8A: Supplemental O2

Question 1

What are the three mechanical ventilation controls?

Answer 1

1. Volume
2. Rate
3. Pressure

Question 2

Will a pt with a control mode ventilator be in PT?

Answer 2

No because they will likely not be awake

Question 3

What is a control mode ventilator?

Answer 3

Total exertional control for rate, depth, and pressure without any participation from the patient

Question 4

What types of patients will have a control mode ventilator?

Answer 4

Sedated or pharmacologically paralyzed

Question 5

What is an assist control mode ventilator?

Answer 5

Machine has a set rate but is also response to patient initiation

Question 6

What is IMV mode?

Answer 6

Intermittent Mandatory Ventilation

Question 7

Describe IMV mode

Answer 7

• Allows patient to initiate breath
• Provided support to volume
• Mandatory breath is delivered at preset rate regardless of pt’s effort

Question 8

What is SIMV mode?

Answer 8

Synchronized Intermittent Mandatory Ventilation

Question 9

Describe SIMV mode

Answer 9

• Set rate allows for some pt controlled ventilation
• Stacks ventilation of top of spontaneous effort at set rate

Question 10

When is the mandatory breath initiated with SIMV mode?

Answer 10

Initiated by the pt’s spontaneous inspiratory effort

Question 11

What triggers assisted ventilation in assist mode?

Answer 11

Pt’s spontaneous effort

Question 12

Does assist mode have a set rate?

Answer 12

No

Question 13

What is PSV mode?

Answer 13

Pressure Support Ventilation

Question 14

Describe PSV mode

Answer 14

Every time that the pt starts a breath, it will put extra pressure to get to level

Question 15

What is PEEP?

Answer 15

Positive End-Expiratory Pressure

Question 16

When will a pt need PEEP?

Answer 16

They are breathing on their own but have early airway closure so there is not enough time for gas exchange

Question 17

What does PEEP provide?

Answer 17

A treshold-like pressured that is applied at the end of expiration to maintain higher than atmospheric pressure in the airways

Question 18

What is the result of PEEP?

Answer 18

Delays early airway closure and keeps alveoli open

Question 19

What is IPPB?

Answer 19

Intermittent Positive Pressure Breathing

Question 20

Describe IPPB

Answer 20

Intermittently interjects positive pressure into the tubing to provide slight increase in time for gas exchange

Question 21

What is inspiratory hold?

Answer 21

Present pressure or predetermined volume is reached and triggers the hold

Question 22

What are the effects of inspiratory hold?

Answer 22

Allows for collateral ventilation, encourages even ventilation

Question 23

What is a CPAP?

Answer 23

Continuous Positive Airway Pressure

Question 24

What does CPAP maintain?

Answer 24

Positive pressure in the airway at all times, basically just continuous PEEP

Question 25

What are the results of CPAP?

Answer 25

Assists in preventing early airway closure in pt’s with small airway disease

Question 26

What is an incentive spirometer?

Answer 26

Visual feedback to assist in deep breathing exercises used when voluntary effort is below 60% of premorbid state

Question 27

What does an incentive spirometer provide?

Answer 27

Quantitative goal for increasing inspiration

Question 28

What are types of oxygen masks?

Answer 28

• Aerosol
• Venturi or veni-mask
• Face tent

Question 29

What are whiskers?

Answer 29

Mask modification of adding tubes to the ventilation holes to maximize high concentration O2

Question 30

Why should masks have humidity added to them?

Answer 30

Because of the dryness of high concentrations of straight O2

Question 31

What level is considered a high flow rate?

Answer 31

> 40% O2

Question 32

When is the use of a high flow rate considered?

Answer 32

When individuals are in acute respiratory distress

Question 33

Describe high flow rate O2 delivery

Answer 33

Always humidified and can be delivered through intubation when other assist is either anticipated or required

Question 34

What modification is made to a high flow oxygen delivery for a COVID patient?

Answer 34

Will not have humidity added because it would increase the transmission

Question 35

What should TV and RR be for the use of low flow O2?

Answer 35

TV: 300-700 mL
RR: < 25

Question 36

What levels of oxygen (L/min) are considered to be low flow rates?

Answer 36

< 4 L/min

Question 37

What is the % of O with a 1L/min flow rate?

Answer 37

24%

Question 38

What is the % of O with a 2L/min flow rate?

Answer 38

28%

Question 39

What is the % of O with a 3L/min flow rate?

Answer 39

32%

Question 40

What is the % of O with a 4L/min flow rate?

Answer 40

36%

Question 41

What level of oxygen is delivered with a nasal cannula (NC)?

Answer 41

Usually less than 6L of O2

Question 42

What level of oxygen is delivered with a Venturi or Venti-mask?

Answer 42

25-50% of O2

Question 43

What type of oxygen delivery are BiPAP and CPAP?

Answer 43

Low flow - positive pressures used for sleep apnea

Question 44

What is a tracheostomy collar?

Answer 44

Placed over the pt’s tracheostomy opening - type of low flow delivery

Question 45

What % of oxygen is delivered by a tracheostomy collar?

Answer 45

25-60%

Question 46

When is a re-breather mask used?

Answer 46

Acute distress

Question 47

Describe how a re-breather mask works?

Answer 47

Re-breathe the air that they expire because it still has a high concentration of O in it because they are breathing rapidly and do not have good ventilation