Patients with anaphylaxis should not suddenly sit, stand, or be placed in the upright position. Instead, they should be placed on the back with their lower extremities elevated or, if they are experiencing respiratory distress or vomiting, they should be placed in a position of comfort with their lower extremities elevated. This accomplishes 2 therapeutic goals: 1) preservation of fluid in the circulation (the central vascular compartment), an important step in managing distributive shock; and 2) prevention of the empty vena cava/empty ventricle syndrome, which can occur within seconds when patients with anaphylaxis suddenly assume or are placed in an upright position. Patients with this syndrome are at high risk for sudden death. They are unlikely to respond to epinephrine regardless of route of administration, because it does not reach the heart and therefore cannot be circulated throughout the body
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ReplyDeleteOXYGEN CYLINDER ENDURANCE CALCULATION FORMULA
ReplyDeleteduration of flow in minutes = (gauge pressure-safe residual pressure) x constant/ flow rate in liters per minute
safe residual pressure:200
constants:
D cylinder 0.16
E cylinder 0.28
M cylinder 1.56
H cylinder 3.14
For example, a "D" oxygen cylinder with an available cylinder pressure of 1800 p.s.i.(2000-200) has 288 litters of available oxygen (1800 x 0.16 = 288).
Remember that the available liters do not include the oxygen that is still left in the
cylinder when the safe residual level is reached.