Exam III Flashcards
Neonates may be extubated from what rate?
10-12
A CO2 >55 what will PIP range would the RT need to achieve?
Increase the PIP to 25-30
What is the maximum PEEP therapy?
10
True or False: To support weaning we have to ensure that the problem has been solved
True
For ventilator weaning the FIO2 must decrease in increments of 2-5% to achieve what percent?
40%
What are the minimum acceptable ventilator settings for CPAP trials
PIP <25 cmH2O
RR 10-12 bpm
FIO2 .40
PEEP <5
CPAP NIV is typically started at an FIO2…
10% higher than the ventilator setting
How do you calculate the E-Time?
60/RR=TCT TI+X=TCT
On a pneumatic ventilator, the pressure manometer swings back towards the negative side. What must you do?
Increase flow
On a pneumatic ventilator, when evaluating what is set and the patient’s data you notice that they are hitting the pressure max (decrease in compliance). What does this mean?
They are in PC, if the PIP is lower than P Max they are in volume control
On a pneumatic ventilator, if the patient is constantly hitting the pmax what is their compliance?
Down
What is PAW affected by?
PEEP, PIP, I:E Ratio, Flow
How do you calculate MAP?
(PIP-PEEP)xTIxFlow
_____________________ +PEEP
60
What is a pao2 <50 and an FIO2 >60% an indication for?
PEEP therapy
Describe true statements involving PAW
-Keep PAW between 10-14
-MAP >12 may contribute to barotrauma
-It is the average pressure on the airways and lungs during a complete inspiratory and expiratory cycle
-Calculated electronically by vent
-Increasing MAP, increases oxygenation
True or False: Pressure limited ventilation, an increase in PEEP may include an increase in pco2
True
In PC, if we increase PEEP there will be an increase of CO2 why?
The DP is smaller, therefore making a smaller VT and causing a rise of CO2
What are the ETT sizes, landmarks, and laryngoscope sizes?
> 1000g 2.5 ETT, Miller 00
1000-2000g 3.0 ETT, Miller 0
2000-3000g 3.5 ETT Miller 0
3000-4000 3.5-4.0 Miller 1
Landmarks:
1000-7cm
2000-8cm
3000-9cm
A patient has CDH and the physician is requesting to evaluate for a PPHN what do we do to determine this?
Hyperoxia/Hyperventilation Test:
-Administer 100% FIO2 and manually ventilate for 5-10 min
-If pao2 >100 then they have PPHN
-Little to no change means CDH
Scenario: CDH patient is started on INO. What are some values you must remember for inital set up of HFOV?
MAP set 2-5 above conventional, Bias Flow set to 20 (10-15 for pre-term)
If a baby on HFOV has no wiggle, what must you increase?
Increase the amp
A patient on HFOV has a low CO2, what must you do?
Decrease the amp 3 times then increase the hertz
Scenario- 40 week GA not vigorous (i.e. mec baby) what are the initial settings for this patient?
Initial Settings:
<1000g
VTE 4-6
RR 30-50
PEEP 3-5
FIO2 10% above what they were on or 1.0 unless contraindicated
TI .25-.4
PIP 18-25
PS 6-10 Per VTE
Trigger .25-.50
<1500g
VTE 5-6
RR 20-45
PEEP 5-7
FIO2 10% above what they were on or 1.0 unless contraindicated
TI .4-.5
PIP 18-25
PS 6-10 per VTE
Trigger .25-.50
INO is not available for a MEC patient, what should you for the patient?
Keep the abg between ph7.45-7.50 and CO2 25-35 torr-decrease PVR drop co2 to blow it off
