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Establishing Need For Vent Flashcards

1
Q

Normal VT range

A

400-700 mL

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2
Q

What mL/kg is considered adequate breathing

A

Greater than 5mL/kg

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3
Q

What respirations are a cause for concern

A

Greater than 35 breaths/min

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4
Q

What are causes of bradypnea

A

Excessive sedation
Anesthesia
Narcotic O.D.
Excessive alcohol
Head trauma
Increase intracranial pressure
Neurologic disease
Hypothermia
Cardiogenic shock

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5
Q

Normal range for a VE

A

5-10L/min

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6
Q

Signs of increased WOB

A

Accessory muscle

Intercostal retractions

Asynchronous CW to diaphragm movement

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7
Q

Disorders/disease that increase WOB

A

Severe pneumonia
ARDS
CHF
Pulmonary Edema
Shock
Trauma
Smoke/chemical inhalation
Aspiration
Near drowning

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8
Q

Early stage of respiratory failure (signs)

A

Increased HR
Increased RR
Increased WOB
Intercostal retractions
Nasal flaring
Diaphoresis
Oxygen Desat

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9
Q

Patient presentation for Late stage respiratory failure

A

Excitement
Overconfident
Restless
Anxiety
Headache
Shallow breaths
Confused, coma, and tired
Apnea

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10
Q

Signs of severe respiratory failure

A

Slowed/irregular breathing
Reduces chest expansion
Cardiac arrhythmia
Hypotension

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11
Q

Causes of apnea

A

Cardiac arrest
Respiratory arrest
O.D.
Trauma
Cervical spine injury
Neuromuscular disease
Anesthesia

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12
Q

Explain maximum voluntary ventilation

A

Have them maintain ventilation for 12-15 secs

Should ventilate 15-20 times resting minute ventilation

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13
Q

What range should the VC be

A

3-5 liters

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14
Q

What does the maximum inspiratory pressure (MIP) test measure

A

The strength of the muscles of inspiration during forced breathing

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15
Q

What does Negative Inspiratory Force (NIF) test

A

Test normal respiratory muscle function. Usually greater than 60cmH2O

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16
Q

What MVV value indicates ventilatory support

A

Less than or equal to 2(VE)

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17
Q

What vital capacity in mL/kg indicates noninvasive support

A

Less than 20mL/kg

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18
Q

What VC in mL/kg indicates invasive ventilation

A

10-15mL/kg

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19
Q

What NIF value that indicates invasive ventilation

A

Less than 20cmH2O

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20
Q

What does Maximum Expiratory Pressure (MEP) measure

A

Strengths of expiratory muscles

21
Q

Men’s MEP maximal expiratory and inspiratory pressure

A

Expiratory
233-84 cmH2O

Inspiratory
-124 (+or-) 44 cmH2O

22
Q

Women’s MEP maximal expiratory and inspiratory pressure

A

Expiratory
152-54 cmH2O

Inspiratory
-87 (+or-) 32

23
Q

What (MEP) indicates the need for ventilation

A

Near 40 cmH2O

24
Q

Define “acute”

A

Rapid and without warning development of syndromes

25
Q

Parameters of acute respiratory failure

A

Increase in arterial PaCO2
Decreased pH
Bicarbonate in normal range

26
Q

Parameters for Chronic respiratory failure

A

PaCO2 is elevated
pH close to normal
Bicarbonate elevated

27
Q

Parameters for Acute on Chronic respiratory failure

A

PaCO2 is elevated
pH is decreased
Bicarbonate is elevated

28
Q

How do you treat refractory hypoxemia

A

Many need CPAP, PEEP or MV

29
Q

Oxygenation problems caused by poor matching of gas and blood

A

Pulmonary shunt
Low ventilation to perfusion ratio
Diffusion problem
Hypoventilation

30
Q

Common causes of hypoxemic respiratory failure

A

Atelectasis
Pneumonia
Pulmonary edema
Pulmonary fibrosis
ARDS

31
Q

Goals of Mechanical Ventilation

A

Maintain tissue oxygenation

CO2 clearance

Supports/replaced the normal ventilatory pump

32
Q

Indications for NIV

A

At least two of the following:

RR>25

Moderate to severe acidosis
7.30-7-25
PaCO2 45-60 mmHg

Moderate to severe dyspnea w/ accessory muscle use and paradoxical breathing

Beneficial in cardiogenic pulmonary edema

33
Q

From NIV to MV

A

Respiratory arrest

RR>35 or Severe WOB

pH< 7.25 or Hypercapnia > 60 mmHg

Failure of NIV positive pressure

Hyper-somnolence

Heart Failure

Nausea or Vomiting

34
Q

Indication for mechanical ventilation

A

Apnea

Acute ventilatory failure

Impending ventilatory failure

Severe O2 problem/ refractory hypoxemia

35
Q

SaO2 wnl

36
Q

SaO2 with mild hypoxemia

37
Q

SaO2 with moderate hypoxemia

38
Q

SaO2 with moderate to severe hypoxemia

39
Q

SaO2 with very severe hypoxemia

40
Q

How often can you preform NIF

A

Every half an hour to an hour

41
Q

What makes up the ventilator pump

A

Nerves controlled by respiratory center in the brain

AW

Thoracic cage

Respiratory muscles

42
Q

Normal SaO2

43
Q

Mild hypoxemia SaO2

44
Q

Moderate hypoxemia SaO2

45
Q

Severe hypoxemia SaO2

46
Q

Very severe hypoxemia SaO2

47
Q

What order does SaO2 decline in severity

48
Q

How do you treat refractory hypoxemia

A

Moderate to high O2 with PEEP, CPAP or Mechanical ventilation

Vent Support (6 decks)

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