Stridor
Stridor = sound on inspiration associated with airway narrowing; stridor at rest implies a reduction in airway diameter of >50%
Lactate and Lactic Acidosis
Lactate and Lactic Acidosis. Product of anaerobic glycolysis which reflects type A (oxygen delivery) or type B (altered metabolism) causes
Urinary Anion Gap
Urinary Anion Gap = [Na+]+ [K+] - [Cl-]
Rapid Sequence Intubation (RSI)
Rapid sequence intubation (RSI) is an airway management technique that produces inducing immediate unresponsiveness (induction agent) and muscular relaxation (neuromuscular blocking agent) and is the fastest and most effective means of controlling the emergency airway
Sodium Bicarbonate Use
Sodium Bicarbonate Use. metabolic acidosis leads to adverse cardiovascular effects. bicarbonate must be administered in a solution as sodium bicarbonate
Respiratory Compensation in Metabolic Disorders
The extent of respiratory compensation for a metabolic disorder is determined by the balance between the abnormality in the pH (hence the drive to change) and how hard it is to get there (eg. work of respiratory muscles in hyperventilation)
Intubation, Hypotension and Shock
A modified rapid sequence intubation (RSI) approach is usually preferred in hypotensive, shocked patients
Respiratory Alkalosis
Respiratory Alkalosis = a primary acid-base disorder in which arterial pCO2 falls to a level lower than expected.
Rapid sequence airway (RSA) and PALM
Rapid sequence airway (RSA) is a modified form of rapid sequence intubation that uses an LMA inserted following induction (+/- administration of neuromuscular blockade) to maximise peri-intubation oxygenation prior to endotracheal tube insertion
Respiratory Acidosis
Respiratory acidosis = a primary acid-base disorder in which arterial pCO2 rises to an abnormally high level.
Pretreatment drugs for RSI
Traditionally there are four options for pretreatment for Rapid Sequence Intubation (RSI): atropine, lidocaine, fentanyl, and defasciculating dose of a non-depolarising neuromuscular blocker
Normal Anion Gap Metabolic Acidosis
Normal Anion Gap Metabolic Acidosis (NAGMA). HCO3 loss and replaced with Cl- -> anion gap normal. if hyponatraemia is present the plasma [Cl-] may be normal despite the presence of a normal anion gap acidosis -> this could be considered a 'relative hyperchloraemia'.