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ARTP > 07: Basic Vent Function > Flashcards

07: Basic Vent Function Flashcards

1
Q

Positive pressure ventilation

A

Airway pressure applied to patients airway through artificial airway

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2
Q

Negative pressure ventilation and types

A

Machine creating negative extrathoracic pressure
Iron lung
Chest cuirass

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3
Q

Two ways vents can be triggered into inspiration

A

Patient or machine

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4
Q

Trigger

A

Starts inspiration

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5
Q

pressure trigger

A

Patient spontaneously inhales -> drops pressure -> triggers inspiration

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6
Q

Time triggered

A

Machine begins inspiration at preset time
(RR:10 -> triggers every 6 seconds)

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7
Q

Flow triggered

A

Patient spontaneously inhales -> changes flow -> triggers

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8
Q

Advantages of flow trigger

A

Improved response to pt effort and requires less effort from pt

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9
Q

Base flow range on flow triggered ventilation

A

8-10lpm

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10
Q

Trigger flow range on flow trigger ventilation

A

1-3lpm

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11
Q

Flow trigger works in

A

All modes

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12
Q

Spontaneous modes of ventilation

A

Pt determines RR, inspiratory flow rate, and size of breath
PSV SIMV CSV

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13
Q

Exhalation valve

A

Closes on inspiration -> passive exhalation
MUST BE FUNCTIONAL FOR PEEP

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14
Q

Internal circuit

A

Air inside machine -> external circuit

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15
Q

External circuit

A

gas from vent -> pt -> exhalation valve

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16
Q

Time cycled

A

Inspiration ends when set time expires

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17
Q

PIP reached on time cycled?

A

Machine holds inspiration until inspiratory time expires

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18
Q

Flow cycled

A

Inspiration ends when minimum flow met

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19
Q

Pressure cycled

A

Inspiration ends when preset pressure is met

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20
Q

Changes in airway resistance/lung compliance in pressure cycled cause what to change

A

Volume and flow

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21
Q

Volume cycled

A

Inspiration ends when preset volume delivered

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22
Q

Changes in resistance and compliance in volume cycled change what?

A

Pressure

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23
Q

CMV

A

Continuous mandatory ventilation
NO spontaneous breaths

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24
Q

IMV

A

Intermittent mandatory ventilation
Mandatory rate set, pt can spontaneously breath additional breaths

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25
Q

SIMV

A

Synchronized intermittent mandatory ventilation
If machine senses pt effort, it synchronizes the mandatory and spontaneous breaths

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26
Q

CSV

A

Continuous spontaneous ventilation
All breaths spontaneous

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27
Q

Mode

A

Control selecting how machine will deliver inspiration and expiration

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28
Q

PIP

A

Peak/maximum inspiratory pressure
Pressure required to deliver set volume

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29
Q

MAP

A

Mean airway pressure
Average pressure of full breath cycle

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30
Q

MAP increased?

A

Blood flow to heart decreased

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31
Q

A/C

A

Assist/control
Assisted breaths if breathing over set rate

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32
Q

Pressure support is only in

A

Spontaneous breaths

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33
Q

SIMV spontaneous breaths are delivered at what volume?

A

Volume pt desires

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34
Q

Spontaneous inhalation in A/C

A

Sensitivity adjusted to allow the breath to achieve set Vt in VC or PIP in PC

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35
Q

Trigger variable

A

What starts the breath

36
Q

Target variable

A

Upper boundary set/maintained (not control)

37
Q

Cycle variable

A

Ends inspiration

38
Q

Types of cycle variables

A

Pressure
Volume
Time
Flow

39
Q

Flow cycled only applies to

A

Spontaneous breathing

40
Q

Time cycled can be set for

A

Volume or pressure control

41
Q

Increasing flow does what to I-time and E-time

A

Increases I-time
Decreases E-time

42
Q

Decreased flow does what to I-time and E-time?

A

decrease I-time
increase E-time

43
Q

Increased flow does what to the I:E

A

Decreases (1:3 -> 1:4)

44
Q

Decreased flow does what to I:E

A

Increases (1:4 -> 1:3)

45
Q

Volume control presets

A

Volume and flow

46
Q

Pressure control presets

A

Pressure and time

47
Q

Time control presets

A

I-time and E-time

48
Q

In volume cycled, what effects the I & E time and what determines it

A

Rate, volume, and flow effect
Volume determines

49
Q

60 / BPM =

A

Amount of time per breath cycle

50
Q

I-time =

A

Breath cycle time / I + E in I:E ratio desired

51
Q

E-time =

A

Breathe cycle time - I-time

52
Q

The bigger the E-time

A

The smaller the ratio

53
Q

Pressure support ventilation

A

Used for overcoming Raw from ETT -> 5-7cmH2O
To increase Vt -> >7
Only in spontaneous breathing
Flow cycling

54
Q

Limit variable

A

limits variable during inspiration but does not end it

55
Q

Pressure limit

A

Max inspiratory pressure (MIP)

56
Q

Inflation hold (plateau) does what to I time and E time

57
Q

What to adjust to improve oxygenation

A

PEEP and flow

58
Q

Pressure limiting relief valve alarm (high pressure alarm)

A

Set high pressure reached. -> alarm -> relief valve opens and releases any pressure in system

59
Q

PEEP

A

Pressure above atmospheric pressure in lung on exhalation (NV: 5 cmH2O)

60
Q

What is used to increase MAP

61
Q

Patient must be doing what type of breathing for CPAP

A

All spontaneous breaths

62
Q

Square wave form

A

Constant inspiratory flow
Best for pt: stiff lung and increased RR
Decreases inspiratory time

63
Q

Sinusoidal wave form

A

Spontaneous
Most Ike normal breathing
Flow not constant

64
Q

Tapered/decelerating wave form

A

Flow rate high at inspiration, but then drops
Best for pt: increased Raw (asthma) or high PIP

65
Q

Tapered/decelerating effect on I And E time

A

Increase I
Decrease E

66
Q

What happens when you change from square to tapered wave forms?

A

Increases I time
Decreases E time and PIP

67
Q

Pressure control mode

A

Pressure limited and time cycled
Flow pattern ALWAYS decelerating/tapered

68
Q

Inverse I:E

A

Utilized when pt is critical and adjusting FiO2 and PEEP does not improve oxygenation
Used with PEEP and PC
Becomes time cycled and pressure limited ventilation

69
Q

CMV

A

Pt breathing some on own, but not efficient enough
Each breath delivered at set volume

70
Q

SIMV

A

Vent and patient initiated

71
Q

Mode for weaning from A/C (CMV)

72
Q

How to increase spontaneous tidal volume

A

Increase PS

73
Q

How to determine tidal volume

A

5-8 ml/kg of IBW

74
Q

IBW equation

A

50 or 45.5 + 2.3(ht-60)

75
Q

Pt scenario: apnea, not strong enough to initiate an assisted breath and decreased LC

A

A/C or CMV

76
Q

Pt strong enough to assist vent, what mode do u use?

77
Q

What mode to use if pt oxygenation is poor with all other efforts

78
Q

Large Vt but low PaO2, what mode?

A

PEEP or CPAP

79
Q

Strong enough to assist vent, but low spontaneous breaths, what mode?

80
Q

Flow trigger helps what kind of patients?

81
Q

Poor oxygenation but PC does not work?

A

Inverse I:e

82
Q

Dr ordered parameters

A

Mode
Vt in VC or PIP in PC
RR
FiO2
PEEP
PS if in SB

83
Q

Pressure to hold lung open

84
Q

What mode?

86
Q

ARTP (9 decks)

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