glycol aspirin poisoning an alcoholic
ketosis
DKA intravenous normal Saline and insulin infusions
Lactic acid maintain tissue perfusion normal salinee is more effective than
normal Na plus bicarb
Treatment protocols for patients with ARDS C. Breathing: Institute mechanical
ventilation
Give this one a try later!
. 1. If work of breathing is not being met, as evidenced by the following: 2.
Patient fatigue 3. Elevated PaCO2 (partial pressure of carbon dioxide in
, arterial blood)
Noninvasive bilevel positive airway pressure (BiPAP).
Give this one a try later!
Primarily for those with hypoxemia and hypercapnia (i.e., COPD
exacerbation)
COPD nicotine i. The first-line medications include the following:
Give this one a try later!
bupropion SR, nicotine gum, nicotine inhaler, nicotine lozenge, nicotine
nasal spray, nicotine patch, and varenicline.
C. Low-volume alarms when volume returned to the ventilator is less than the set limit
Give this one a try later!
May result from disconnecting tubing, or from ETT cuff leak 2. May result
from decreased patient tidal volumes (shallow breaths)
Describe static and plateau pressures on a ventilator
,Give this one a try later!
Persistent breath-to-breath peak pressures greater than 45 cm H2O are a
risk factor for barotrauma. When a ventilator mode uses a target tidal
volume in adults, the settings should be in the range of 6-8 ml/kg ideal
body weight in adults. (The goal is to not exceed the plateau pressure of
30 cm of H2O in order to prevent barotrauma.)
D. Typical PEEP settings range from 5 to 10 cm H2O.
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1. "Higher" PEEP (up to 10-20 cm H2 O) may be used with lowcompliance
conditions such as acute respiratory distress syndrome.
2. Additional factors to consider before attempting weaning:
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a. Physical ability i. Respiratory rate < 30 breaths per minute ii. Minute
ventilation < 12 L/minute b. Mechanical efficiency i. Vital capacity 10-15
ml/kg ii. Negative inspiratory force > 20 cm H2O c.
Causes of atelectasis
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, C. Type 3: Owing to increased atelectasis due to low functional residual
capacity (FRC). Causes include: 1. General anesthesia 2. Upper abdominal
surgery 3. Obesity 4. Smoking
D. Low FIO2 alarms if below set FIO2
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1. Interruption in oxygen supply E. Apnea alarms if no spontaneous or
mechanical breath detected within set time frame 1. Patient apnea 2.
Mechanical failure
Treatment protocols for patients with ARDS 12.d. Permissive hypercapnia,
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with bicarbonate repletion to avoid excessive acidosis (severe ARDS) 4.
The patient should be sedated for comfort
Asthma - Mild persistent
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Symptoms > 2 days/week but not daily, 3-4 nighttime awakenings/month, >
2 days/week but not daily and not more than 1 time per day use of a SABA
for symptom relief, minor limitation with normal activity, FEV1 > 80%
predicted, and normal FEV1 /FVC
