Questions and Answers
You are ventilating an intubated patient and note decreased compliance with each delivered ventilation. Which of the following conditions would be the LEAST likely cause of this?
Common signs of a laryngeal fracture include all of the following, EXCEPT:
Factors that increase the amount of energy needed for ventilation include all of the following, EXCEPT:
A 60-year-old woman presents with difficulty breathing. Your initial action should be to:
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Which of the following MOST accurately describes the process of gas exchange in the lungs?
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A 49-year-old man presents with acute shortness of breath. Initial management should consist of:
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Study Notes
Ventilation Challenges
- Decreased compliance during ventilation in intubated patients can arise from conditions like tension pneumothorax, diffuse bronchospasm, and surfactant deficiency.
- Beta-2 receptor stimulation is the least likely cause of decreased compliance as it usually facilitates bronchodilation.
Laryngeal Fracture Signs
- Common signs of laryngeal fracture include stridor, hemoptysis, and dysphagia.
- Hematemesis (vomiting blood) is an uncommon sign, although swallowing large amounts of blood may lead to this symptom.
- Laryngeal fractures typically result from blunt trauma, often seen in motor vehicle accidents.
Energy for Ventilation
- Increased energy requirements for ventilation can be caused by decreased pulmonary compliance, surfactant deficiency, and increased airway resistance.
- Beta-2 receptor stimulation decreases the energy needed for ventilation by promoting bronchodilation.
- Normal unassisted ventilation energy use is approximately 3% of total body expenditure, potentially escalating to 35% with health impairments.
Initial Actions in Respiratory Distress
- Patients presenting with hypoxemia symptoms, such as cyanosis and tachycardia, should receive supplemental oxygen promptly.
- Monitoring and potential ventilation assistance are crucial as the patient's condition may deteriorate.
Gas Exchange in the Lungs
- Gas exchange occurs in the lungs via diffusion, moving from higher to lower concentration areas.
- Pulmonary respiration involves oxygen moving from the alveoli (PO2 ~100 mm Hg) into the bloodstream and carbon dioxide diffusing from the bloodstream into the alveoli (PCO2 ~0 mm Hg).
- Blood returning from the right heart to the lungs has a higher concentration of carbon dioxide compared to oxygen (PCO2 ~46 mm Hg, PO2 ~40 mm Hg).
Management of Acute Shortness of Breath
- Signs of inadequate ventilation, such as confusion and low oxygen saturation (79%), necessitate immediate ventilatory support.
- Bag-mask ventilation with supplemental oxygen is often required before definitive airway management, such as intubation.
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Description
Test your knowledge on airway management with these flashcards featuring challenging scenarios and conditions. Each card presents critical questions regarding intubation and laryngeal injuries, helping you prepare effectively for clinical situations.
