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Class Notes

· cricothyrotomy - An incision in the cricoid membrane, where it bleeding occurs it is an area of \u200b\u200bfew blood vessels.

Disadvantages :

1. No demos with the membrane and drill another area.

Advantages

1. procedure is very fast but should not be the first selection.

2. not require specialized equipment.

Criteria for Mechanical Ventilation :

1) Decreased level of consciousness.

2) 15mg vital capacity less than 1kg

3) 70torr PaO2 with minor fraction of inspiratory O2 concentration ( Fi O2) of 0.40

4) alveolar arterial O2 Broadcasting of 400t greater FiO2 1.0 orr

5) PaCO2 greater than 50 torr.

6) Dead Space / Tidal volume (Va / VT) increased from 0.6

7) lower inspiratory effort - 25cm/H2O.

Mechanical Ventilation

ü Using a fan is the final step in a series of therapeutic maneuvers to improve the management of respiratory failure.

ü In general, the assistance of a ventilator is indicated in pts who can not breathe satisfactorily without assistance or suspected of any possible complication next.

ü Indications for use :

1. Pts with apnea - cessation of breathing

2. Criterion blood gas - pH, PCO2, PO2

3. Severe Hypoxemia - lower PO2 40mmHg

4. impending respiratory failure - When we almost certainly goes faulty pt.

5. Acute respiratory failure - less than 50 mmHg PO2 / higher PCO2 50 mmHg

6. Ventilatory Failure - Ph ↑ PCO2 ↓ conditions that cause it:

Ø Trauma to Head (intracranial)

Ø "Overdose "

Ø Neuromuscular Disease

7. Neuromuscular Disease:

Ø myasthenia gravis Muscles

Ø Guillen Barre feet ↑

Ø Polio head ↓