p.3
Central Venous Access: Indications and Complications
What are the major complications associated with CVCs?
Mechanical, infectious, and therapeutic complications.
p.3
Central Venous Access: Indications and Complications
Why is knowledge of CVC complications important?
It allows for prompt recognition and management of complications, which can reduce morbidity, mortality, length of hospitalization, and cost.
p.7
Cardiopulmonary Resuscitation (CPR) Protocols
What are the three components of the TRIAD for diagnosing cardiac arrest?
1. Loss of consciousness 2. Apnea 3. Loss of apical & central pulsations (carotid, femoral)
p.8
Airway Management Techniques in Emergencies
What are the three methods to assess breathing?
Look for chest wall movement, listen to breath sounds, and feel air flow.
p.11
Cardiopulmonary Resuscitation (CPR) Protocols
What is the recommended dose of epinephrine for vasopressor use?
0.01 – 0.02 mg/kg IV every 3-5 minutes.
p.10
Airway Management Techniques in Emergencies
What is the technique for mouth-to-nose breathing?
Seal the mouth shut and breathe steadily through the nose.
p.2
Respiratory Failure: Types and Causes
What are some causes of restrictive lung disease leading to respiratory failure?
Pulmonary edema, neuromuscular disease, morbid obesity, and pulmonary embolism.
p.3
Central Venous Access: Indications and Complications
What are typical indications for central venous catheters (CVCs)?
Hemodynamic monitoring, large volume blood resuscitation, infusion of vasoactive drugs, total parenteral nutrition (TPN), renal replacement therapy, failure to achieve peripheral access, and transvenous pacing.
p.3
Central Venous Access: Indications and Complications
What are some examples of mechanical complications from CVC insertion?
Arterial puncture, pneumothorax, and hematoma.
p.2
Respiratory Failure: Types and Causes
What is the definition of respiratory failure?
Inability of the lung to provide adequate arterial oxygenation and CO2 elimination.
p.2
Respiratory Failure: Types and Causes
What are the clinical manifestations due to hypoxia in respiratory failure?
Dyspnea, tachypnea, central cyanosis, tachycardia, arrhythmia, hypotension, drowsiness, coma, convulsion, and death.
p.6
Discharge Criteria from Intensive Care Units
What condition must be managed before a patient can be discharged?
Cardiac dysrhythmias must be controlled.
p.7
Cardiopulmonary Resuscitation (CPR) Protocols
What should be checked after the 3S steps in a collapsed patient?
Check for carotid pulsation.
p.8
Cardiopulmonary Resuscitation (CPR) Protocols
What does post-resuscitation care aim to achieve?
To restore quality of life and minimize neurological insult.
p.9
Cardiopulmonary Resuscitation (CPR) Protocols
What is one of the golden rules for performing high-quality chest compressions?
Ensure proper rate, depth, and recoil.
p.6
Discharge Criteria from Intensive Care Units
What is the recommended likelihood of deterioration for long-stay patients before discharge?
Low likelihood of deterioration in the next 24 to 48 hours.
p.6
Discharge Criteria from Intensive Care Units
What type of care do patients need when treatment has been withdrawn?
Basic nursing care and drugs for comfort.
p.10
Airway Management Techniques in Emergencies
What often results in airway obstruction during loss of consciousness?
Loss of tone in the muscles of the airway and falling back of the tongue.
p.7
Cardiopulmonary Resuscitation (CPR) Protocols
What does BLS stand for and what does it entail?
Basic Life Support; it is life support without the use of special equipment.
p.2
Respiratory Failure: Types and Causes
What characterizes Type II respiratory failure?
Decreased PaO2 with increased PaCO2, usually due to hypoventilation.
p.6
Management of Coma Patients
What is a critical condition mentioned that requires careful management?
Acute severe pancreatitis.
p.6
Discharge Criteria from Intensive Care Units
What should be true about the admission etiological factor for discharge?
It should be under control or not significant anymore.
p.10
Airway Management Techniques in Emergencies
How is the head tilt, chin lift technique performed?
One hand is placed on the forehead and the other on the chin, tilting the head upwards to displace the jaw anteriorly.
p.9
Cardiopulmonary Resuscitation (CPR) Protocols
Where should the palm of one hand be placed during chest compression?
On the concavity of the lower half of the sternum, 2 fingers above the xiphoid process.
p.1
Routine Biochemistry in Coma Management
What routine biochemistry tests are important in coma management?
Urea, electrolytes, glucose, calcium, and liver biochemistry.
p.6
Discharge Criteria from Intensive Care Units
What is one criterion for discharge from the intensive care unit?
Patients not on any support or intervention that cannot be provided in the ward.
p.2
Respiratory Failure: Types and Causes
What are some treatment options for respiratory failure?
O2 supplementation, mechanical ventilation, removal of secretions, control of infection, bronchodilator, nutritional support, and treatment of the underlying cause.
p.7
Cardiopulmonary Resuscitation (CPR) Protocols
What is the definition of CPR?
An emergency medical procedure for a victim of cardiac arrest or respiratory arrest.
p.10
Airway Management Techniques in Emergencies
What should you do while performing mouth-to-mouth breathing?
