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Causes of respiratory acidosis
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Terms in this set (1011)
Causes of respiratory acidosis
Acute
- Airway obstruction
- Pulmonary disease (pneumonia, asthma, PE, aspiration)
- CNS depression (drugs, intracranial catastrophe)
- Neuromuscular disorders (MG, GBS)
- Thoracic trauma

Chronic
- Lung disease (COPD, fibrosis)
- Neuromuscular (ALS, muscular dystrophy)
- Obesity hypoventilation
International Headache Society classification of headache
Primary headaches
- Migraine
- Tension
- Cluster
- Other

Secondary headaches
- Traumatic
- Vascular
- Nonvascular intracranial
- Substance/withdrawal
- Infection
- Homeostasis disorder
- Disorder of head or face structures
- Psychiatric

Cranial neuropathies
Types of infectious diarrhea
Secretory
- Features: Persists despite fasting, pH >6, Absence of reducing substances
- Vibrio, salmonella, shigella, E. Coli, C. Diff

Osmotic
- Opposite of secretory
- Presence of poorly absorbed solutes from altered gut flora, damage to mucosal absorptive surface, or substance ingestion
- Laxatives, juice diet

Inflammatory (dysentery)
- Destruction of villous cells or dysfunction of cellular transporters (enteroinvasive)
- Viruses, salmonella, shigella, campylobacter
NEXUS CT Chest Decision Rule
CT indicated if any
- Abnormal CXR
- Rapid deceleration (fall >5-6m or MVC >65km/h)
- Distracting painful injury
- Tenderness: chest wall, sternum, thoracic spine, scapula
Headache red flags
- Age >50
- Immunocompromised
- Malignancy or B sx
- First headache
- Febrile
- Thunderclap
- Post-traumatic
- Onset w/ exertion
- Focal deficits
- Signs of increased ICP
Factors that predispose children to severe complications of vomiting and diarrhea (5)
Relatively larger ECF compartment

Rapid fluid turnover
- Higher metabolic rate
- Increased BSA:M index
- Higher body water content

Limit stores of metabolic substrates (fat, glycogen)

Limited ability/desire to access fluids when ill

Limited ability to conserve water through kidneys (concentrate urine) compared to adults
Describe cerebral autoregulation
CBF = CPP/CVR
CPP = MAP - ICP

Autoregulation between MAP 50-150

↓PCO₂ = rapid ↓CBF

↓PO₂ = ↑CBF (to a certain extent)
Indications for open fixation of flail chest (4)
Open fixation
- Unable to wean from ventilator secondary to mechanics of flail chest
- Persistent pain
- Severe chest wall instability
- Progressive decline in pulmonary function
Complications of
1. Rib fractures (9)
2. Blunt myocardial injury (11)
Rib fractures
- HTX
- PTX
- Atelectasis
- Pulmonary contusion
- Pneumonia
- Post-traumatic neuroma
- Empyema
- Non-union
- Costochondral separation

Blunt cardiac
- Dysrhythmia
- Conduction ∆
- CHF
- Cardiogenic shock
- Hemopericardium ± tamponade
- Cardiac rupture
- Valvular rupture
- Intraventricular thrombus ± thromboembolic phenomena
- Coronary artery occlusion
- Ventricular aneurysm
- Constrictive pericarditis
Most common
1. Area of rib fracture
2. Site of tracheobronchial injury
3. Culprit vessels in HTX
4. Site of blunt traumatic aortic injury
Rib fractures
- Ribs 4-9, posterolateral (posterior angle)

Tracheobronchial injury
- Within 2cm of carina

HTX
- Intercostal/internal mammary arteries

Aortic tear
- Aortic isthmus, just distal to L subclavian (80-90%)
- Ascending aorta proximal to brachiocephalic vessels