KETTERING (SPECIAL PROCEDURES)
150 QUIZZES EXAM WITH COMPLETE
SOLUTIONS GRADED A+
QUESTIONS AND ANSWERS
What is the purpose of HBO (Hyperbaric Oxygen Therapy)? ANSWER - Increasing PO2
by increasing barometric pressure
What are some diseases/disorders treated by hyperbaric O2 therapy? ANSWER - a. CO
poisoning
b. decompression sickness (bends) aka nitrogen narcosis
c. tissue tranplants/grafts
d. anaerobic infections (gas gangrene)
How can HBO be administered? ANSWER - In a monoplace (one person) or multiplace
chamber (up to 12 people)
At what atmospheric pressure absolute (ATA) is most HBO therapy conducted at?
ANSWER - 2-3 atmospheric pressure absolute (ATA). Do not go above 3!
At what ATA can most chambers provide pressure between for HBO? ANSWER - 2-6
ATA
What is administered during HBO? ANSWER - 100% O2 by mask
What is the purpose of Helium/Oxygen Therapy (He/O2)? ANSWER - Decrease patient
WOB by delviering low density gas (most important property) that can easily maneuver
around obstructions such as constricted vessels.
How does heliox therapy work? ANSWER - At molecular level, O2 is encased in the
helium gas, acting as a lubricant and speeding O2 through upper airway obstructions.
,What are indications for Heliox therapy? ANSWER - a. Post extubation stridor
b. Severe asthma/status asthmaticus
c. obstructive tumors
d. foreign body aspiration (most common)
e. partial vocal cord paralysis
What is the most common indication for Heliox therapy? ANSWER - Foreign body
aspiration
What are the concentrations used for Heliox therapy? ANSWER - 80:20
70:30 (least effective)
What are some things you should consider before adminsitering Heliox therapy?
ANSWER - a. Administer with a NRB
b. When you have to use a O2 flowmeter, you need to calculate the actual flow delivered to
the patient
How do you calculate the actual flow being delivered to a patient on Heliox therapy using
an O2 flowmeter? ANSWER - actual flow = indicated flow x factor
What are the factors used for each Heliox concentration? ANSWER - 80:20 = 1.8
70:30 = 1.6
Calculate the actual flow being delivered to a patient during Heliox therapy at a
concentration of 80/20 with a flow of 12lpm. ANSWER - actual flow = indicated flow x
factor
actual flow = 12 x 1.8 = 21.6
Calculate the actual flow being delivered to a patient during Heliox therapy at a
concentration of 70/30 with a flow of 8lpm. ANSWER - actual flow = indicated flow x
factor
actual flow = 8 x 1.6 = 12.8
, Explain what INO is. ANSWER - INO or Inhaled Nitric Oxide is a gas that acts as a
potent pulmonary vasodilator, improving pulmonary blood flow and PaO2 but doesnt effect
the systemic system (or the BP).
What are the indications that a patient needs INO? ANSWER - a. Primary Pulmonary
Hypertension
b. Refractory Hypoxemia related to increased PAP
c. Increased PVR
d. Right heart failure/cor pulmonale
What is the difference between Primary and Secondary Pulmonary Hypertension?
ANSWER - Primary pulmonary hypertension is an idiopathic (unknown origin)
hypertensive vasculopathy only affecting pulmonary circulation. Secondary pulmonary
hypertension is associated with an underlying disease process.
What is the dosage of INO? ANSWER - Standard initial: 20-40ppm (parts per million)
What dosage should INO not exceed? ANSWER - 80ppm
What are some side effects of INO? ANSWER - a. Methemoglobin (MetHB) levels may
increase
b. Nitrogen dioxide (NO2) levels may increase and are toxic to the body at levels greater
than 10 ppm
c. Rebound pulmonary hypertension
What is rebound pulmonary hypertension and what can cause it? ANSWER - Increased
PAP, cardiopulmonary instability, and in some cases, the need to continue NO beyond the
intended period of use. It is possible that sildenafil, a phosphodiesterase-5 inhibitor, may
prevent recurrence of rebound. One of the causes is weaning INO too quickly.
When do NO2 levels become toxic to the body? ANSWER - When they are greter than
10ppm
How do you discontinue INO? ANSWER - a. Carefully and slowly to avoid rebound
b. NO levels should be decreaed to loweest possible dose, 5ppm or less.
150 QUIZZES EXAM WITH COMPLETE
SOLUTIONS GRADED A+
QUESTIONS AND ANSWERS
What is the purpose of HBO (Hyperbaric Oxygen Therapy)? ANSWER - Increasing PO2
by increasing barometric pressure
What are some diseases/disorders treated by hyperbaric O2 therapy? ANSWER - a. CO
poisoning
b. decompression sickness (bends) aka nitrogen narcosis
c. tissue tranplants/grafts
d. anaerobic infections (gas gangrene)
How can HBO be administered? ANSWER - In a monoplace (one person) or multiplace
chamber (up to 12 people)
At what atmospheric pressure absolute (ATA) is most HBO therapy conducted at?
ANSWER - 2-3 atmospheric pressure absolute (ATA). Do not go above 3!
At what ATA can most chambers provide pressure between for HBO? ANSWER - 2-6
ATA
What is administered during HBO? ANSWER - 100% O2 by mask
What is the purpose of Helium/Oxygen Therapy (He/O2)? ANSWER - Decrease patient
WOB by delviering low density gas (most important property) that can easily maneuver
around obstructions such as constricted vessels.
How does heliox therapy work? ANSWER - At molecular level, O2 is encased in the
helium gas, acting as a lubricant and speeding O2 through upper airway obstructions.
,What are indications for Heliox therapy? ANSWER - a. Post extubation stridor
b. Severe asthma/status asthmaticus
c. obstructive tumors
d. foreign body aspiration (most common)
e. partial vocal cord paralysis
What is the most common indication for Heliox therapy? ANSWER - Foreign body
aspiration
What are the concentrations used for Heliox therapy? ANSWER - 80:20
70:30 (least effective)
What are some things you should consider before adminsitering Heliox therapy?
ANSWER - a. Administer with a NRB
b. When you have to use a O2 flowmeter, you need to calculate the actual flow delivered to
the patient
How do you calculate the actual flow being delivered to a patient on Heliox therapy using
an O2 flowmeter? ANSWER - actual flow = indicated flow x factor
What are the factors used for each Heliox concentration? ANSWER - 80:20 = 1.8
70:30 = 1.6
Calculate the actual flow being delivered to a patient during Heliox therapy at a
concentration of 80/20 with a flow of 12lpm. ANSWER - actual flow = indicated flow x
factor
actual flow = 12 x 1.8 = 21.6
Calculate the actual flow being delivered to a patient during Heliox therapy at a
concentration of 70/30 with a flow of 8lpm. ANSWER - actual flow = indicated flow x
factor
actual flow = 8 x 1.6 = 12.8
, Explain what INO is. ANSWER - INO or Inhaled Nitric Oxide is a gas that acts as a
potent pulmonary vasodilator, improving pulmonary blood flow and PaO2 but doesnt effect
the systemic system (or the BP).
What are the indications that a patient needs INO? ANSWER - a. Primary Pulmonary
Hypertension
b. Refractory Hypoxemia related to increased PAP
c. Increased PVR
d. Right heart failure/cor pulmonale
What is the difference between Primary and Secondary Pulmonary Hypertension?
ANSWER - Primary pulmonary hypertension is an idiopathic (unknown origin)
hypertensive vasculopathy only affecting pulmonary circulation. Secondary pulmonary
hypertension is associated with an underlying disease process.
What is the dosage of INO? ANSWER - Standard initial: 20-40ppm (parts per million)
What dosage should INO not exceed? ANSWER - 80ppm
What are some side effects of INO? ANSWER - a. Methemoglobin (MetHB) levels may
increase
b. Nitrogen dioxide (NO2) levels may increase and are toxic to the body at levels greater
than 10 ppm
c. Rebound pulmonary hypertension
What is rebound pulmonary hypertension and what can cause it? ANSWER - Increased
PAP, cardiopulmonary instability, and in some cases, the need to continue NO beyond the
intended period of use. It is possible that sildenafil, a phosphodiesterase-5 inhibitor, may
prevent recurrence of rebound. One of the causes is weaning INO too quickly.
When do NO2 levels become toxic to the body? ANSWER - When they are greter than
10ppm
How do you discontinue INO? ANSWER - a. Carefully and slowly to avoid rebound
b. NO levels should be decreaed to loweest possible dose, 5ppm or less.
