10: Common Vent Settings/controls Flashcards
If your patient is in a spontaneous mode of ventilation with no set rate, which alarm would you see if the pt was to stop breathing?
Apnea
Which alarm would you see if the ventilator loses medical gas supply
Vent inoperative (A/C)
Which modes of ventilation can we support a pt’s spontaneous breathing with pressure support?
PSV SIMV CPAP + PSV
Which monitored value would you utilize to assure the preset tidal volume is being delivered to the pt?
Exhaled Vt (end-tidal volume)
Which alarm would you monitor during CPAP ventilation to assure preset CPAP pressure is being maintained?
Low pressure alarm
What are some possible causes for the low exhaled minute volume (VE) alarm to sound?
Leak/disconnect, pneumo, bradypnea,air trap, asynchronous etc
What occurs when the ventilator loses electrical power?
Battery operation alarm use battery backup
What would you do if all electrical power to the ventilators in the ICU is lost?
Call sup
Bag
After a vent circuit change, where would you discard the vent circuit?
Biohazard/trash
Possible causes for the high pressure alarm to sound?
Cough
Kink/occlusion
Water in circuit
Secretions
Bronchospasm
Pneumo
Decreased LC
Increased Raw
What value would you be obtaining if you pressed the inspiratory hold button?
Plateau pressure
What value would you be obtaining if you pressed the expiratory hold (pause) button
Total PEEP
Contraindications for use of HME
Hemoptysis
Copious/thick secretions
Ve <5 or >10
Vte<75%
Hypothermia
Uncorrectable large leak
When to perform SST, EST or pre-use check?
Between pt’s
Circuit change
HME -> heated circuit
Type of neb best for pt on vent?
Vibrating mesh
What should always be done prior to suctioning a pt while on mech ventilation?
Hyperoxygenat/silence alarms
What does “air hungry” mean and how to correct problem?
Unable to breathe in sufficient air/dyspnea
Increase flow
Reasons for high respiratory rate alarm to sound?
Trigger sensitivity too low
Anxiety/fear/agitation
Pain
Respiratory distress
Tachypnea
Pt in PC, what are some possible causes for pt’s exhaled Vt to trend down?
Decreased LC
Increased Raw
When to replace a pt’s vent circuit?
PRN/when soiled
Per hospital policy
What is high pressure cycling and why could it occur?
When certain pressure reached, vent cycles to exhalation
Asynchronous/cough
What valve opens if the ventilator loses or becomes disconnected from gas source
Safety valve -> pt breaths spontaneously room air
High minute ventilation alarm should be set at
10-15% above baseline/set
Low minute ventilation alarm should be set at
2 L below baseline
High RR alarm should be set at
2x set rate
Low RR should be set at
2 below set
Low Vt alarm should be set at
100-200 ml below set/measured
Low peep alarm should be set at
2-3 below set
High pressure alarm should be set at
10-15 cmH20 above baseline PIP
Low pressure alarm should be set at
5-10 below baseline PIP
Cstat =
And normal values
Measured Vt / Pplat - PEEP
60-100 (non vented)
40-60 (vented)
Cdyn =
And NV
Measured Vt / PIP - PEEP
50 -80 (non vented)
30 - 50 (v)
Raw =
And NV
PIP - plat / flow in L/sec
0.5-2.5
How should you dispose of excessive vent circuit condensation form the vent circuit
Away from pt, not back to vent, in trash
Vent tubing condensation is considered
Infectious waste
You have a pt on active Passover humidification with the temp set at 31C and secretions still thick, how to correct?
Increase temp
