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Patient monitoring > Anesthesia Machine 2 > Flashcards

Anesthesia Machine 2 Flashcards

1
Q

What are the 7 Common Ventilator Settings

A
  1. Tidal Volume (Vt)
  2. Respiratory Rate (RR)
  3. Peak Inspiratory Pressure (PIP) or Pmax
  4. Positive End Expiratory Pressure (PEEP)
  5. Continuous Positive Airway Pressure (CPAP)
  6. Inspiratory:Expiratory (I:E) ratio
  7. Inspiratory time (Ti)
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2
Q

This is the lung volume representing the normal volume of air displaced between normal inhalation and exhalation when extra effort is not applied.

A

tidal volume

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3
Q

What is the traditional normal tidal volume for a patient?

A

5-10mL/kg

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4
Q

What is the new normal tidal volume for a patient?

A

6-8mL/kg and to supplement with higher respiratory rates

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5
Q

Whenever we breathe for patients and force air into their lungs, it generates ______ inside the lungs

A

pressure

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6
Q

Is the pressure generated inside a patient’s lungs DIRECTLY PROPORTIONAL OR INVERSELY PROPORTIONAL to how much volume we deliver when we give the breath

A

DIRECTLY PROPORTIONAL

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7
Q

higher tidal volumes will generate ______ inspiratory pressure

A

higher

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8
Q

Using the RR, what is the equation to find how many seconds each breath takes?

A

**60sec/RR
–ex. RR=12
length of breaths is
60/12 =5secs

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9
Q

If the respiratory rate is slower, each breath will be _____?

A

longer

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10
Q

The inspiratory time will be longer if ___?

A

the RR is slower

ie. the breaths are longer

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11
Q

What do we not generate when the inspiratory time is longer and we breath for the patient?

A

as high of a pressure inside the lungs…..because we’re delivering the breath over a longer period and aren’t forcing the breath in as fast

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12
Q

The faster the respiratory rate, the _____ each breath (and the ____ the inspiratory time) will be

A

shorter

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13
Q

When do we generate a higher pressure inside the lungs when we breath for patients because we’re delivering the breath over a shorter period and are forcing the breath in faster

A

When the inspratory time is shorter

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14
Q

What is PIP or Pmax?

A

This is the maximum amount of pressure you’re willing to give in order to expand a patient’s lungs with a ventilator breath

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15
Q

What pressure should anesthetists should stay under on intubated patients in order to avoid barotrauma?

A

35-40cmH2O

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16
Q

8 Common Causes Of High Peak Inspiratory Pressure

A
  1. Right mainstem intubation
  2. bonchoconstriction/bronchospasm
  3. Coughing/bucking while on the ventilator
  4. Trendelenburg
  5. Insufflation pressure from laparoscopic surgery
  6. Increased resistance through the endotracheal tube
  7. Too high of a tidal volume
  8. Too fast of a respiratory rate (too short of an inspiratory time)
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17
Q

What is the first sign of right mainstem intubation is elevated peak inspiratory pressure

A

Right mainstem intubation

18
Q

What does delivering a breath through a smaller diameter generate?

A

a higher inspiratory pressure

19
Q

What are some things you could do to decrease the inspiratory pressure during Bronchoconstriction/bronchospasm?

A

give more propofol because pt may be too lightly anesthetized or albuterol

20
Q

Besides Bronchoconstriction/bronchospasm, what else can be caused from the pt being too lightly anesthetized that will increase PIP?

A

Coughing/bucking while on the ventilator

21
Q

If patients are coughing/bucking while on the ventilator, what else could they experiencing?

A

bronchospasm

22
Q

What position creates resistance to diaphragm expansion, due to gravity and all of the abdominal contents pressing against the diaphragm?

A

Trendelenburg

23
Q

What can cause Increased resistance through the endotracheal tube?

A
  • muscus plug
  • smaller diameter of ETT
  • kinked ETT
24
Q

If your patient will be in Trendelenburg position for a surgery, what size ETT should you use and why?

A

A larger diameter because it creates less resistance and thus less PIP in the lungs since the patient will already have increased PIP from their positioning.

25
Q

We’re especially more likely to generate too high of a pressure if we delver ____mL/kg tidal volume

A

> 10mL/kg

26
Q

Decreased inspiratory time= ______ respiratory rate?

A

increased

27
Q

increase in respiratory rate = _____ PIP

A

increased
–because we’re forcing the breath in at a faster rate, which means more pressure is going to be generated inside the lungs when we deliver the breath

28
Q

What mode on the anesthesia machine helps keep alveoli open to prevent atelectasis?

A

PEEP (Positive End Expiratory Pressure )

29
Q

What does PEEP do physiologically?

A

When an anesthetist delivers “PEEP”, it means that they leave a small amount of positive pressure in the circuit (lungs) at the end of expiration

30
Q

What is the normal amount of PEEP?

A

5cmH2O range

31
Q

Definition of residual volume

A

amount of air in lungs after max expiration

32
Q

What does PEEP memic that our lungs naturally do?

A

residual volume

33
Q

CPAP is “constant _____” (not just at end the of expiration)

A

PEEP

34
Q

Does CPAP or PEEP leave a small amount of positive pressure in the circuit AT ALL TIMES

A

CPAP

35
Q

common uses for CPAP in the OR

A

preoxygenate

Intubated patients undergoing lung surgery

36
Q

What delivers oxygen to the operative lung during surgery without expanding it?

A

CPAP

37
Q

Where else besides the OR is the CPAP machine used and why?

A

In the recovery room for sleep apnea patients because they usually fall back asleep after the ETT is taken out.

38
Q

What refers to the amount of time that is allotted for each inspiration and expiration in one breath?

A

I:E ratio

39
Q

What is the normal I:E ratio?

A

1:2

40
Q

We can ______ the inspiratory time if we lower the respiratory rate and/or ______ the expiratory time.

A

increase (longer inhalation)

shorten

41
Q
  1. We can ______ the expiratory time if we lower the respiratory rate and/or _____ the inspiratory time
A

increase (longer exhalation)

shorten

Patient monitoring (1 decks)

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