Seal your lips over the patient’s mouth and blow steadily into it, watching the chest rise.
p.5
Admission Criteria for Intensive Care Units
What is a common post-operative complication that requires ICU admission?
Acute respiratory failure.
p.9
Cardiopulmonary Resuscitation (CPR) Protocols
How long should chest compressions be continued before reassessing cardiac rhythm?
For 2 minutes, equivalent to 5 cycles of 30:2.
p.6
Management of Coma Patients
What are some potential causes for patient deterioration in anesthesiology?
Airway swelling, metabolic disorders, coagulopathies, hypoxemia, hypercarbia, hypovolemia, intracranial events.
p.11
Cardiopulmonary Resuscitation (CPR) Protocols
When is NaHCO3 used in resuscitation?
Only if there is metabolic acidosis, given empirically at 1 mmol/kg.
p.3
Central Venous Access: Indications and Complications
What are the most common sites for CVC insertion?
Internal jugular vein (IJV), subclavian vein (SV), femoral vein (FV), and upper extremity veins (basilic, cephalic, brachial) for peripherally inserted central catheter (PICC).
p.10
Airway Management Techniques in Emergencies
What is the jaw thrust technique used for?
To maintain airway patency.
p.1
Management of Coma Patients
What is the role of EEG in coma diagnosis?
It is valuable in diagnosing metabolic coma and encephalitis.
p.1
Management of Coma Patients
What should be administered empirically if there's a suggestion of infection in coma patients?
Broad spectrum antibiotics and/or antivirals.
p.10
Airway Management Techniques in Emergencies
What is the first step in mouth-to-mouth breathing?
Hold the airway open and pinch the nostrils closed.
p.4
Central Venous Access: Indications and Complications
What is a serious risk associated with wire embolism?
It can lead to vascular complications.
p.6
Management of Coma Patients
What intervention cannot be performed in a general ward?
Continuous veno-venous hemofiltration.
p.4
Central Venous Access: Indications and Complications
What does CRBSI stand for?
Catheter-Related Bloodstream Infection.
p.9
Cardiopulmonary Resuscitation (CPR) Protocols
What should be minimized during CPR?
Interruption of chest compressions.
p.10
Airway Management Techniques in Emergencies
What is the head tilt, chin lift technique used for?
To maintain airway patency.
p.2
Respiratory Failure: Types and Causes
What characterizes Type I respiratory failure?
Decreased PaO2 with normal PaCO2, usually due to lung pathology.
p.2
Respiratory Failure: Types and Causes
What are the clinical manifestations due to hypercapnia in respiratory failure?
Tachycardia, sweating, dyspnea, tachypnea, drowsiness, coma, and death.
p.7
Cardiopulmonary Resuscitation (CPR) Protocols
What does ACLS stand for and what does it involve?
Advanced Life Support; it involves life support with the use of special equipment (e.g., airway, endotracheal tube, defibrillator).
p.11
Cardiopulmonary Resuscitation (CPR) Protocols
What procedures are included in resuscitation for cardiac issues?
Defibrillation and cardioversion.
p.1
Management of Coma Patients
What should be monitored frequently in coma patients?
Vital functions and high flow oxygen.
p.9
Cardiopulmonary Resuscitation (CPR) Protocols
What surface should the patient be placed on for chest compression?
A hard surface, such as a wooden board.
p.8
Cardiopulmonary Resuscitation (CPR) Protocols
What is the first cornerstone for optimizing outcomes after cardiac arrest?
Early recognition and call for help.
p.9
Cardiopulmonary Resuscitation (CPR) Protocols
What is the recommended rate of chest compressions during CPR?
100 – 120 compressions per minute.
p.7
Cardiopulmonary Resuscitation (CPR) Protocols
How is apnea confirmed in a patient?
By confirming cessation of respiration.
p.1
CSF Examination and Risk Assessment
When should a lumbar puncture be performed in coma patients?
Only after careful risk assessment and not if an intracranial mass lesion is suspected.
p.1
Management of Coma Patients
What type of diet is recommended for coma patients?
A liquid diet through a fine intragastric tube, providing 3000 kcal daily.
p.7
Cardiopulmonary Resuscitation (CPR) Protocols
What are the 3S steps before initiating resuscitation for a collapsed patient?
1. Ensure your own safety 2. Check the level of responsiveness by gently shaking the patient 3. Shout for help.
p.4
Central Venous Access: Indications and Complications
What is an AV fistula?
A connection between an artery and a vein, which can be a complication of catheter use.
p.6
Management of Coma Patients
What is a key consideration for preoperative optimization in patients?
Hemodynamic instability and/or major fluid and electrolyte disturbance.
p.1
Management of Coma Patients
What are the essentials of long-term care for coma patients?
Skin care, oral hygiene, eye care, fluid management, calorie intake, and catheterization when necessary.
p.9
Cardiopulmonary Resuscitation (CPR) Protocols
What should be done in case of difficult venous access during CPR?
Intraosseous drug and fluid administration.
