Interpretation of an ABG, followed by SBAR (situation, background, assessment, recommendation) referral to ITU for ventilatory support.

Interpretation of an ABG, followed by examiner

questions on further management.

Questions you may be asked

Q. What are the indications for CPAP and BIPAP?
A. Indications for CPAP include type 1 respiratory
failure refractory to high-flow supplementary oxygen.
Indications for BIPAP are:

Q. Briefly explain how CPAP and BIPAP work.

A. CPAP works by:
Positive airway pressure throughout the respiratory cycle
Splinting the alveoli open during expiration, thus
preventing premature closure/collapse of the alveoli
Increasing the time and surface area available for
ventilation, therefore increasing gas exchange and
oxygenation of the blood
BIPAP works by:
Providing positive pressure throughout the respiratory cycle

Pressure being more positive during inspiration

than expiration
High positive pressures during inspiration
splinting the alveoli open and thus increasing
oxygenation
Lower positive pressures during expiration
increasing minute ventilation so that more air (and
hence CO2) is exhaled per unit time
Q. How do you calculate the oxygen delivery to
tissues?
A. Oxygen delivery (mL O2/min)=Cardiac output (L/
min)x[Hb] (g/L)x1.31 (mL O2/g Hb)Sao2
Q. What are the potential complications of an ABG?
A. Haematoma formation (can cause compression
of the artery and compromise blood flow)
Damage to local structures
False aneurysm formation
Failure to get blood despite multiple attempts
Q. How can lactic acidosis be classified?
A. Type A lactic acidosis is caused by tissue hypoperfusion (e.g. systemic inflammatory response syndrome,
hypoxia, severe anaemia)
Type B lactic acidosis has three subtypes:
Drugs (e.g. metformin, paracetamol overdose)
Tumours (e.g. lymphoma)
Inborn errors of metabolism (e.g. glucose
6-phosphate deficiency)