Asthma versus CHF V/Q mismatch and ETCO2 - EMTLife.com - The #1 ...
Also, "the sound of sand falling on a balloon" (rales) on inhalation, and sometimes on exhalation, which is the sound of alveoli and bronchioles that were glued shut, opening by the negative pressure of inhalation and resultant differential versus ambient air "pop"ing open each one. Usually starts at bases and works way up, but if the room is quiet, and the pt's mouth is wide open, you can hear rales without a scope, assuming your IPOD has not been too loud all these years. The only finding that differs from normal is that you might (keep in mind this is a very non-specific finding) see in CHF some narrowing of the ETCO2 waveform due to reduced tidal volumes without restricted airflow. However, it isn't common and it's not a good way to differentiate. In asthma on the other hand, you may (again...not always and don't rely on it as a diagnostic finding) see widening of the ETCO2 waveform as the patient's exhalation is prolonged due to the restriction in airflow that is bronchospasm. Rhan, you're in Mississippi, nearly every CHF'er I pick up also has COPD. And if you use the same protocols as I do, and I think you might, you have to call and ask "Mother May I" in order to give either a neb or lasix. To differentiate look for JVD, pitting edema, musical wheeze, orthopnea, fever, and try to tell which came first in that pts' particular episode. You'll need to tell the OLMC if it is either CHF, COPD, pneumonia, or a combination. A lot of doctors subscribe to the "chicken soup" school of medicine when it comes to Albuterol. Can't hurt, might help. I've just never liked that approach. I think that most medics and many doctors have a hard time, or maybe were not well taught, to differentiate between the two. Wheezing can occur with any kind of restriction, not just Asthma. I always look for diaphoresis, hypertension, and normal inspiratory to expiratory ratio for CHF. The only finding that differs from normal is that you might (keep in mind this is a very non-specific finding) see in CHF some narrowing of the ETCO2 waveform due to reduced tidal volumes without restricted airflow. However, it isn't common and it's not a good way to differentiate. In asthma on the other hand, you may (again...not always and don't rely on it as a diagnostic finding) see widening of the ETCO2 waveform as the patient's exhalation is prolonged due to the restriction in airflow that is bronchospasm.
V Q Mismatch - Bookshelf
Visual Mnemonics for Physiology and Related Anatomy
V/Q Mismatch NOTES V/Q MISMATCH V/Q ratio -> ratio of alveolar ventilation (V) to pulmonary blood flow (Q) Normally equal to 0.8 In airway obstruction the ...Understanding Mechanical Ventilation, A Practical Handbook
3.7.2 V/Q Mismatch V/Q mismatch is by far the most common (and therefore the ... If ventilation is reduced in proportion to perfusion, a low-V/Q mismatch is ...Diagnostic nuclear medicine
(1979) PIOPED(1990) Revised PIOPED Normal No Q defects Very low Low Multiple V/Q matches Single subsegmental V/Q mismatch No Q defects No Q defects Same as ...General Thoracic Surgery
The finding of lobar or whole-lung V/Q mismatch is suggestive of these disorders , although these findings may also occur in other situations, as discussed ...Pulmonary embolism
Moderate = 25-75% segment; large >75% segment; VQ mismatch = Nl V and Nl X-ray or Q > V or X-ray in region of Q defect. Data from PIOPED [2] and Gottschalk ...Complete Information Directory
Ventilation/perfusion ratio - Wikipedia, the free encyclopedia
On the other side Ventilation-perfusion mismatch is the term used when the ventilation ... from the apex to the base, but Q does it more strongly thus lowering the V/Q ratio. ...
V/Q Mismatch - What is V/Q Mismatch
V/Q mismatch is a condition whereby ventilation and perfusion of the lungs are not evenly matched. Learn more about V/Q mismatch.
V/Q mismatch
V/Q mismatch is the presence of a degree of shunt and a degree of dead space in ... The difference in V/Q mismatch is that the extent to which this occurs is ...
Interpretation of V/Q Scan for Pulmonary Embolus
V/Q ratio: Perfusion defect that has any ventilatory abnormality of comparable ... perfusion mismatch in the lower lung zones on V/Q scanning may be ...
VQ Ratio
VQ Ratio. Normal V (ventilation) is 4 L of air per minute. Normal Q ... When the V/Q is < 0.8, there is a VQ mismatch caused by poor ventilation. For more ...