CH3 TroubleShoot

Question 1

Problem: High Peak Airway (P AW ) Pressures
Your first step should be to perform what?
pressure (PPLAT ). T

Answer 1

perform an inspiratory pause and measure the plateau pressure (PPLAT)

Question 2

What does the plateau pressure represents?

Answer 2

The alveolar pressure

Question 3

What does the peak pressure represents?

Answer 3

combination of the alveolar pressure and airway resistance.

Question 4

This pressure represents the Equilibration of all pressure when flow is stopped

Answer 4

Plateau pressure

Question 5

What is the best assessment of alveolar pressure?

Answer 5

Plateau pressure

Question 6

What represents the resistance of conducting airway

Answer 6

The Difference between peak airway pressure and plateau pressure

Question 7

High airway resistance is characterized by what gradient?

Answer 7

Increase in the gradient between the Peak airway pressure and plateau pressure.

Question 8

High PAW , Low PPLAT —this means the problem is

Answer 8

high airway resistance.

Question 9

Causes of high airway resistance with low PPLAT

Answer 9

Mucus plugging, kinked tube, bronchospasm , tube too small (may have to changed out tube or accept high PAW)

Question 10

High PAW , HIGH PPLAT this means the problem is

Answer 10

Problem is in the lungs

Question 11

Causes of high airway resistance with High PPLAT

Answer 11

Mainstem intubation, atelectasis, ARDS< pulmonary edema, pneumothorax

Question 12

Problem: Dynamic Hyperinflation (Auto-PEEP)

(bronchospasm, COPD, mucus plugging) makes it worse.

Answer 12

This is usually due to inadequate time for exhalation. High airway resistance

Question 13

With Hyperinflation , what do you see on the ventilator screen?

Answer 13

The ventilator’s expiratory flow waveform will not return to the baseline of zero flow.

Question 14

Absent breath sounds on one side—

Answer 14

pull the endotracheal tube back a

few centimeters

Question 15

3 top diagnoses to consider when there is a sudden drop in SpO2

Answer 15

Mainstem intubation
tension pneumothorax
mucus plugging

Question 16

Absent breath sounds on one side, even with the tube in the right place—think

Answer 16

pneumothorax, or mucus plugging with complete atelectasis of the lung

Question 17

Tension pneumothorax should be suspected if breath sounds are ______and if the patient is _____

Answer 17

are absent on one side and if the patient is hypotensive.

Question 18

Suspected tension pneumothorax: The treatment is

Answer 18

immediate needle decompression and placement of a chest tube

Question 19

Falling ETCO2 with unchanged or rising PaCO2 —the widening gradient between the two suggests an _______ in what ?

Answer 19

increase in dead space ventilation.

Question 20

Falling ETCO2 with unchanged or rising PaCO2 : 3 main causes

Answer 20

Pulmonary embolism
Falling cardiac output (cardiogenic or hypovolemic shock)
Dynamic hyperinflation with autoPEEP

Question 21

Falling ET CO2 and falling PaCO2 —indicates

Answer 21

an increase in alveolar ventilation.

Question 22

Falling ET CO2 and falling PaCO2 : 3 main causes

Answer 22

Pain, agitation, FEVER, SEPSIS.