Emotional State: 1. Anxiety/ nervousness: watching every movement; asthma, respiratory failure, hypoxia 2. Depressed: quiet, denial 3.

Anger/ combative/ irritable: electrolyte imbalance 4. Euphoria: drugs, OD 5. Panic: hypoxia, tension pneumothorax, status asthmaticus. A-a Gradient: 1. If normal, hypoxia caused by hypoventilation, consider drug overdose, neuromuscular disorder. 2. If abnormal & SpO2 improves with increased FiO2. Consider PE, pneumothorax, asthma, emphysema, pneumonia, bronchitis, heart failure, congenital heart disease, aging. 3. If abnormal & refractory hypoxemia occurs, hypoxia caused by shunting problem onsider pneumonia, atelectasis, pulmonary edema or ARDS.

Interpreting EKGs: Left Bundle Branch Block: 1. 2 R waves in V5 and V6 2. Cannot diagnose infarct 3. Same as anterior Hemiblock = posterior hemiblock which is also same as biphasicular block Right Bundle Branch Block: 1. 2 R waves in V1 and V2 2. QRS is wide and looks like an M Anterior Hemiblock: 1. Q in lead I and S in III 2. QRS slightly widened 3. Occurs in left anterior descending of RCA with MI and heart disease 4. Causes Right Axis Deviation 5. May be associated with RBBB 6. 50% of posterior MIs Posterior Hemiblock: 1. S in 1 and Q in 3 2. Normal or slightly widened QRS 3. Occurs in Right anterior descending of RCA with MI or heart disease 4. Causes Right Axis Deviation 5. Rule out other causes of RAD 6. Rare, causes AV block, deadly Bifasicular Block: 1. A combination of blocks 2. Anterior Hemiblock + RBBB 3. Posterior Hemiblock + RBBB 4. Anterior Hemiblock + Posterior Hemiblock (also called LBBB) 5. May cause intermittent AV block Right Axis Deviation: 1. QRS negative in lead I 2. QRS positive in AVF 3. QRS negative in AVF and lead I if extreme RAD 4. QRS in V1, V2 isoelectric 5. Slender person with ventricular heart 6. Ventricular hypertrophy 7. Pulmonary disease 8. MI on left side of heart Left Axis Deviation: 1. QRS positive in lead I 2. QRS negative in AVF 3. QRS in V5 and V6 are isoelectric 4. Obese patients 5. Left Ventricular Hypertrophy 6. MI right side of heart
Respiratorytherapycave.blogspot.com 09/08/2009

Adjusting Flow Termination on Vision/Bipap: 1. Start: 25% for adults 1. Higher percentage desired (40%) a. In leak situation b. To reduce auto PEEP 2. Low Percentage desired (10%) a. To maximize tidal volume More EKG interpretations: Left Ventricular Hypertrophy: 1. QRS complexes with exaggerated amplitude both in height and depth 2. S wave in V1 is deep, large R in v5 3. Height of S in V1 + R in V5 =>35 mm 4. T wave inversion in V5 and V6 with a gradual downward slope Hyperkalemia: Flat p waves, wide QRS, peaked T Hypokalemia: Flat T waves, wide QRS, u waves Hypercalcemia: QT interval shortens Hypocalcemia: Prolonged QT interval Digitalis effect: a. PABS early sign 1. Gradual down-sloping of ST segment 2. Low K enhances Digitalis effect Quinidine Effects: (Anti-arrhythmic) 1. Widening of p waves and QRS 2. Often ST depression, prolonged QT 3. Maybe presence of U wave