Ventilator

Question 1

Titdal Volume (Vt)

Answer 1

volume of normal breath

Question 2

Inspiratory Reserve Volume (IRV)

Answer 2

Amount of air that can be forcefully inhaled

Question 3

Expiratory Reserve Volume (ERV)

Answer 3

Amount of air that can be forcefully exhaled.

Question 4

Residual Volume (RV)

Answer 4

Amount of air left in respiratory tract after forceful exhalation.

Question 5

Total Lung Capacity (TLC)

Answer 5

IRV + TV + ERV + RV

Question 6

Dead space

Answer 6

Surfaces of airway not involved in gaseous exchange
2ml/kg
Gas exchange only occurs in alveoli

Question 7

Central Chemoreceptors

Answer 7

Located in Medulla and Pons.
driven by CO2 and H+ in CSF
Responds slowly

Question 8

Peripheral Chemoreceptors

Answer 8

Located in Aortic arch and carotid bodies.
Driven by O2, CO2 and H+
Bodies pulse ox

Question 9

Apneustic respirations

Answer 9

Long inhalation with brief exhale (gasp).
Associated with brain injury affecting the Pons.

Question 10

Ataxic respirations

Answer 10

Completely irregular with increasing periods of apnea.
Caused by damage to Medulla.

Question 11

Biot’s Respirations

Answer 11

Quick shallow inspirations followed by periods of apnea.
Damage to medulla.

Question 12

Cheyne-Stokes Respirations

Answer 12

Progressively deeper and faster respirations followed by a gradual decrease that end in apnea. cycle continues.

Question 13

Kussmaul’s Respirations

Answer 13

Deep, labored, fast.
Associated with DKA

Question 14

Hypoxic Respiratory Failure

Answer 14

Increase O2 and Peep

Question 15

Hypercarbic Respiratory Failure

Answer 15

Inability to remove CO2.
Evidenced by respiratory acidosis (ETCO2 >45)
Increase tidal volume and rate

Question 16

Tidal Volume (Vt)

Answer 16

4-8 mL/kg of IBW
Volume of air given each breath.
Too much can lead to (VILI) Ventilator Induced Lung Injury)

Question 17

Rate (F)

Answer 17

12-20 BPM

Question 18

Minute Volume (Ve)

Answer 18

(F) x (Vt)
Amount of air breathed by Pt per minute
Desired Ve = IBW in kg /10=LPM

Question 19

Inspiratory : Expiratory Ratio (I:E)

Answer 19

1:2
Takes longer to exhale.

Question 20

Fraction of Inspired Oxygen (FIO2)

Answer 20

0.21 - 1.0
21 to 100% concentration.
More accurate than LPM.

Question 21

Positive End Expiratory Pressure (PEEP)

Answer 21

0-20 cm H2O
helps keep alveoli open to improve oxygen diffusion.

Question 22

Volume control

Answer 22

A preset volume is given.
Pressures are monitored.
Volume is consistent every breath.

Question 23

Pressure control

Answer 23

A preset pressure is delivered every breath.
Volume varies with each breath.
Volumes are monitored.

Question 24

Peak Inspiratory Pressure (PIP)

Answer 24

Peak pressure delivered during inhalation.
<35 cmH2O

Question 25

Plateau Pressure (Pplat)

Answer 25

Measured during inspiratory pause. Caused by lung elasticity. <30 cmH2O

Question 26

Controlled Mandatory Ventilation (CMV)

Answer 26

Vent controls entire breath cycle. Pt has no control. Used in sedated and apneic Pts. Often paralyzed.

Question 27

Assist Control (AC)

Answer 27

Inhale triggered by Pt or preset time. Vent supports every breath. Full (Vt) given every breath. Risk of (VILI) ventilator induced lung injury due to breath stacking.

Question 28

Synchronized Intermittent Mandatory Ventilation (SIMV)

Answer 28

If Pt fails to take a breath the vent will provide a mechanical breath.

Question 29

Pressure Support Ventilation (PSV)

Answer 29

Reduces work of breathing. Pt determines (Vt), (F). Requires consistent ventilatory effort by Pt. Like an assisted Pull up.

Question 30

Continuous Positive Airway Pressure (CPAP)

Answer 30

Continuous PEEP

Question 31

Bi-Level Positive Airway Pressure (BPAP)

Answer 31

Alternating levels of PEEP. Less PEEP during exhalation.

Question 32

(DOPES) Ventilator alarm pneumonic

Answer 32

Dislodged: low pressure Obstructed: High pressure Pneumothorax: High pressure Equipment: Machine failure. (Batteries) Stacked breaths: High pressure.

Question 33

Low pressure alarm

Answer 33

Disconnection Chest tube leaks Circuit leaks Airway leaks Hypovolemia

Question 34

High pressure alarm

Answer 34

Kinked line Coughing Secretions Pt biting tube Reduced lung compliance Increased airway resistance

Question 35

Basic Vent setup

Answer 35

1. Determine IBW 2. Determine (Vt) 4-8 ml/kg 3. Set (Ve) goal kg/10 = LPM +/- 3L 4. Ve/Vt = RR

Question 36

IBW

Answer 36

Male: 50kg+ 2.3kg( height in inches - 60) Female: 45.5kg + 2.3kg(height in inches - 60)