Oxygen therapy

Question 1

causes of airway obstruction

Answer 1

CNS depression
foreign body (blood, vomit, secretions, food) 
trauma 
blocked tracheostomy 
swelling (infection, oedema) 
laryngospasm, bronchospasm

Question 2

causes of breathing porblem

Answer 2

CNS depression causing decreased repsiratory drive
poor/diminished respiratory effort from muscle weakness/pain/restrictive abnormalities
disorders of lung function - pneumonia, pneumothorax, haemothorax, asthma, PE, ARDS, oedema

Question 3

cause of circulatory problem

Answer 3

primary cardiac –> ischaemia, arrhytjmia, cardiac failure, tamponade, rupture, myocarditis, HOCM

secondary cardiac –> asphyxia, tension pneumothorax, blood loss, hypoxia, hypothermia, septic shock, hyperthermia, rhabdomyolysis

Question 4

assessing breathing

Answer 4

Look for signs of respiratory distress
• Count respiratory rate
• Assess depth/quality of breathing
• Note chest deformity, raised JVP, abdominal
distension
• Record FiO2 and SpO2
• Listen near the face then palpate, percuss &
auscultate the chest
• Trachea position?
• Decide upon specific treatments

Question 5

oxygen flow l/min and FiO2: 1

Answer 5

24%

Question 6

oxygen flow l/min and FiO2: 2

Answer 6

28%

Question 7

oxygen flow l/min and FiO2: 3

Answer 7

32%

Question 8

oxygen flow l/min and FiO2: 4

Answer 8

36%

Question 9

oxygen flow l/min and FiO2: 5

Answer 9

40%

Question 10

oxygen flow l/min and FiO2: 6

Answer 10

44%

Question 11

oxygen flow l/min and FiO2: 7

Answer 11

48%

Question 12

oxygen flow l/min and FiO2: 8

Answer 12

52%

Question 13

oxygen flow l/min and FiO2: 9

Answer 13

56%

Question 14

oxygen flow l/min and FiO2: 10

Answer 14

60%

Question 15

nasal cannulae flow rate

Answer 15

1-6l/min

Question 16

hudson mask flow rate

Answer 16

5-10l/min

Question 17

NRM

Answer 17

12-15l/min

Question 18

BVM

Answer 18

15l/min + positive pressure

Question 19

CPAP

Answer 19

1-15L + positive pressure

Question 20

ventilator

Answer 20

1-15L + invasive positive pressure

Question 21

blue venturi flow rate and oxgyen delivered

Answer 21

2L/min 24%

Question 22

white venturi flow rate and oxgyen delivered

Answer 22

4l/min 28%

Question 23

yellow venturi flow rate and oxgyen delivered

Answer 23

8l/min 35%

Question 24

red venturi flow rate and oxgyen delivered

Answer 24

10l/min 40%

Question 25

green venturi flow rate and oxgyen delivered

Answer 25

15l/min 60%

Question 26

NRBM

Answer 26

15l/min 85%

Question 27

What criteria do you look at if spontaneous pneumothorax

Answer 27

age>50 and significant smoking history | evidence of underlying lung disease on exam / CXR

Question 28

what to do if bilateral/ahemodynamically unstable pneumothorax

Answer 28

proceed to chest chain

Question 29

primary pneumothorax mx if >2cm / breathless

Answer 29

aspiration with 15-18G cannula

Question 30

primary pneumothorax mx if not <2cm / breathless q

Answer 30

consider discharge review in OPD 2-4 weeks time

Question 31

secondary pneumothorax >2cm/breathless

Answer 31

chest drain size 8-14

Question 32

secondary pneumothorax size 1-2cm mx

Answer 32

aspirate with a 16-18G cannula

Question 33

secondary pneumothorax <1cm

Answer 33

admit with high flow oxygen and observe for 24 hours

Question 34

what happens if you aspirate a pneumothorax size 1-2cm and it is unsuccessful

Answer 34

insert a chest drain

Question 35

triangle of safety

Answer 35

lateral border of pec major mid axillary line level of nipple

Question 36

ECG findings PE

Answer 36

``` sinus tachy S1Q3T3 non specific ST changes RAD s wave (I and aVL) >1.5mm Q wave in III and avf p pulmonale RBBB ```