CSE RESPIRATORY I FULL REVISION NOTES
WITH AIRWAY MANAGEMENT AND BREATHING
MECHANICS CONCEPTS
◉ Epiglottitis.
Answer: Comes in drooling, emergency needs to go to the OR for
intubation. Order a lateral neck X ray (thumb sign), administer
racemic epi.
◉ initial neonate vent settings.
Answer: PC/SIMV
Vt 4-5 mL/kg
RR 30-35
FIO2 40-60% (always use previous FiO2 or 0.10 above)
I-time .3-.6 (.4-.5-ideal)
PEEP 5
PIP 20-25
* always write down settings if Rate is decreased also decrease PIP
◉ how to treat low ventilator alarms.
Answer: Low Volume
1) manually ventilate
,--> check ventilator circuit connections
check tubing connections
assess chest rise
verify alarm settings
check the delivered tidal volume
check the integrity of the ET cuff
check the humidifier
check the exhalation valve
if intubated confirm ETT position
occlude the Y and cycle the ventilator
◉ HIV/drug use/homeless.
Answer: IG: pt. is homeless IV meth user, give HIV (ELISA) test,
pneumocystis jiroveci pneumonia underlying condition
DM: pentamidine (NebuPent) aerosolized administered w//
respiguard (a one way valve neb to prevent the therapist from
exposure to the drug)
◉ pregnant women with blisters.
Answer: chicken pox (varicella zoster virus)
-use airborne precautions (wear N95 mask, private room, negative
pressure room) HFNC on 40%,
,-clean stethoscope with 70% alcohol wipes leave inside room.
◉ LAMA medications.
Answer: 1st line of treatment for COPD
(Tiotropium bromide) Spiriva
(Tiotropium) Spiriva Respimat
(Umeclidinium) Incruse Ellipta
(Ipatropium bromide) Atrovent
◉ LAMA/LABA medications.
Answer: 2nd line of treatment for COPD
Anoro Ellipta (umeclidinium/vilanterol)
Spiolto Respimat (tiotropium/olodaterol)
◉ APGAR score.
Answer:
◉ adult vent settings.
Answer: -VC/AC
- SIMV (weaning mode) If physician disagrees, then pick SIMV
-*always write down/use previous FiO2 or .10 above
, -minimum rate of 10 (never change the rate in AC, when making
changes after ABG)
-pay attention to total rate and volume for issues
- eliminate other choices not fitting
◉ ICS/LABA.
Answer: Advair (Fluticasone/ salmeterol)
Symbicort (budesonide/ formoterol)
Breo Ellipta (fluticasone/vilanterol)
◉ Initial Assessment (visuals).
Answer: General appearance
color
heart rate
Height and Weight
Sensorium
medical history
Pulse ox
◉ Bedside.
Answer: palpitation
percussion
WITH AIRWAY MANAGEMENT AND BREATHING
MECHANICS CONCEPTS
◉ Epiglottitis.
Answer: Comes in drooling, emergency needs to go to the OR for
intubation. Order a lateral neck X ray (thumb sign), administer
racemic epi.
◉ initial neonate vent settings.
Answer: PC/SIMV
Vt 4-5 mL/kg
RR 30-35
FIO2 40-60% (always use previous FiO2 or 0.10 above)
I-time .3-.6 (.4-.5-ideal)
PEEP 5
PIP 20-25
* always write down settings if Rate is decreased also decrease PIP
◉ how to treat low ventilator alarms.
Answer: Low Volume
1) manually ventilate
,--> check ventilator circuit connections
check tubing connections
assess chest rise
verify alarm settings
check the delivered tidal volume
check the integrity of the ET cuff
check the humidifier
check the exhalation valve
if intubated confirm ETT position
occlude the Y and cycle the ventilator
◉ HIV/drug use/homeless.
Answer: IG: pt. is homeless IV meth user, give HIV (ELISA) test,
pneumocystis jiroveci pneumonia underlying condition
DM: pentamidine (NebuPent) aerosolized administered w//
respiguard (a one way valve neb to prevent the therapist from
exposure to the drug)
◉ pregnant women with blisters.
Answer: chicken pox (varicella zoster virus)
-use airborne precautions (wear N95 mask, private room, negative
pressure room) HFNC on 40%,
,-clean stethoscope with 70% alcohol wipes leave inside room.
◉ LAMA medications.
Answer: 1st line of treatment for COPD
(Tiotropium bromide) Spiriva
(Tiotropium) Spiriva Respimat
(Umeclidinium) Incruse Ellipta
(Ipatropium bromide) Atrovent
◉ LAMA/LABA medications.
Answer: 2nd line of treatment for COPD
Anoro Ellipta (umeclidinium/vilanterol)
Spiolto Respimat (tiotropium/olodaterol)
◉ APGAR score.
Answer:
◉ adult vent settings.
Answer: -VC/AC
- SIMV (weaning mode) If physician disagrees, then pick SIMV
-*always write down/use previous FiO2 or .10 above
, -minimum rate of 10 (never change the rate in AC, when making
changes after ABG)
-pay attention to total rate and volume for issues
- eliminate other choices not fitting
◉ ICS/LABA.
Answer: Advair (Fluticasone/ salmeterol)
Symbicort (budesonide/ formoterol)
Breo Ellipta (fluticasone/vilanterol)
◉ Initial Assessment (visuals).
Answer: General appearance
color
heart rate
Height and Weight
Sensorium
medical history
Pulse ox
◉ Bedside.
Answer: palpitation
percussion
