ARDS Flashcards
If a patient has evidence of respiratory failure or compromise airway, what is indicated?
Endotracheal intubation and mechanical ventilation
What is mechanical ventilation?
Positive or negative pressure breathing device that can maintain ventilation oxygen delivery for a prolonged period time
What clinical evidence might you see if a patient is in need of endotracheal intubation and mechanical ventilation?
The patient will have a continuous decrease oxygenation (pao2), and increase in arterial carbon dioxide levels, (paco2), and persistent alkalosis initially (increased pH)
Which type of ventilator is noninvasive?
Negative pressure ventilators
What type of ventilator expands the chest using negative pressure and releases the pressure causing a breath?
Negative pressure ventilator
What is inspiratory reserve volume?
The maximum volume of air that can be inhaled after a normal inhalation.
The volume of air your lungs can hold on a regular inspiration
Tidal volume
What is expiratory reserve volume?
The maximum volume of air they can be exhaled forcibly after a normal exhalationmm
What is vital capacity?
The maximum volume of air exhaled from the point of maximum inspiration
What is residual volume?
The volume of air remaining in the lungs after a maximum acceleration.
What is total lung capacity?
The volume of air in the lungs after a maximum inspiration.
How are positive pressure ventilators classified?
According to the mechanism that ends inspiration and starts expiration
How do positive pressure ventilators work?
Inflate the lungs by exerting positive pressure on the airway, pushing air in, and forcing the alveoli to expand during inspiration
Which positive pressure ventilator delivers a preset volume of air with each inspiration and cycles off allowing passive exhalation? It can cause barotrauma?
Volume cycled ventilators
Which positive pressure ventilator delivers a flow of air until it reaches a preset pressure and then cycles off allowing expiration to occur.
Pressure cycled ventilators
Which positive pressure ventilator is used to open the alveoli in situations characterized by closed small airways such as atelectasis and ARDS
High frequency oscillatory Support ventilators
In this mode of ventilation there’s a fixed rate and tidal volume. Breaths are initiated automatically.
Controlled mode of ventilation
Name a disadvantage of controlled ventilation
If the patient attempts to initiate a breath, the ventilator alarms and blocks the patient from initating a breath
How is controlled ventilation and assist-control ventilation similar and different?
They both have a preset tidal volume and ventilation rate but the assist - control ventilator allows the patient to take occasional breaths without alarming
Which mode of ventilation has a tidal volume and a ventilator rate preset and can respond to the patient’s inspiratory effort if a breath is initiated?
Assist-controlled ventilation
Name a disadvantage of assist-controlled ventilation
If the patient’s spontaneous rate increases the ventilator continues to deliver a preset tidal volume with each breath
Which ventilator allows spontaneous breathing at the patient’s own rate and tidal volume giving breaths between at a set tidal volume and read
Synchronize intermittent mandatory ventilation/ intermittent mandatory ventilation
If you were attempting to wean a patient off of ventilator, and what order would you expect the ventilators to be used?
Assist-controlled (a/c), then simv/imv, then cpap/bipap
An iron lung is considered what type of in a liter?
A negative pressure ventilator
What type of patients might have a body wrap?
ALS patients or myasthenia gravis patients
True or false? Weight and size of the patient determines the size of Ambu bag used?
True
True or false.? You can use a positive pressure ventilators with or without intubation
False. You always need to be intubated to use positive pressure ventilators
What kind of patient would you expect to need a controlled ventilator?
Coma patients
What is bucking the vent? What should you do if a patient does this?
When the patient is trying to breathe over the ventilator. If the patient is on the vent to rest the brain from a motor vehicle accident we might use drugs to sedate the patient. Otherwise in cases like pneumonia we would get ABGs to see if the patient can take steps to wean off the ventilator
Can all ventilators provide just pressure support?
Yes
A cpap/bipap is what kind of ventilator?
Pressure support ventilator