65 - Critically Ill Patients + Mechanical Ventilation Flashcards
mechanical ventilation
process by which FiO2 is move din + out of lungs by mechncl vntlr
FiO2 of room air
21%
** also lowest setting we can give**
Target FiO2 is to maintain….
SpO2 >92%
PaO2 60-80 mmHg
signs of O2 toxicity
-uncontrolled coughing
-chest pain
-dyspnea
Positive Pressure Ventilation
during insprtn, vent pushes air into lungs under pos pressure
exprtn occurs pssvly like norm
2 types
2 types of pos pressure vent
volume vent
pressure vent
volume vent
tidal vol is consistent w each breath
-airway pressure varies to reach tidal vol
pressure vent
tidal vol delivered varies depending on selected pressure, compliance, + resistant factors
hyper/hypovent pH
hyper=alkalosis
hypo=acidosis
Mechanical Ventilation
SETTINGS
1 FiO2
2 RR
3 Tidal Vol [Vt]
4 Positive End Expiratory Pressure [PEEP]
5 Pressure Support
6 Peak Inspiratory Pressure [PIP]
FiO2
amt of O2 given
-lowest is 21 bc thats room air
Tidal Volume
volume of gas exchange w each breath
-to keep lungs open
-based on body wt
low Vt is indicated for _____
and high Vt may cause _____
low= stiff non compliant lungs
high= tachycardia, decr BP, + lung injury
PEEP
used to keep alveoli open
-norm 5
-can go up to 20
Higher PEEP can cause…
1 barrel trauma/pneumothorax
2 incr intrathoracic pressure> decr venous return> decr CO
3 incr ICP
Pressure Support
pushes the air closer to the patient so that they patient can take the breath on their own
-used for weaning
Peak Inspiratory Pressure [PIP]
highest airway pressure
high PIP may be caused by..
biting
Mechanical Ventilation
MODES
1 Assist Control [AC]
Assist Control [AC]
each breath is either assist [pt initiated] or controlled [ventilator initiated] w guaranteed Vt
-full vent support
Synchronous Intermittent Mandatory Ventilation
provides full support to the preset
-used for weaning in addition to sedation vacation
presets: vol controlled or pressure controlled
4 settings for AC mode
1 RR
2 Vt
3 PEEP
4 FiO2
ET Tube can stay for…
14 days
RR + Vt control ____ by changing _____
PCO2 by changing alveolar ventilation
FiO2 + PEEP control ___ by _____
PO2 by changing oxygenation
5 days of no improvement on ET…
the HCP will consider Trache
Pressure Support Vent/CPAP MODE
second weaning
-pt A+O + awake
-drops RR + Vt
settings: pressure support, PEEP, FiO2
tidal vol formula
6-8mL/kg
ALARMS
High Pressure Alarm causes
-secretions,
-coughing, gaggings,
-fighting vent
-kinks
High Pressure Alarm causes
-secretions,
-coughing, gaggings,
-fighting vent
-kinks
High Pressure Alarm causes
-secretions,
-coughing, gaggings,
-fighting vent
-kinks
Vent asynchrony intervention
muscle paralytic
sedative drugs
-propofol
-etomidate
opioid
fentanyl
muscle relaxant
rrocuronium
low pressure alarm
-vent is disconnected
-air leak
apnea alarm
-resp arrest
-oversedation
-change in condition
-loss of airway
echo is last straw
-if mech vent doesnt work,
use echmo. takes blood + infuses O2 and returns
