RCP140 (Oxygenation & Ventilation Assessment)

P(A-a)O2 Increases

Diagnose Carbon Monoxide Poisoning: Uses a Hemoximeter

Ventilation summarized

can lead to a false sense of security in that pulse oximeter readings may appear normal although tissue hypoxia appear

Survivors (to discharge) –Average ETCO2: ___

Difference between alveolar and arterial PO2.

Mainstream (hazards/complications)

Equipment Related Changers: Increase ETCO2

Signal Artifact ___ and some causes are Low perfusion (hypotension, cold), motion artifact.

This is a capnograph of a 30-year old man who is under anesthesia. What does the slope at III indicate?

Rationale for Noninvasive Monitoring

What are the 4 types of hypoxia?

 P-to-F ratio <200 indicates

ventilation occurs under conditions in which alveoli are ventilated but not perfused. PE, Hypovolemia, Cardiac arrest

refers to the dead space caused by anatomical structures (the airways leading to the alveoli).

Patient Application - Sites in Small children & babies

C(a-v)O2 = CaO2 − CvO2, Normally, 4-5 vol%

CvO2= Oxygen content of mixed venous blood

Each g% Hb can carry ___

Cor Pulmonale Recap: Three major causes:

Why do RT's compare the light absorption of Hb & HbO2 to measure the oxygen saturation of arterial blood?

Arterial-Venous Oxygen Content Difference: Decreases:

Dead Space-Tidal Volume Ratio: VD/VT =

Water Vapor can condense on the sensor cell & cause falsely high CO2 readings

If the PetCO2 reading is low immediately following intubation- indicates tube is in the ___

Hypoxemia may suggest tissue hypoxia, it does not necessary mean the absolute existence of tissue hypoxia.

If the mean airway pressure is 35 cmH2O and the patient is on 70% FiO2 with a PaO2 of 80 what is their OI?

Estimate of oxygen carried by hemoglobin & dissolved in blood plasma. Normal Range = 17-20% volume

70%, 80%, 90% equivalent to PO2 values of 40 mm Hg, 50 mm Hg, and 60 mm Hg. This rule works only in the middle range

Grossly inaccurate when a finger probe is placed on the ear or forehead

NOT ACCURATE when sat is > than70

difference between abg and capnography values of exhaled carbon dioxide

Which of the following may have caused a patient to have a sudden increase in PETCO2?

 Abnormally low arterial oxygen tension (PaO2) and can be associated with hypoxia. Eg. can be offset by an increased CO

PaO2 reliable indicator assuming that abnormal forms of hemoglobin & not present.

RBC production is called erythropoiesis Increased RBC’s is called

Cor Pulmonale: condition commonly arises out of complications from high blood pressure in the pulmonary arteries, occurs

refers to external artificial airways and circuits that may, add to the total dead space during mechanical ventilation.

ETCO2 is usually ___ lower than PaCO2

What are norms for shunting?

 P-to-F ratio 200-300 indicates

low or inadequate oxygen for aerobic cellular metabolism. ­Absence of O2, lactic acid is produced causing acidosis

perfusion occurs under conditions in which alveoli are perfused but not ventilated. Ex: Mucus plugging, Atelectasis

Pulse Oximeter maintenance: Wipe probe & monitor with an alcohol soaked cloth between patients.

___ of Oxygen will dissolve in every 100 mL of blood for every 1 mmHg of PO2

refers to ventilated areas that are designed for gas exchange (alveoli), but do not actually participate.

What is one problem associated with using mainstream sensors in capnometry?

The oxygen saturation result from the blood gas analyzer is calculated NOT measured!

Normal: 5-10 mmHg on room air, should not exceed 30mmHg. Normal= 25-65 torr on 100%

  P-to-F ratio: Normal=

Non-survivors –Average ETCO2: ___

___ the measurement of the amount of light that is absorbed as it passes through a substance.

Total Oxygen Delivery DO2 = QT × (CaO2 × 10)

In healthy person: 98% of the oxygen that ___ into pulmonary capillary combines with Hemoglobin

hormones respond by stimulating bone marrow to increase red blood cell (RBC) production

Cor Pulmonale leads to:

Reflects changes in Oxygenation within 5 MINUTES

On 100% A-a gradient

Sudden Loss of Waveform: Fully obstructed Airway,..

A decrease in ETCO2 would indicate a _____ in ventilation or a decrease in perfusion.

Affinity to hemoglobin is greater than

Equipment Related Changers: Decrease in EtCO2

Verification of airway placement: False readings can occur in patients who have ben without CPR for a period of time.

__are simple bedside devices that measure Hb saturation by way of a noninvasive probe

Arterial-Venous Oxygen Content Difference: Increases

An increase in ETCO2 would indicate a ____ in ventilation

Normal is 5-10 mmHg, Difference greater than 15 mmHg indicates a pulmonary embolism

Four things to verify prior to reporting results:

Patient Application - Sites in Adults & children

The weight measurement of hemoglobin, in reference to 100 mL of blood, is known as the

Secretions can block sample tubing, Water trap required

A Safety Monitor must be:

A pulse oximeter sensor is made up of two different parts:

Normal Capnogram

Pulse oximetry is based on which process?

Cor Pulmonale Recap: The term used to denote:

Mainstream-DISAVANTAGES:

Increased values indicate the patient’s condition is worsening and Normal is less than 10. (Paw* FiO2)/ PaO2) *100

Oxygenation summarized:

Cor Pulmonale caused by three main manifestations seen in chronic pulmonary disease

The Masimo RAD-57 is the world’s first and only

Measures exhaled carbon dioxide content and plots it against time using infrared absorption

Under conditions of low blood flow, which location may give a more accurate pulse oximetry reading than a finger tip?

Capnography in Bronchospastic Diseases: If lack of alveolar plateau consider: