FREE ACCS Technological and Procedural Proficiency Questions and Answers
What is the primary use of a central venous catheter in critical care?
Central venous catheters are primarily used for the administration of intravenous fluids and medications, as well as for measuring central venous pressure. They are not used for arterial pressure monitoring, respiratory assessment, or echocardiography.
How do you manage and interpret data from advanced monitoring systems in a critically ill patient, and what steps do you take if the data suggests a deterioration in the patient's condition?
Advanced monitoring systems provide critical data that help in managing a patient's condition. If data suggests deterioration, the first step is to carefully review and interpret the data to determine potential causes. Adjusting settings based on accurate data and initiating interventions tailored to the patient's condition is crucial for effective management. Simply increasing sedatives or disconnecting equipment without assessing the underlying issue would not address the root cause of the problem.
Describe the procedure for initiating and adjusting mechanical ventilation in a patient with acute respiratory distress syndrome (ARDS). What specific parameters and settings are critical to monitor and adjust in this scenario?
In ARDS, a low tidal volume strategy (6-8 mL/kg of ideal body weight) helps reduce ventilator-induced lung injury. Moderate PEEP helps to improve oxygenation by recruiting collapsed alveoli. Adjustments are guided by arterial blood gas results and the patient’s clinical response. High tidal volumes or inappropriate PEEP settings could worsen lung injury and should be avoided.
Explain the process for performing and interpreting a bedside echocardiogram in a critically ill patient. What key findings would you look for, and how would these findings influence your management plan?
Bedside echocardiography in a critical care setting involves assessing multiple factors including cardiac function (left and right ventricles), signs of cardiac tamponade, and right heart pressures. These findings are crucial for guiding comprehensive management strategies, such as fluid resuscitation, inotropic support, and ventilation adjustments. Relying on a single parameter or ignoring other critical aspects can lead to suboptimal management.
Which device is used to continuously monitor a patient’s blood pressure in a critical care setting?
An arterial line is used for continuous blood pressure monitoring and arterial blood gas sampling. Pulse oximeters measure oxygen saturation, ECG monitors heart activity, and central venous catheters are used for central venous pressure monitoring and medication administration.