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Acute > COVID and Mechanical Ventilation > Flashcards

COVID and Mechanical Ventilation Flashcards

1
Q

What is FiO2? What is normal room air?

A

fraction of inspired O2

normal room air is 20-21%

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2
Q

What is tidal volume?

A

normal amount of air ventilated at rest

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3
Q

What is PEEP?

A

positive end expiratory pressure - pressure at the end of exhalation that keeps alveoli from collapsing to allow for gas exchange

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4
Q

What is purpose of BiPAP (bilevel positive airway pressure)

A

Purpose is to decrease the effort for the patient to exhale

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5
Q

What is the purpose of CPAP (continuous positive airway pressure)?

A

Purpose is to keep airways from collapsing during inhalation and exhalation

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6
Q

What are contraindications for PT for BiPAP and CPAP?

A

no contraindications but still need to check medical status which may determine if they are fit for PT

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7
Q

What is volume control?

A

preset tidal volume delivered at a set respiratory rate

- used when pt has no spontaneous breathing

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8
Q

What is pressure control?

A

predetermined amount of pressure at a set rate

  • ventilator determines inspiratory time
  • pt has no spontaneous breathing
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9
Q

What is assist control?

A
  • delivers a specific amount of tidal volume

- patient or ventilator can trigger when breaths are taken

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10
Q

What is Pressure regulated volume control (PRVC)?

A

combines pressure and volume controlled ventilation

- preset tidal volume is delivered at set rate, but w/ lowest possible pressure

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11
Q

What is SIMV (synchronous intermittent mandatory ventilation)?

A

used to assist patients who have some, but not sufficient breathing

  • delivers certain number of breaths in coordination w/ respiratory effort of patient
  • used for weaning and does have increased work of breathing
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12
Q

What is pressure support ventilation?

A
  • small amount of pressure occurs on inspiration

- Patient initiates all breaths

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13
Q

What is volume support?

A
  • tidal volume and PEEP are set
  • patient initiates breathing
  • ventilatory support in proportion to patient’s inspiratory effort and target volume
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14
Q

What should be documented in note based on telemetry?

A

vent mode
RR
FiO2
PEEP

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15
Q

What are red alarms for mechanical vent?

A
  • high pressure
  • circuit disconnected
  • apnea
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16
Q

What are yellow alarms for mechanical vents?

A
  • low tidal volume
  • high respiratory rate
  • low minute ventilation
  • low inspiratory pressure
17
Q

5 major factors to consider during weaning off mechanical vent?

A
  • respiratory demand and ability of neuromuscular system to cope w/ O2 demand
  • oxygenation
  • CV performance
  • Psychological factors
  • adequate rest and nutrition
18
Q

weaning off mechanical vent signs of distress

A
  • tachypnea > 30 breaths/min
  • decreased pH < 7.25-7.30 w/ increased PaCO2
  • paradoxical breathing patterns
  • HR change > 20 bpm\
  • BP change > 20 mmHg
  • agitation, panic, diaphoresis, cyanosis, angina, or arrhythmias
19
Q

What are contraindications for a patient on a mechanical vent?

A
  • comatose, unresponsive, does not follow commands
  • severe agitation/combativeness
  • PEEP > 10cm H20 or FiO2 > 0.6 (60%)
  • uncontrolled active bleeding
20
Q

What can prolonged vent support lead to?

A
  • skin breakdown
  • joint contractures
  • deconditioning
21
Q

Acute care activities for patient on mechanical vent

A
  • AROM
  • Resistive therapeutic exercises
  • Aerobic activities
  • bed mobility
  • reaching activities w/ emphasis on trunk rotation
  • head and neck therapeutic exercise and positioning - extensors
  • diaphragmatic breathing
22
Q

What amount of O2 can someone safely go with?

A

6 liters or less

23
Q

What is a trach collar?

A

collar w/ blue tubes

  • nasal cannula for trach
  • allows patient to breathe on their own but they have a trach
24
Q

What is a passy muir valve?

A

purple valve that allows someone w/ a trach to speak

25
Q

What is used to increase arterial O2, improve lung compliance for a patient on pressure control?

A

PEEP

26
Q

What is used if patient is on high level of respiratory support?

A

Assist control

- patient has some breathes but is very minimal

27
Q

What helps prevent barotrauma?

A

pressure regulated volume control (PRVC)

Acute (14 decks)

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