Capnography - Exam 1

Question 1

What is the capnograph showing?

Answer 1

Normal capnograph

Question 2

What is the capnograph showing?

Answer 2

Inadequate seal

Question 3

What is the capnograph showing?

Answer 3

Hypoventilation

Question 4

What is the capnograph showing?

Answer 4

Hyperventilation

Question 5

What is the capnograph showing?

Answer 5

Esophageal intubation

Question 6

What is the capnograph showing?

Answer 6

Early Loss of Paralysis

Question 7

What is the capnograph showing?

Answer 7

Patient overbreathing

Question 8

What is the capnograph showing?

Answer 8

Obstruction

Question 9

What is the capnograph showing?

Answer 9

Cardiac Oscillations

Question 10

What is the capnograph showing?

Answer 10

Rebreathing / Bad soda lime

Question 11

What is the capnograph showing?

Answer 11

ROSC

Question 12

In 1989 it was mandated that CO2 must be identified in expired gas to confirm placement of ___ or ___

And ____ had to be assessed in every general anesthetic

Answer 12

ETT
LMA

Ventilation

Question 13

What did ASA mandate in 2011?

Answer 13

CO2 monitoring for any patient undergoing moderate or deep sedation

Question 14

This is the measurement and quantification of inhaled or exhaled CO2 concentrations

Answer 14

Capnometry

Question 15

This is a method of CO2 measurement and a graphic display over time and the best method to confirm endotracheal intubation

Answer 15

Capnography

Question 16

Which is more common: measuring CO2 via side stream or main stream

Answer 16

side stream

Question 17

Which method of CO2 measurement has a transport time delay and rise time? Side stream or mainstream?

Answer 17

SIde stream

Question 18

This type of CO2 measurement method aspirates a gas sample and analyzes away from the airway at a rate of 50-200 mL/min

Answer 18

Side stream

Question 19

We are concerned about hypercarbia in our patients because of these 5 things:

Answer 19

-Respiratory acidosis
-Increased CBF
-Increased ICP
-Increases PVR
-Potassium shifts into blood (hyperkalemia)

Question 20

We are concerned about hypocarbia and want to measure it in our patients because of these 5 things:

Answer 20

-Respiratory alkalosis
-Decreased CBF
-Decreases PVR
-Potassium shifts into cells
-Blunt normal urge to breathe

Question 21

6 Physiologic causes of decreased ETCO2

Answer 21

-Hypothermia
-Hypotension
-Hyperventilation
-Hemorrhage
-PE (pulm hypoperfusion)
-Cardiac arrest

Question 22

Equipment malfunction causes of decreased ETCO2

Answer 22

-Disconnect
-Esophageal intubation
-ETT / LMA cuff leak
-Poor Sampling
-Airway obstruction

Question 23

Equipment malfunction causes of increased ETCO2

Answer 23

-Rebreathing
-Exhausted / Dessicated CO2 absorber
-Leak in circuit
-Faulty inspiratory / expiratory valves

Question 24

6 Physiologic causes of increased ETCO2

Answer 24

-Increased metabolic rate (sepsis, fever, seizures)
-Thyrotoxicosis
-Increased CO
-Bicarbonate administration
-Hypoventilation
-COPD

Question 25

What is the normal difference in PaCO2 and ETCO2? Which one is higher?

Answer 25

5 mmHg

Question 26

What are the 3 problems with trying to guess PaCO2 based off ETCO2

Answer 26

-V/Q mistmatch can increase difference -Sampling line may not get alveolar gas delivered to it due to breathing patterns -Capnograph problems

Question 27

What two types of clinical measurement of CO2 are common?

Answer 27

-IR light absorption (in the OR) -Chemical indicator

Question 28

You know you have CO2 in the tube when the litmus paper / chemical indicator turns ____

Answer 28

YELLOW

Question 29

CO2 monitor requirements (aka if we built a CO2 monitor it must meet these criteria)

Answer 29

-CO2 reading +/- 12% of actual value -Interference caused by ethanol, acetone, halogenated volatiles must be disclosed -High CO2 alarm for inhaled and exhaled CO2 -Low exhaled CO2 alarm

Question 30

Phase one in capnograph is: When ___ ends The lungs ____ Gas in circuit and ____ ____ ____ exits

Answer 30

When inspiration ends Lungs recoil Gas in circuit and anatomic dead space exits

Question 31

Name the phases of the capnograph: Phase 1: Phase II: Phase III: Phase 0:

Answer 31

Phase 1: Baseline Phase II: Expiratory upstroke Phase III: Alveolar Plateau Phase 0: Inspiratory downstroke

Question 32

The beta angle on a capnograph is ___ degrees and begins the ___

Answer 32

90 Inspiratory

Question 33

Do we measure ETCO2 at the beta or alpha angle?

Answer 33

BETA

Question 34

The alpha angle is usually __-__ degrees and represents the emptying of the alveoli and transition to __ __

Answer 34

100-110 Dead space