FCCS (Fundamentals of Critical Care Support) Exam with Answers
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FCCS
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FCCS
FCCS (Fundamentals of Critical Care Support) Exam with Answers
1. What is the single
most important in-
dicator in critical ill-
ness?
tachypnea
2. Beck's Triad hypotension, JVD, muffled heart sounds
- a/w cardiac tamponade
3. What is the thyro-
mental distance?
4. What does it mean
when...
3. What is the thyro- It is the distance in finger breadths between the ante-
mental distance? rior prominence of the thyroid cartilage (adam's apple)
and the tip of the mandible (chin). It is an estimate
of the length of the mandible and the available space
anterior to the larynx
4. What does it mean - approx 6 cm
when the thyromen- - indicates the larynx might be more anterior and there-
tal space is < 3 fin- fore difficult to visualize during laryngoscopy
gerbreadths?
** a more acute angulation of the stylet at the distal
end of the endotracheal tube may be helpful.
5. Patient is apneic w/ Bag them.
a pulse. What do - One handed bag compressions should be delivered
you do? 10-20 times per min. Each compression should take
place over 1 second.
** If patient starts spontaneously breathing, try to be
synchronous with their respiratory efforts.
** If/once the patient is breathing easily and adequate
Vt are being inhaled, enough to produce minute venti-
lation, stop bagging.
6. What is the goal of to provide adequate minute ventilation: the product of
manual mask venti- the tidal volume delivered during each resuscitation
lation? bag compression and the number of compressions per
min.
, FCCS (Fundamentals of Critical Care Support) Exam with Answers
** The total gas volume within most adult resus bags
is 1 to 1.5 LITERS
7. Bag mask should 100% oxygen at a rate of 15L/min
be connected to
% oxygen
and flow at a rate of
8. HFNC - Uses up to 100% oxygen source
- Provides higher amounts of FIO2 (0.32-1.0) in pa-
tients with high minute ventilation requirements by
matching patient's inspiratory demands and minimiz-
ing air dilution
- These devices also can generate PEEP (that is diffi-
cult to measure; can cause barotrauma in theory)
- Flow rates up to 60L/min
- heated and humidified oxygen
9. NRB - AKA Reservoir Face Mask
- Bag is filled with 100% oxygen from a supply source
(tank)
- The flow rate must be adjusted so that the bag re-
mains completely or partially distended throughout the
respiratory cycle
- When the mask is properly applied, oxygen delivery
can be maximized but rarely exceeds a FIO2 of 0.6 to
0.9
- One way flap valves minimize entrapment of room air
which dilutes FiO2
- NRB is a high oxygen high, flow device.
- non humidified oxygen
** commonly used to improve oxygenation in patients
with severe hypoxemia until further eval and treat-
ments are accomplished.
10. Aerosol Face Mask - This mask has large side holes, the mask itself is
attached to large bore tubing to a nebulize that blends
, FCCS (Fundamentals of Critical Care Support) Exam with Answers
100% oxygen and room air to deliver a PRESET FIO2
level (done by dial on oxygen adapter)
- If the entire aerosol mist disappears from the mask
during. inhalation, the patient's inspiratory flow de-
mands are probably exceeding the capacity of the
nebulizer and room air is being entrained.
- minimum flow rate = 8L/min
- Max FIO2 = 40-60%
- This is a variable oxygen, moderate-flow device.
11. Simple Face Mask - minimum flow rate: 6L/min (to clear CO2 from mask)
- humidified O2
- Approx. concentrations L to FIO2 ratios:
6L = 40%
7L = 50%
8L = 60%
12. Venturi Face Mask - aka air entrainment face mask
- delivers O2 through a jet mixing device that increases
the velocity of oxygen and causes a controlled entrain-
ment
- the FiO2 can be more precisely controlled from .24 to
.5 (24% to 50%) at high flow rates simply my selecting
the interchangeable nozzle and adjusting the O2 flow
rate
- this is a high flow, controlled oxygen device.
13. Nasal Cannula flow 1L = 24%
rate to FIO2 esti- 2L = 28%
mates if RR and 3L = 32%
tidal volumes are 4L = 36%
normal 5L = 40%
6L = 44%
14. NPPV uses two lev- CPAP
els of positive air-
way pressure, com-
bining modalities
of pressure sup-
, FCCS (Fundamentals of Critical Care Support) Exam with Answers
port ventilation and
what?
15. What is CPAP? continuous positive airway pressure
- Allows spontaneous breathing from a gas source
at an elevated baseline system pressure (higher than
atmospheric pressure)
- Functionally equivalent to PEEP.
16. By convention, PSV PSV = IPAP
mode is referred CPAP = EPAP
to as
and CPAP is re- The difference between these two numbers deter-
ferred to as mines the tidal volume generated.
when talking about
NPPV/BIPAP
17. Initiation of NPPV - Do not delay intubation if needed and keep in mind
guidelines the patient's resuscitation status.
- Consider ABG analysis prior to initiation.
- Explain the procedure.
- Keep head of bed at e45°.
- Ensure appropriate mask or helmet size.
- Assess the patient's tolerance of the mask by apply-
ing it by hand before securing the harness.
- Adjust the difference between EPAP and IPAP to
achieve and effective VT and CO2 clearance. Adjust
EPAP for alveolar recruitment in increments of 2 cm
H2O per step to improve oxygenation. Depending on
the ventilator, a similar increase in IPAP may be re-
quired to maintain the same VT.
- If assist-control volume ventilation is used, begin with
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