kettering - ventilation
Terms
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- What are acceptable bedside pulmonary function masurements
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Vt= 5-8 (below 5 unacceptable)
VC 10XVT (<2 X VT unacceptable
RR 8-12 >20 or <8 bad
VE 5-6 >10 bad
MIP -80 (<-20 bad)
Static Comp 60-100 <25 bad) - What does an increase in Peak Pressure mean?
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-Increase airway resistance
- Needs suctioning or bronchodilator - What does an increase in plateau pressure mean?
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-Decrease static compliance
- Lungs stiffer due to loss of volume from atelectasis or shunting
- Decrease FRC (needs PEEP - What is airway resistance
- Difference between peak pressure and plateua pressure
- What can affect mean airway pressure (Paw)
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Peak Inspiratory Pressure, rate, IT time, PEEP, peak frlow,
tidal volume, inflation hold - What does SIMV mode do?
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-provides minimum minute vent
- Reduces barotrauma
- Used with tachypnea to avoid hyperventilation - When is pressure control ventilation used?
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-When PIP is high (>50)
- with IPPV or IRV (inverse- PT requires high Fi02 (>60%) or high PEEP (>15)
- - How do you normalize a high PacO2
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1. Decrease dead space
2. Increase tidal volume
3. Increase Resp. Rate - How do you normalize a low PacO2
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1. Increase deadspace
2. Decrease RR
3. Decrease tidal volume - What is the target PaCO2 for head injury patients
- 25-30 mmHg
- How do you increase a low Pa02
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1. Increase Fi02 by 5-10% (up to 60%)
2. Increase PEEP by 5 unless unacceptable side affects occur - How do you decrease a low Pa02
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1. Decrease Fi02 to less that 60%
2. Decrease PEEP - What is expiratory retard
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- Expiratory resistance
- Opposite of PEEP
- Pursed lip breathing
- Used with COPD patients to prevent airway collapse - When is PEEP/CPAP therapy used
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- Increase FRC
- Improved oxygenation caused by shunting
- therapy is 10-30 cm H20 and more - How should sigh volumes be set
- Volume seat at double the Vt of less
- What would cause a low pressure alarm in a ventilator
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1. A leak in the vent circuit
2. not enough flow
3. ET tube cuff leak - What would cause a high pressure alarm in a ventilator
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1. equipment obstruction (vent circuit)
2. Pt obstruction (et tube, pneumo, increase Raw, secretions - What would cause the low exhaled volume alarm to go off
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1. Equipment disconnect (vent circuit)
2. Low spontaneous tidal volume - What does mophine sulfate cause
- a decrease rr and tidal volume
- What does valuim/versed cause
- anti-anxiety sedative, anticonvulsant
- What deos Pavulon (Pancuronium Bromide)
- causes total muscle relaxation
- What does Curare (Tubocurarine) cause
- Paralyzation
- What does anectine (succin) cause
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-paralyze
- fast acting drug lasts 3-10 minutes
- given primarity for intubation - What are the lowest settings on the vent prior to extubation
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-SIMV 4 breaths/minite
- Fi02 of 40%
- Peep 5