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A comprehensive overview of the key lessons learned from the covid-19 pandemic, covering a wide range of topics related to the disease. It delves into the approved vaccines in the us, the limitations of certain treatments, the characteristics of covid-19 infections, the effectiveness of different types of masks, the recommended medications for mild to severe cases, the management of respiratory support for hospitalized patients, the challenges with oxygen delivery systems, and the evolving understanding of the disease. The document offers valuable insights and practical information that can be useful for healthcare professionals, researchers, and the general public in navigating the ongoing pandemic and preparing for future public health emergencies.
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Pfizer-BioNTech Moderna are ___ in the US - correct answer approved in the US Johnson and Johnson Janssen are limited due to - correct answer life threatening blood clots most people who get covid are - correct answer unvaccinated fully vaccinated people who get covid are called - correct answer breakthrough infection **may develop symptoms but are less severe rapid point of care (POC) testing - correct answer results in 30 minutes; must have current infection laboratory tests can take days and is called - correct answer transcription polymers reaction (PCR) *the gold standard & nucleic acid application test (NAATs) negative results should be considered - correct answer presumptive and should be considered with PCR least protective mask - correct answer cloth filtered moderate protective mask - correct answer N safest mask - correct answer N95 (respirators) how to protect yourself from covid when you are over the age of 2 - correct answer wear a facemark, wash your hands for 20 seconds with soap and water, 6 feet social distancing medication for the treatment of mild to moderate COVID - correct answer paxlovid nirmatrelvir dosage - correct answer 2x 150mg tablet ritonavir dosage - correct answer 1100 mg tablet 2x for 5 days what medication should be used in hospitalized patients requiring supplemental oxygen or invasive mechanical ventilation; 24 hours after administering ICU - correct answer dexamethasone
aerosol-generating procedures is - correct answer a treatment or procedure that generates more aerosols than during coughing, sneezing, speaking, or normal breathing. generating bioaerosols containing micro-organisms carries the risk of contamination and transmission medical aerosols - correct answer the aerosols (10-30%) that are generated from medical devices like nebulizers fugitive aerosols - correct answer remaining aerosols that are released or echoed to the environment not all aerosols generated can cause - correct answer infection and contamination nebulization/SVN - correct answer aerosols concentration is increased, and the patient will inhale part of it and the rest will be fugitive aerosols. use expiratory filter in the exhalation portal with aerosol face mask, use scavenger or filter facemask intubation with spontaneous breathing patients - correct answer sedatives are used to suppress cough and reduce dispense or aerosol intubation boxes are not recommended PFT - correct answer filters are recommended to be attached to the mouthpiece or mask otherwise, contained aerosol particles will be all over the room or lab cardiopulmonary rehabilitation and cardiopulmonary exercise - correct answer wearing procedure masks is highly recommended, and educate the patients to cover their mouth with a tissue or mask reducing the risk of bioaerosols not aerosol generating procedure (APG) - what devices are not APG and can be safely used during COVID - correct answer HFNC, CPAP, NIV what is recommended for HFNC patients - correct answer wearing a procedure facemark over cannula HFNC doesn't generate bioaerosols beyond patient normal breathing, can't disperse around the room
compared to HFNC and conventional oxygen therapy, CPAP had - correct answer 34% of its group, within the Perkins study, undergo adverse events CPAP will be mainly effective in patients that have - correct answer COVID-19 tied with acute hypoxemic RF Bilevel ventilators can be deployed for - correct answer invasive ventilation when critical care ventilators are unavailable IPAP (ventilation focused) and EPAP (oxygenation focused) are setting that are used for bilevel ventilation. the difference between IPAP and EPAP is - correct answer the level of pressure support that the patient is receiving to assure precise FiO2 and deliver high Fio2, it is best to use - correct answer a bilevel ventilator with an integral oxygen blender hypoxemia-induced compensatory mechanisms: primary compensatory mechanisms increase - correct answer cardiac output and hyperventilation this occurs when PaO2 is less than or equal to 60mmHg hypoxemia-induced compensatory mechanisms: hypoxic ventilator response is dependent on - correct answer PaCo hypoxemia-induced compensatory mechanisms: a normal PaCo2 of 35-45 enhances the - correct answer ventilatory response to hypoxemia hypoxemia-induced compensatory mechanisms: normally paco2 is the stimulus for respiratory drive, when pao2 is below 45 mmhm it becomes - correct answer the primary stimulus respiratory drive hypoxemia-induced compensatory mechanisms: when pao2 is below 30, erratic breathing begins followed by - correct answer apnea and brain stem death hypoxemia and sudden clinical deterioration in COVID-19: people with diminished adrenergic response and cardiovascular reverse experience - correct answer worsening hypoxemia compared to healthy people hypoxemia and sudden clinical deterioration in COVID-19: these factors increase the likelihood of - correct answer metabolic acidosis, cardiovascular failure and ARDS
