Oxygen Delivery systems and mechanical ventilation

[Staradmiral]

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How important is knowing the different oxygen delivery systems and mechanical ventilation methods for Step 2 CK. There is a section in Step Up to Medicine on it p. 97&101, however I find it really technical and bland. I have not seen any kaplan questions ask anything about this stuff, but it was in the step Up questions

nasal cannula
simple face mask
Venturi mask
non-rebreathing mask
SIMV
Assisted Control ventilation

Do I need to memorize this for Step 2 CK? or is it a waste of time?

Thank you

 

[Torquer]

Havent yet taken the exam but will soon. having gone through UW though, I can tell you i got pretty irritated by the mechanical ventilation questions. All based on effects of altering PEEP, FiO2, Tidal Volume, RR etc. UW does a pretty good job of explaining the concepts but the fact that its on the bank would suggest to me that theres a possibility of getting the odd ventilation question.

Guess it comes down to the sort of score you're aiming for!

 

[Firewood]

I feel the same way about ventilators. I am willing to take the hit on the topic and just not study the info, other than reviewing my answers in UWorld. I personally think it's low-yield, but I'll tell you after I take my test on Friday if I was wrong.

 

[turkeyjerky]

I don't recall having any questions on this topic on the test. My guess is that they are fair game, however, but that it's tested at a fairly low level. I'd just know the order for O2 delivery devices, ie NC->Simple->Non-rebreather->BVM, w/ the fact that a Venturi mask allows precise delivery of FiO2, and some simple vent topics, like you adjust PEEP and FiO2 for oxygenation and TV or RR for Ventilation (aka pCO2) and that Low tidal volume (6 cc/kg ideal body wt) is good for ARDS.

 

[ArcGurren]

I had two questions on mechanical ventilation. I had done some rotations in the ICU so I was at least somewhat familiar with the basics of mechanical ventilation; otherwise I can understand how it's irritating to study. Some simple things are definitely very testable. For example, in ARDS you want a low tidal volume and you want to increase PEEP, for someone with bullous emphysema you want to decrease PEEP to prevent barotrauma. etc.

As far as ventilatory methods go, one thing that's potentially testable is that prior to intubation for respiratory failure, you want to at least try a trial of BiPAP to see if it works (I think there were some UW questions about this).

 

[Firewood]

I had two questions about this on my test today. Nothing in Step Up covered it. If you want to learn it, you'll have to go to a supplemental source.

 

[Staradmiral]

Thanks for the info

 

[joeDO2]

this medscape article gives a nice down and dirty on mechanical ventilation. only takes a few minutes to read to familiarize yourself with it. although it may not be super high yield for boards, its pretty important stuff to know depending on what you want to do. certainly need to know for IM, CCM, EM, anesthesia. might as well take a few minutes now.

http://emedicine.medscape.com/article/810126-overview