Ventilators

Question 0

AC

Answer 0

Assist Control

• preset Vt/PIP
• pt triggers breaths (receives full preset breath)
• Back up rate set

Question 1

CMV

Answer 1

Controlled Mandatory/Mode Ventilation

• early mode
• preset Vt or PIP
• Preset Rate
• pt cannot initiate (apprehension & air hunger)
• requires sedation / paralysis

Question 2

AC complications

Answer 2

• Resp Alkalosis (pts triggers 2 breaths + Back up rate= tachypnea)
• Asynchrony machine & pt
• May worsen air trapping in COPD pts
• stacked breaths (pt’s breath immediately before scheduled breath - delivers 2 preset Vt breaths. Barotrauma)

Question 3

IMV

Answer 3

Intermediate Mandatory Ventilation

• Preset rate, VT/PIP
• pt can initiate breath, but only delivers amount pt draws. (Does not deliver full present Vt/PIP)

Question 4

IMV Complication

Answer 4

If pt takes breath right before schedules breath, delivers amount requested plus scheduled breath. Results in air stacking. Barotrauma.

Question 5

SIMV

Answer 5

Synchronized Intermittent Mandatory Ventilation.

• Preset Rate Vt/PIP
• vent senses initiated breaths.
• if initiated breath close to scheduled breath, delivers preset amount. Otherwise delivers amount drawn by pt.
• can still lead to hyperventilation, respiratory alkalosis, air trapping in COPD pts.

Question 6

SCOPE - high pressure alarm

Answer 6

Suction (mucus plug)
Connections (valves on circuit/kinked)
Obstructions
Pneumothorax
ETT dislodgement (suggests deep dislodgement)

Question 7

Acute Respiratory Deterioration w/ PIP Decrease

Answer 7

Air leak, hyperventilation

Question 8

Acute Respiratory Deterioration w/ PIP no change

Answer 8

PE, extra thoracic process

Question 9

Acute Respiratory Deterioration w/ PIP increase & no Plateau Pressure change.

Answer 9

(Airway obstruction) Aspiration, Bronchospasm, secretions, tracheal tube obstruction.

Question 10

Acute Respiratory Deterioration w/ PIP increase & Plateau Pressure increase

Answer 10

(Decreased compliance)
Abdominal distention
Asynchronous breathing
Atelectasis
Auto-PEEP
Pneumothorax
Pulmonary Edema

Question 11

PIP=

Pplat=

Answer 11

PIP= airway problem
Pplat= lung structure problem

Question 12

Some causes of atelectasis

Answer 12

Tight lungs, ARDS, pulmonary edema, pulmonary contusions

Question 13

Low pressure alarms

Answer 13

D/C o2 source, disconnection, ETT extubation, hypovolemia (chest is tissue, blood and air…take away blood: increased chest cavity size)

Question 14

Methemoglobinemia and saturation

Answer 14

SPO2 reads high when low, reads low when high.

>40% will direct SPO2 to 85%

Question 15

Laminar Flow

Answer 15

Measured using Reynolds number (Re=pVD/u)
-considered laminar if Re is less than 2000.

Increase Velocity/flow, tubular diameter= turbulent flow.

Laminar flow requires slower gas velocity, through smaller tubes.

Question 16

Volume Adjustments for low O2 SATs

Answer 16

Increase FiO2, increase PEEP

Question 17

Volume Adjustments for high O2 SATs

Answer 17

Decrease FiO2” decrease PEEP

Question 18

Volume Adjustments for ETCO2 >45

Answer 18

Increase RR, increase Vt

Question 19

Volume Adjustments for ETCO2

Answer 19

Decrease RR, decrease Vt

Question 20

Pressure Adjustments for low O2 SAT

Answer 20

Increase FiO2, increase PEEP

Question 21

Pressure Adjustments for high O2 SATs

Answer 21

Decrease FiO2, decrease PEEP

Question 22

Pressure Adjustments for ETCO2 >45

Answer 22

Increase PC, increase RR

Question 23

Pressure Adjustments for ETCO2

Answer 23

Decrease PC, decrease RR