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Interventions 3 > Initiation of Mechanical Ventilation > Flashcards

Initiation of Mechanical Ventilation Flashcards

1
Q

Indications for Mechanical Ventilation

A

The indications for mechanical ventilation are (ASIA)

  1. Apnea
  2. Severe Refractory Hypoxemia
  3. Impending Ventilatory Failure
  4. Acute Ventilatory Failure
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2
Q

Impending Ventilatory Failure Adult Assessment

A

Vital Signs

Ventilatory pattern

Paradoxical breathing

Retractions

Progressive muscle weakness

Serial blood gases trending worse

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3
Q

Impending Ventilatory Failure Neonatal Assessment

A

Vital Signs

Oxygen requirements

Cyanosis

Retractions

Nasal Flaring

Grunting

ACoRN

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4
Q

VD/Vt

A

Normal: 0.25-0.4

Critical >0.6

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5
Q

RR (bpm)

A

Normal: 12-20

Critical >35

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6
Q

Vt (ml/kg)

A

Normal: 4-8

Critical <4

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7
Q

VC (ml/kg)

A

Normal: 65-75

Critical <10

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8
Q

MIP

A

Normal: -80 to -100

Critical 0 to -20

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9
Q

Absolute Contraindications

A

No absolute contradictions to ventilatory support exist if the above indications are present, but… Are you planning to use Invasive or non-invasive support

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10
Q

Normal Lungs

Neo Circuit

A

Infant circuit with active humidity

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11
Q

Normal Lungs

Ped Circuit

A

>25 kg uses adult/passive (unless indications for active)

<25 kg use infant circuit with active humidity

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12
Q

Normal Lungs

Adult Circuit

A

Adult circuit with passive humidity (unless indication for active)

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13
Q

Normal Lungs

PEEP

A

Match to the FiO2 (once it is weaned to required level); consider optimal PEEP/open lung ventilation

Watch for CV compromise

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14
Q

Normal Lungs

Neo PEEP

A

6 cmH2O

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15
Q

Normal Lungs

Ped PEEP

A

5 cmH2O

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16
Q

Normal Lungs

Adult PEEP

A

5 cmH2O

17
Q

Normal Lungs

Ti

A

Adjust for pressure equilibrium

Note I:E

18
Q

Normal Lungs

Neo Ti

A

0.3-0.4 sec

19
Q

Normal Lungs

Teen Ti

A

0.8-1 sec

20
Q

Normal Lungs

Child Ti

A

0.7-0.8 sec

21
Q

Normal Lungs

Pre-School Ti

A

0.6-0.8 sec

22
Q

Normal Lungs

Toddler Ti

A

0.5-0.75 sec

23
Q

Normal Lungs

Infant Ti

A

Infant 0.35-0.55 sec

24
Q

Normal Lungs

Adult Ti

A

0.8-1.2 sec

25
Q

Normal Lungs

Adult MV

A

~100 mL/min/kg

Initially adjusted based on PaCO2

MV may be higher if the pt is febrile

26
Q

Normal Lungs

RR

A

Assess ofr auto triggering and auto PEEP

27
Q

Normal Lungs

RR

A

Assess ofr auto triggering and auto PEEP

28
Q

Normal Lungs

Neo RR

A

40-50 bpm

29
Q

Normal Lungs

Ped RR

A

Infant 30-50 bpm

Toddler 24-40 bpm

Pre-School 20-35 bpm

Child 18-30 bpm

Teen 12-20

30
Q

Normal Lungs

Adult RR

A

12-16 bpm

31
Q

Normal Lungs

Vt

A

Want a plateu pressure <30 cmH2O

32
Q

Normal Lungs

Neo Vt

A

5 ml/kg

33
Q

Normal Lungs

Ped Vt

A

6-8 ml/kg

34
Q

Normal Lungs

Adult Vt

A

6-8 ml/kg

Interventions 3 (34 decks)

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