HyPoxia the basics. By deborah dewaay md Medical University of South Carolina May 29, 2012 Acknowledgment: antine stenbit md. Objectives. Knowledge: Understand the difference between hypoxia and hypoxemia Understand physiologic adaptation to hypoxia
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Medical University of South Carolina
May 29, 2012
Acknowledgment: antinestenbit md
Stop the fluids!
Give nitroglycerin 1st to venodilate (SL or paste).
Lasix: Dilate now, pee later. ESRD: give it anyway (dilate now, dialyze later)
If dry: stabilize with oxygen
When in doubt get a spiral CT (once stable enough).
Throughout all of this mess, don’t forget your ABC’s, ask RTs help with CPAP/BiPAP…
So you know they are hypoxic/hypoxemic: but you need to know
Shunt = Really Bad V/Q mismatch
Low FIO2 (altitude) No A-a gradient
(CNS↓, MM, Nerve, NMJ) Corrects w/ O2?
Shunt V/Q mismatch
(atalectasis, CHF, PNA (Asthma, COPD, PNA, CHF,PE)
PE, intracard or intrapul shunt)
***if diffusion limitation is suspected in addition to the above, get PFTs after patient is stable