Initial Vent set up

Question 1

Determine the pts vents need based on…

Answer 1

1. Is the problem restrictive, obstructive, or normal patient lung.
2. Calculate pts. IBW

Question 2

Vent modes for Normal lung mechanics

Answer 2

Use either PC, PRVC, VC to achieve Vt
3-5 ml/kg
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1. Use either PC, PRVC, VC, to achieve 
Vt 6-8 ml/kg

Question 3

Most common initial vent mode

Answer 3

AC-PC
Or
AC-VC

Question 4

VC

Volume control

Answer 4

1. Set sensitivity/trigger 1-3
2. Set Rate 10-20
3. Set fi02 40-60% (100% in Emergency)
4. Set PEEP 0-5
5. Set Vt (based on 3-5 or 6-8 ml/kg IBW)
6. Set flow(V) (40-60) to achieve I:E of 1:2- 1-4
7. Flow pattern=ramp

Question 5

PC pressure control

Answer 5

1. Set sensitivity(trigger) 1-3
2. Set Rate 10-20
3. SetFi02 40-60% 100% Emergency
4. Set PEEP 0-5
5. Set pressure limit 15-25 to achieve appropriate Vt.
6. Set I-time .8-1.2 to achieve an I:E of 1:2 to 1:4
7. Rise time(leave set at 1+ (default setting))

Question 6

PRVC (pressure volume control)

Answer 6

1. Set sensitivity(trigger) 1-3
2. Set Rate 10-20
3. Set Fi02 40-60% 100% Emergency
4. Set PEEP 0-5
5. Set target Vt
6. Set set pressure limit in alarms 30-40
7. Set I-time .8- 1.2
8. Set rise time

Question 7

SIMV

spontaneous intermittent mechanical ventilation

Answer 7

Just add pressure support 5-10
Choose breath type (PC or VC)
Set vent parameters then attach Pt. to vent.
Set Alarms

Question 8

Ventilator Alarm parameters

Answer 8

Pressure (PIP) high=10-15
(PIP) low= 5 below

Rate= high=10-15
Low=5 below

Ve=high=+2
Low=-2

Vt=high=+200ml
Low=100ml below

Question 9

PSV (pressure support ventilation)

Answer 9

Gets added on to a spontaneous mode.

SIMV applies to spontaneous inspiration only

Used to overcome RAW

Used to achieve spontaneous Vt less than or equal to 5ml/kg

Pressure limited/ patient cycled

Question 10

Auto PEEP (intrinsic PEEP)

Answer 10

To determine amount of auto PEEP,
The assess flow versus time graph

Fix by :::

1. Increasing E-time (by increasing flow or decreasing Vt.)
2. decrease rate Or volume
3. Sedate
4. Bronchodilators