Capnography

Question 1

PaO2 of 60 mmHg equals…

Answer 1

SaO2 of 90%

Question 2

PaO2 of 40 mmHg equals…

Answer 2

SaO2 of 75%

Question 3

The strength of non-covalent binds between two substances

Answer 3

Affinity

Question 4

Describes the ability of hemoglobin to carry increased amounts of CO2 in the deoxygenated state

Answer 4

Haldane Effect

Question 5

An increase in CO2 results in a decrease in blood pH, resulting in hemoglobin releasing their load of O2

Answer 5

Bohr Effect

Question 6

Technology used in Pulse Oximetry

Answer 6

1. Photoelectric (optical) plethysmography
2. Spectrophotometry
3. Light Emitting Diodes (LED)

Question 7

Uses light absorption to produce waveforms from the blood pulsating in the vascular beds

Answer 7

Photoelectric (Optical) Plethysmography

Question 8

The science that uses light wavelengths to measure light absorption through a substance, in our case blood

Answer 8

Spectrophotometry

Question 9

Indications to for using Oximetry

Answer 9

• Noninvasive
• For continuous monitoring of arterial oxyhemoglobin saturation
• To monitor the adequacy of oxyhemoglobin saturation

Question 10

Advantages of Pulse Oximetry

Answer 10

• Noninvasive
• Saturations can be monitored continuously at the bedside in real time
• Little training or knowledge is required to use the equipment
• Safe and usually quite accurate

Question 11

Disadvantages of Pulse Oximetry

Answer 11

• Abnormal forms of Hb can not be measured
• HbCO is measured as HbO2 therefore false SpO2 readings
• Not as accurate as co-oximetry

Question 12

Appropriate Oximetry Sites

Answer 12

• Finger
• Toe
• Ear
• Bridge of nose
• Forehead
• Infant: across the foot or hand

Question 13

Factors that effect Accuracy of Pulse Oximetry

Answer 13

• Motion
• Low perfusion
• External lights
• False nails/Nail polish
• Wrongs types of sensor or incorrect placement (to light/loose)
• Dysfunctional Hb
• Anemia
• Vascular dyes

Question 14

Partial pressure of CO2 in arterial blood

Answer 14

PaCO2

Question 15

Measurement of the concentration of CO2 at the end of exhalation

Answer 15

EtCO2

Question 16

Difference between EtCO2 and PaCO2 (normally 2-5 mmHg)

Answer 16

A-ADCO2

Question 17

Measurement and the numerical display of CO2 at the patients airway

Answer 17

Capnometry

Question 18

Measurement and waveform display of CO2 concentration at the patients airway

Answer 18

Capnography

Question 19

Waveform display of CO2 throughout respiration

Answer 19

Capnogram

Question 20

Indications for EtCO2

Answer 20

• Intubated applications
• Non-intubated

Question 21

Intubated Applications

Answer 21

• Verifying ETT placement
• Monitoring ETT position during transport
• Head injury
• CPR (effectiveness, ROSC, Predictor of survival)

Question 22

Non-Intubated Applications

Answer 22

• Bronchospastic disease (asthma, COPD)
• Hypoventilation states
• Shock states (sepsis, hypovolemia, anaphylaxis, cardiogenic)
• Hyperventilation

Question 23

Normal values of PaCO2

Answer 23

35-45 mmHg

Question 24

Normal values of EtCO2

Answer 24

35-45 mmHg

Question 25

Causes of low EtCO2

Answer 25

- Mechanical (circuit disconnect, leaks) - Respiratory (airway obstruction, bronchospasm, displaced ETT, hyperventilation, mucous plug) - Circulatory (cardiac arrest, embolism, sudden hypovolemia) - Metabolic (hypothermia)

Question 26

Causes oh high EtCO2

Answer 26

- Mechanical (excessive mechanical dead space, faulty valve) - Respiratory (COPD, respiratory depression or insufficiency) - Circulatory (increased cardiac output) - Metabolic (hyperthermia, malignant hyperthermia)