crt

thumb sign

steeple sign

• x-ray = concave shape free fluid with a menisus
• concave superior interface border
• dull to percussion

• xray = diffused scattered throughout ,patchy infiltrates, plate like infiltrates
• flat to percussion

• fine rales
• pink suptum
• xray= opaque, enlarged heart, batwing, fluff infiltrates
• orthopnea

• Sudden onset of shortness of breath
• xray wedge shaped infiltrates

• increased plateau and pip
• xray= reticulogranular, honeycomb, ground glass

• hyperresonant to percussion
• hyperlucency
• sudden onset of tachypnea

• air entrainment mask
• elevated eosinophil count

tree in winter problem

hyperresonat

• 360 joules
• pulseless v-tech
• ventricular flutter
• ventricular fibillation

• cpr
• epinephrine,amiodarone, lidocain

• confrim in 2 leads
• epinephrine and atropine
• do not defib

• Ipap most exceed EP
• increase ipap only to blow of co2
• increase both ipap and epap to improve o2

• inflection point of a volume-press loop graph
• acceptable oxygen with no cardovascular
• increase static compliance with acceptable o2

• = press
• incraese with high co2

• leak in the vent circuit
• insufficent flow
• endotracheal/tracheostomy tube cuff

• equipment disconnect
• low spontaneous tidal volume

• secretions
• hernated cuff
• coughing
• decressed compliance
• pneumothorax
• pinched circuit
• water in circuit
• clogged hme

• rr- 20
• vt- 300-500 ml
• mip/nif-25
• vc- 10-15ml
• V.E- <10 l/min

• increase dead space
• decrease rate or vt

• decrease or remove deadspace
• increase vt and rate

• 4-12
• high = cardiac
• normal pulmonary
• left heart

• 2-6
• when high fluid overload
• when low dehydration or vasodilation

decreased compliance and increased airway resistance

increased compliance and decreased airway resistance

current mi

hyperkalemia

previous MI

• 5-10
• treat >20 mmhg
• hyperventilated untill paco2 is 25-30 mm hg

No chest movement

chest movement

• inverse positive pressure ventilation optium peep therapy
• press control ventilation

• 28% 10:1
• 40% 3:1
• 60% 1:1

• under the epiglottis
• infants
• straight

• vallecula
• curved

• Subject- what the pt tells you
• objective - actual fact

• wheezing
• bronchoconsteiction
• rhonchi (coarse rales )
• secreations in the large airways
• rales (crackles)
• secrations in the middle-sized airways
• treat with chest pt
• Stridor
• upper airway obstruction
• mild-cool mist
• moderate- racemic epi
• severe - intubate

• secrations in the airway
• kinked et tube
• excess water in the vent circuit
• bronchoconstrion

• ARDS
• plumonary fibrosis
• plumonary edema

• 25/10
• increased equals pulmonary hypertention, left ventricular failure, fluid overload
• decreased equals pulmonary hypotenstion, hypovolemia,cardiovascular collapse

• incease flow
• add exoiratory retard

test upper airway obstrucation

• low flows
• increase rv and tlc

85-100 mmg

rates of 100 to 600 per/min

15 hz or 900 per/min

• suction control and water seal bubble
• should be located in the pleural space surrounding the lung

• 20-40%
• if high relates to pulmonry embouls

use when determining placement of et tube

lungs in 3- demensional body

increase the 3 demensionality of the lung, helpful in spotting internal issues such as masses, blebs, or leasions

defferenting between croup and acute epiglottitis

masses, lesions, or nodules

primary dignostic tool for bronchtiectasis

• hyperresonant- copd or pneumothorax
• dull- pneumonia
• flat-atelectasis

• pulmonary fibrosis
• atelectasis
• lobectomy
• pneumothorax

tension pneumothorax

• good test to measure for restrictive lung diesase
• should be hogher then fvc

• best indicator of obstrucation
• normal is 85% minimum 75%
• obstructive imparirment is consider present if less then 75%

