FCCS (Fundamentals of Critical Care Support)
1. What is the single tachypnea
most important in-
dicator in critical ill-
ness?
2. Beck's Triad hypotension, JVD, muffled heart sounds
- a/w cardiac tamponade
3. What is the thyro- It is the distance in finger breadths between the anterior prominence of the
mental distance? thyroid cartilage (adam's apple) and the tip of the mandible (chin). It is an
estimate of the length of the mandible and the available space anterior to the
larynx
4. What does it mean - approx 6 cm
when the thyromen- - indicates the larynx might be more anterior and therefore difficult to visu-
tal space is < 3 fin- alize during laryngoscopy
gerbreadths?
** a more acute angulation of the stylet at the distal end of the endotracheal
tube may be helpful.
5. Patient is apneic w/ Bag them.
a pulse. What do - One handed bag compressions should be delivered 10-20 times per min.
you do? Each compression should take place over 1 second.
** If patient starts spontaneously breathing, try to be synchronous with their
respiratory efforts.
** If/once the patient is breathing easily and adequate Vt are being inhaled,
enough to produce minute ventilation, stop bagging.
6. to provide adequate minute ventilation: the product of the tidal volume
delivered during each resuscitation bag compression and the number of
, FCCS (Fundamentals of Critical Care Support)
What is the goal of compressions per min.
manual mask venti-
lation? ** The total gas volume within most adult resus bags is 1 to 1.5 LITERS
7. Bag mask should 100% oxygen at a rate of 15L/min
be connected to
________% oxygen
and flow at a rate of
_______
8. HFNC - Uses up to 100% oxygen source
- Provides higher amounts of FIO2 (0.32-1.0) in patients with high minute
ventilation requirements by matching patient's inspiratory demands and
minimizing air dilution
- These devices also can generate PEEP (that is difficult to measure; can cause
barotrauma in theory)
- Flow rates up to 60L/min
- heated and humidified oxygen
9. NRB - AKA Reservoir Face Mask
- Bag is filled with 100% oxygen from a supply source (tank)
- The flow rate must be adjusted so that the bag remains completely or
partially distended throughout the respiratory cycle
- When the mask is properly applied, oxygen delivery can be maximized but
rarely exceeds a FIO2 of 0.6 to 0.9
- One way flap valves minimize entrapment of room air which dilutes FiO2
- NRB is a high oxygen high, flow device.
- non humidified oxygen
** commonly used to improve oxygenation in patients with severe hypoxemia
until further eval and treatments are accomplished.
, FCCS (Fundamentals of Critical Care Support)
10. Aerosol Face Mask - This mask has large side holes, the mask itself is attached to large bore
tubing to a nebulize that blends 100% oxygen and room air to deliver a
PRESET FIO2 level (done by dial on oxygen adapter)
- If the entire aerosol mist disappears from the mask during. inhalation, the
patient's inspiratory flow demands are probably exceeding the capacity of the
nebulizer and room air is being entrained.
- minimum flow rate = 8L/min
- Max FIO2 = 40-60%
- This is a variable oxygen, moderate-flow device.
11. Simple Face Mask - minimum flow rate: 6L/min (to clear CO2 from mask)
- humidified O2
- Approx. concentrations L to FIO2 ratios:
6L = 40%
7L = 50%
8L = 60%
12. Venturi Face Mask - aka air entrainment face mask
- delivers O2 through a jet mixing device that increases the velocity of oxygen
and causes a controlled entrainment
- the FiO2 can be more precisely controlled from .24 to .5 (24% to 50%) at
high flow rates simply my selecting the interchangeable nozzle and adjusting
the O2 flow rate
- this is a high flow, controlled oxygen device.
13. Nasal Cannula flow 1L = 24%
rate to FIO2 esti- 2L = 28%
mates if RR and tidal 3L = 32%
volumes are normal 4L = 36%
5L = 40%
6L = 44%
, FCCS (Fundamentals of Critical Care Support)
14. NPPV uses two lev- CPAP
els of positive air-
way pressure, com-
bining modalities
of pressure sup-
port ventilation and
what?
15. What is CPAP? continuous positive airway pressure
- Allows spontaneous breathing from a gas source at an elevated baseline
system pressure (higher than atmospheric pressure)
- Functionally equivalent to PEEP.
16. By convention, PSV PSV = IPAP
mode is referred to CPAP = EPAP
as _______ and CPAP
is referred to as The difference between these two numbers determines the tidal volume
_______ when talking generated.
about NPPV/BIPAP
17. Initiation of NPPV - Do not delay intubation if needed and keep in mind the patient's resuscita-
guidelines tion status.
- Consider ABG analysis prior to initiation.
- Explain the procedure.
- Keep head of bed at e
45°.
- Ensure appropriate mask or helmet size.
- Assess the patient's tolerance of the mask by applying it by hand before
securing the harness.
1. What is the single tachypnea
most important in-
dicator in critical ill-
ness?
2. Beck's Triad hypotension, JVD, muffled heart sounds
- a/w cardiac tamponade
3. What is the thyro- It is the distance in finger breadths between the anterior prominence of the
mental distance? thyroid cartilage (adam's apple) and the tip of the mandible (chin). It is an
estimate of the length of the mandible and the available space anterior to the
larynx
4. What does it mean - approx 6 cm
when the thyromen- - indicates the larynx might be more anterior and therefore difficult to visu-
tal space is < 3 fin- alize during laryngoscopy
gerbreadths?
** a more acute angulation of the stylet at the distal end of the endotracheal
tube may be helpful.
5. Patient is apneic w/ Bag them.
a pulse. What do - One handed bag compressions should be delivered 10-20 times per min.
you do? Each compression should take place over 1 second.
** If patient starts spontaneously breathing, try to be synchronous with their
respiratory efforts.
** If/once the patient is breathing easily and adequate Vt are being inhaled,
enough to produce minute ventilation, stop bagging.
6. to provide adequate minute ventilation: the product of the tidal volume
delivered during each resuscitation bag compression and the number of
, FCCS (Fundamentals of Critical Care Support)
What is the goal of compressions per min.
manual mask venti-
lation? ** The total gas volume within most adult resus bags is 1 to 1.5 LITERS
7. Bag mask should 100% oxygen at a rate of 15L/min
be connected to
________% oxygen
and flow at a rate of
_______
8. HFNC - Uses up to 100% oxygen source
- Provides higher amounts of FIO2 (0.32-1.0) in patients with high minute
ventilation requirements by matching patient's inspiratory demands and
minimizing air dilution
- These devices also can generate PEEP (that is difficult to measure; can cause
barotrauma in theory)
- Flow rates up to 60L/min
- heated and humidified oxygen
9. NRB - AKA Reservoir Face Mask
- Bag is filled with 100% oxygen from a supply source (tank)
- The flow rate must be adjusted so that the bag remains completely or
partially distended throughout the respiratory cycle
- When the mask is properly applied, oxygen delivery can be maximized but
rarely exceeds a FIO2 of 0.6 to 0.9
- One way flap valves minimize entrapment of room air which dilutes FiO2
- NRB is a high oxygen high, flow device.
- non humidified oxygen
** commonly used to improve oxygenation in patients with severe hypoxemia
until further eval and treatments are accomplished.
, FCCS (Fundamentals of Critical Care Support)
10. Aerosol Face Mask - This mask has large side holes, the mask itself is attached to large bore
tubing to a nebulize that blends 100% oxygen and room air to deliver a
PRESET FIO2 level (done by dial on oxygen adapter)
- If the entire aerosol mist disappears from the mask during. inhalation, the
patient's inspiratory flow demands are probably exceeding the capacity of the
nebulizer and room air is being entrained.
- minimum flow rate = 8L/min
- Max FIO2 = 40-60%
- This is a variable oxygen, moderate-flow device.
11. Simple Face Mask - minimum flow rate: 6L/min (to clear CO2 from mask)
- humidified O2
- Approx. concentrations L to FIO2 ratios:
6L = 40%
7L = 50%
8L = 60%
12. Venturi Face Mask - aka air entrainment face mask
- delivers O2 through a jet mixing device that increases the velocity of oxygen
and causes a controlled entrainment
- the FiO2 can be more precisely controlled from .24 to .5 (24% to 50%) at
high flow rates simply my selecting the interchangeable nozzle and adjusting
the O2 flow rate
- this is a high flow, controlled oxygen device.
13. Nasal Cannula flow 1L = 24%
rate to FIO2 esti- 2L = 28%
mates if RR and tidal 3L = 32%
volumes are normal 4L = 36%
5L = 40%
6L = 44%
, FCCS (Fundamentals of Critical Care Support)
14. NPPV uses two lev- CPAP
els of positive air-
way pressure, com-
bining modalities
of pressure sup-
port ventilation and
what?
15. What is CPAP? continuous positive airway pressure
- Allows spontaneous breathing from a gas source at an elevated baseline
system pressure (higher than atmospheric pressure)
- Functionally equivalent to PEEP.
16. By convention, PSV PSV = IPAP
mode is referred to CPAP = EPAP
as _______ and CPAP
is referred to as The difference between these two numbers determines the tidal volume
_______ when talking generated.
about NPPV/BIPAP
17. Initiation of NPPV - Do not delay intubation if needed and keep in mind the patient's resuscita-
guidelines tion status.
- Consider ABG analysis prior to initiation.
- Explain the procedure.
- Keep head of bed at e
45°.
- Ensure appropriate mask or helmet size.
- Assess the patient's tolerance of the mask by applying it by hand before
securing the harness.