these factors will determine the use of NIV compared to intubation hypoxemia is a poor stimulus for - correct answer dyspnea compared to hypercapnia the four factors that explain the perception of silent hypoxemia in COVID- 19 - correct answer 1. compensatory mild hypocapnia
o If hypoxemia happens >6 hours and persist with therapies that also support gas exchange(example, proning) ECMO timing and duration - correct answer The average length of ECMO was 13 to 20 days, with initiation typically occurring 3 to 6days after the start of mechanical ventilation ECMO ventilator guidelines - correct answer PEEP: 10-15 cm H2O Pplat: <25 cm H2O Driving Pressure: <15 cm H2O Respiratory Frequency: 4-10 breaths/min targeted SpO2: >85% FiO2: <50% absolute contraindications with ECMO and Covid- 19 - correct answer o Advanced age o Clinical frailty score > 3 o Mechanical ventilation > 10 days o Significant underlying comorbidities o Severe multiorgan dysfunction syndrome o Severe acute neurologic injury o Uncontrolled bleeding o Inability to receive blood product relative contraindications with ECMO and COVID- 19 - correct answer o Age > 65 years o Body mass index > 40 o Immunocompromised
what was shown to impact delivered humidity of heated humidification and HMEs - correct answer changes in envoronemental conditions Post-extubation stridor for COVID-19 has been attributed to a much greater rate byseveral groups associated with: - correct answer โ Prolonged intubation โ Excessive airway cuff pressures โ Agitation โ Multiple intubations โ A large ETT diameter relative to the native airway Some factors that might explain the elevation in post-extubation stridor beyond anyspecific COVID-19 pathophysiology - correct answer โ Emergently intubated โ A shock โ Nursed in the prone position ARDs patients can experience - correct answer ventilator-induced lung injury due to high tidal volumes or excessive PEEP this is because the lungs are already injured (ARDS) and have a reduced amount of tissue that is able to accept the volumes and pressure reciprocal organ crosstalk - correct answer ventilator-induced lung injury that contributes to already presentinflammation therefore causing tissue injury to other organs. 3 principles of lung protective ventilation - correct answer 1) Use of physiological tidal volumes (4-8 mL/kg) This in turn keeps the Pplat below 30 cm H2O and the driving pressure below 15cm H2O
patients who require advanced respiratory support such as HFNC, CPAP/NIV should use - correct answer APP it is advised that the use of APP is for - correct answer 8 hours everyday efforts should be made to help in improving patient compliance/tolerance to APP prolonged prone positioning for 24 hours rather than 16 hours could help - correct answer minimize the need for repositioning, but further research is needed to determine it safety and efficacy gas is delivered to the hospital via - correct answer a series of pipes od varying sizes depending upon position in the system and intended endpoint the size of pipes serving in the ICU are - correct answer larger than on general floors advantage of the hsopital-based liquid oxygen (LOX) system is - correct answer a liter of oxygen evaporates into 860 L of gaseous oxygen emergency back up systems in hospitals include - correct answer room-size oxygen concentrators banked cylinders portable liquid systems the pandemic stressed oxygen systems because of - correct answer the unusual high oxygen requirements of so many patients. oxygen deliveries had to be more frequent to meet demands piping system goes to the floors called - correct answer risers piping turns horizontally to feed the bed spaces on that floor called - correct answer laterals lateral have a zone valve that allows that portion to be isolated within the piping system there are choke points. choke points represent - correct answer epresent narrowing of the gasdelivery system and increased resistance reducing flow distal to the choke point, negativelyimpacting high gas consumption therapies The higher the flow through these lines, and the smaller the diameter, the greater the pressure drop
clinical experience with shared ventilation - correct answer The clinical experience concluded that the ventilator must be put in pressure control modebecause in volume control if one patient had a pneumo all of that tidal volume would be divertedto the other patient The main goal is to have a titratable Vt and pressure for each patient. To do this the inspiratoryside has to connect to a Y-piece, one way valve, PEEP meter, flow meter, and HME. Theexpiratory side was set the same way but with another HME at the end of the Y-piece