• 12 to 15 sec
• relates to muscle endurance and general function

• use to evaluate vocal cord dysfunction and paralysis as well as cancerous masses in the upper airway
• tall and skinny loop- restritive
• short and fat loop- obstritive
• round loop- large fixed airway obstrtion

fio2 40-50%

• minimum flow is 7lpm
• max 100%

most efficient device

inser 180o from final postion the twist

should not exceed 1/2 of the internal diameter of the et or trach tube

best to use with equipment used on patients with infections disease such as hepatits

• ethyl and isopropyl are effective
• 70-90%

• gas sterilization
• good for devices that have electical componets

• not good for elecraical componets
• will kill all bactera in 10 min
• will kill everything in 10 hr
• will kill tb in 20 min

• decrease work of breathing
• prevent atelectasis
• improve cough effectivness
• provide brocodaitlaion
• moblize secrtions
• tread/prevent pulmonary edema

• done hourly
• 8-10 breaths
• post-op goal should be half of pre-op

• rate 8-12
• vt 8- 12
• 100% im emergency
• simv/imv- a/c- comtrol

• no vt- only inspiratory pressure and i time
• must set exhaled vt alarms
• only use to modify therpy

20-25 mmhg

• morphine sulfate
• valuim
• versed

treat pvc, v-teac,v-fib

• narcotic analgesies
• meperidine
• morphine

• lying flat on back
• drain upper lobes, anterior segment
• good for post neuro surgical patitnets

• lying face down
• drains lower lobed, posterior basal segment
• superior segments

• manage hypotension
• contraindicated for head trauma
• drain lingular, lateral , and medial segments

used to drain the lower lobes, basal segments, anterior basal ,lateral basal, posterior basal segments

• use 3-4 times per day
• 15- 20 min
• expiratory pressure from 10-20 cm H2O
• rhonchi that clears with coughing is evidence it tis working

• Use
• Inflate cuff till leak is not heard during positive pressure breath 

• Color, pulse, reflex,movement,resp
• Less then 3 cpr
• 4-6 preventive measurement 
• 7-10 good 

• Rr & hr double adults 
• Bp half of adults 

• Mucoid - clear and thick 
• Fetid- foul smelling 
• Purulent- contains pus 
• Copious- large amounts 

Spitting up blood from the teacheobronchial tree lungs 

Enlarged liver 

Shortness of breath as perceived by the pt 

Pt can't breath lying down

Placing pt on blow by at anappropriate fio2

Electrolye imbalance

Chronic Hypoxemia

chf

Heavey sweating, heart failure, fever, infection, anxiety, nervouness

• kyphosis- leaning foward
• scoliosis- side to side
• pectus carinatum- anterior protrusion of the sternum
• pectus Excauatum- depression of part of all the sternum
• Kyphosis- hunchback
• barrel chest- air trapping, copd 

normal rr, depth and rhythm

increased rr (20bpm)

decreased rr (less then 8 bpm)

gradually incrase then decrease rate and depth in a cycle lasting from 30-18- seconds with periods of apnea

increased rate, depth and regular rhythem

increased rr and depth with irregular periods of apnea

increased rate depth, irregular rhythm breath sounds labored

prolonged gasping inspiration followed by extremely short, insufficient expiration

loss of muscle tone and occurs in paralysis

increased muscle size - copd

may indicate a tumor in the lung

indicate an infection

• pleurisy, tb pneumonia, pulmonary infarction, cancer
•  treat with steriods and antibottics

• s1- normal
• s2- normal
• s3- may suggest chf
• s4- cardic abnormality such as mi or cardiomegaly

should appear in the right lower lung field

should normally be in the right ventricle

placed in the right or left subclavin or jugular vein and should rest in the vena cava of the right atrium of the heart

reduced blood flow to tissue injury- acute damage to tissue

necrosis or death of tissue may be recent  (acute) or old

• head-tilt/chin lift
• jaw thrust/modified jaw thrust (broken neck)

• oral - 21-25 cm mark
• nasal- 26-29 cm mark