8A: Supplemental O2 Flashcards
What are the three mechanical ventilation controls?
- Volume
- Rate
- Pressure
Will a pt with a control mode ventilator be in PT?
No because they will likely not be awake
What is a control mode ventilator?
Total exertional control for rate, depth, and pressure without any participation from the patient
What types of patients will have a control mode ventilator?
Sedated or pharmacologically paralyzed
What is an assist control mode ventilator?
Machine has a set rate but is also response to patient initiation
What is IMV mode?
Intermittent Mandatory Ventilation
Describe IMV mode
- Allows patient to initiate breath
- Provided support to volume
- Mandatory breath is delivered at preset rate regardless of pt’s effort
What is SIMV mode?
Synchronized Intermittent Mandatory Ventilation
Describe SIMV mode
- Set rate allows for some pt controlled ventilation
- Stacks ventilation of top of spontaneous effort at set rate
When is the mandatory breath initiated with SIMV mode?
Initiated by the pt’s spontaneous inspiratory effort
What triggers assisted ventilation in assist mode?
Pt’s spontaneous effort
Does assist mode have a set rate?
No
What is PSV mode?
Pressure Support Ventilation
Describe PSV mode
Every time that the pt starts a breath, it will put extra pressure to get to level
What is PEEP?
Positive End-Expiratory Pressure
When will a pt need PEEP?
They are breathing on their own but have early airway closure so there is not enough time for gas exchange
What does PEEP provide?
A treshold-like pressured that is applied at the end of expiration to maintain higher than atmospheric pressure in the airways
What is the result of PEEP?
Delays early airway closure and keeps alveoli open
What is IPPB?
Intermittent Positive Pressure Breathing
Describe IPPB
Intermittently interjects positive pressure into the tubing to provide slight increase in time for gas exchange
What is inspiratory hold?
Present pressure or predetermined volume is reached and triggers the hold
What are the effects of inspiratory hold?
Allows for collateral ventilation, encourages even ventilation
What is a CPAP?
Continuous Positive Airway Pressure
What does CPAP maintain?
Positive pressure in the airway at all times, basically just continuous PEEP
What are the results of CPAP?
Assists in preventing early airway closure in pt’s with small airway disease
What is an incentive spirometer?
Visual feedback to assist in deep breathing exercises used when voluntary effort is below 60% of premorbid state
What does an incentive spirometer provide?
Quantitative goal for increasing inspiration
What are types of oxygen masks?
- Aerosol
- Venturi or veni-mask
- Face tent
What are whiskers?
Mask modification of adding tubes to the ventilation holes to maximize high concentration O2
Why should masks have humidity added to them?
Because of the dryness of high concentrations of straight O2
What level is considered a high flow rate?
> 40% O2
When is the use of a high flow rate considered?
When individuals are in acute respiratory distress
Describe high flow rate O2 delivery
Always humidified and can be delivered through intubation when other assist is either anticipated or required
What modification is made to a high flow oxygen delivery for a COVID patient?
Will not have humidity added because it would increase the transmission
What should TV and RR be for the use of low flow O2?
TV: 300-700 mL
RR: < 25
What levels of oxygen (L/min) are considered to be low flow rates?
< 4 L/min
What is the % of O with a 1L/min flow rate?
24%
What is the % of O with a 2L/min flow rate?
28%
What is the % of O with a 3L/min flow rate?
32%
What is the % of O with a 4L/min flow rate?
36%
What level of oxygen is delivered with a nasal cannula (NC)?
Usually less than 6L of O2
What level of oxygen is delivered with a Venturi or Venti-mask?
25-50% of O2
What type of oxygen delivery are BiPAP and CPAP?
Low flow - positive pressures used for sleep apnea
What is a tracheostomy collar?
Placed over the pt’s tracheostomy opening - type of low flow delivery
What % of oxygen is delivered by a tracheostomy collar?
25-60%
When is a re-breather mask used?
Acute distress
Describe how a re-breather mask works?
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
