Can increase intrathoracic pressure decreased cardiac output can also

Can increase intrathoracic pressure decreased cardiac

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Can increase intrathoracic pressure + decreased cardiac output, can also hyperinflate lungs pneumonia, renal failure, high risk for stress ulcers o Prone position= Increases oxygen without increasing O2 concertation
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Chest tubes WATER SEAL CHAMBER: create a one way flow o Add sterile water to compartment, blue dye already in chamber, NEED AN ORDER TO KNOW MUCH TO ADD TO CHAMBER o Tidaling: Intermittent bubbling is OK o Continuous bubbling NOT OK SUCTION CONTROL CHAMBER o Provides suction to help air/fluid to come out of lungs o Slow, gentle continuous bubbling is OK o NO VIGOUROUS SUCTIONING o Typically filled to -20 cm of water Keep drainage at chest level or below! Check water levels, refill with order What if it comes out? Cover open insertion site with petroleum gauze and cover with 4x4’s tape on ONLY 3 sides, notify MD STAT Never clamp chest tube! Positioning? o Air? Top o Fluid? Bottom Thoracentesis Sitting with arms up to open lung fields pH abnormal uncompensated pH normal compensated ALWAYS keep an ambu-bag in the room for trach care Flail Chest Patho? o Fractured ribs, unstable chest wall that affects breathing Symptoms? o Paradoxical chest movement o SQ emphysema o Tachycardia o Crepitus Diagnosis? o CXR o ABG Pneumothorax Patho? o Lung collapsed due to pressure Causes? o Trauma Signs/Symptoms? o Sharp pain
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o Tachycardic o Dyspnea o Tracheal shift (towards unaffected side) o Absent breath sounds on affected side o SubQ emphysema (rice crispies under skin) Treatment? o Chest tube TYPES: Tension o Excess pressure from AIR in the pleural space o Tracheal shift o SOB, cyanosis, JVD o NEVER CLAMP CHEST TUBE Hemothorax o Blood around lungs due to trauma o SOB, dullness to percussion, decreased Hgb, and might go into shock o Chest tube, fluids Open o Pleural space exposed (gunshot) o NEVER COVER HOLE, 3 pieces of tape and gauze over entry of the wound Chylothorax o Fluid in lungs that compromises oxygenation
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  • Spring '17
  • collins
  • Cardiology, Atrial fibrillation, Cardiac electrophysiology

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