Invasive Ventilation Flashcards
Two Options for Ventilatory Support to Bypass the Upper Airway
Endotracheal tube
Tracheostomy
Invasive Ventilation Provides…
Positive pressure support
5 Indications for Invasive Ventilation
- Relief of upper airway obstruction
- Acute respiratory failure
- Protection of airway
- Improvement of pulmonary toilet in patients with poor secretion management
- Anticipated surgery
Mode of Ventilation
Determines how the ventilator initiates, delivers, and terminates a breath.
Two Variables Invasive Ventilators Can Target
- Tidal volume
- Pressure control
AC (Assist Control) Mode function
Ventilator does all the work. Starts and stops every breath.
AC (Assist Control) Mode indications
3
- Sedated patients
- Severe lung injury
- Severe neurologic insult
Disadvantage of AC (assist control) mode
Ventilator asynchrony
SIMV (Synchronized Intermittent Mandatory Ventilation) Mode
Patient can breathe spontaneously between pre-set breaths.
Pressure support ventilation (PSV) mode
Patient must start and stop each breath. Each breath is supported by CPAP.
5 things to document with invasive ventilation
- Mode
- Rate
- FiO2
- PEEP
- Location of the ventilation tube before and after treatment
4 things that could be red flags for invasive ventilation:
- Patient alertness
- Ability to participate
- Resting vitals
- Work of breathing (WOB)
FiO2 and PEEP Red Flags for Invasive Ventilation
- FiO2 > 60%
- PEEP > 10 cmH2O
3 Types of Suctioning Devices
- Oral (Yankauer suction tip)
- In-line or deep suctioning
- NT (nasotracheal)
4 Indications for Suctioning
- Secretions present
- Coarse breath sounds
- Ventilator waveform analysis
- Increased peak pressure
3 Indications for Ventilator Weaning
- Work of breathing can be supported by PT
- Underlying disease process has resolved
- Patient can manage their own airway and secretions
Should PT See Patients During Weaning Trials?
No — Schedule around weaning trials
AC Mode Settings:
Rate control - yes/no
Tidal volume - yes/no
Additional breaths - yes/no
Minute volume: ____
Rate control - yes
Tidal volume - yes
Additional breaths - no
Minute volume: >/= 5 L/min
SIMV mode settings:
Rate control - yes/no
Tidal volume - yes/no
Additional breaths - yes/no
Minute volume: ____
Rate control - yes
Tidal volume - yes
Additional breaths - yes
Minute volume: >/= 5 L/min
SPONT mode settings:
Rate control - yes/no
Tidal volume - yes/no
Additional breaths - yes/no
Minute volume: ____
Rate control - no
Tidal volume - no
Additional breaths - N/A
Minute volume: Set by patient
