Mechanical ventilation Flashcards

1
Q

what is the purpose of mechanical vent

A

maintain homeostasis btw gas concentrations O2 and CO2

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2
Q

indications

A
airway protection
cardiac arrest
management of ICP
airway obstruction
surgery
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3
Q

FiO2

A

fraction of inspired oxygen

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4
Q

tidal volume

A

normal amount of air ventilated at rest

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5
Q

PEEP

A

positive end expiratory pressure

pressure at end of exhalation keeps alveoli from collapsing

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6
Q

what is the vent controlling

A

respiratory rate

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7
Q

invasive mechanical vent

A
  • intubation of artifical airway into trachea
  • endotracheal tube
  • nasotracheal tube
  • tracheostomy
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8
Q

non-invasive vent

A

BiPAP or CPAP

- last step before intubation

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9
Q

BiPAP

A

bilevel positive airway pressure

- decreases effort for pt to exhale

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10
Q

CPAP

A

continuous positive airway pressure

used to prevent airways from collapsing in inhalation and exhalation

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11
Q

what is a tracheostomy

when is it used

A

long term ventilation
vent placed in trachea

unable to be weaned from ventilator
difficult intubation –> severe morbid obesity
airway block or obstructed

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12
Q

passy-muir valve is used for what

A

placed on trach so pt can talk

the pt will have to work harder to breath with it on so be cautious of that

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13
Q

volume control

A
  • preset tidal volume is delivered at a set respiratory rate
  • pt has no spontaneous breathing
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14
Q

pressure control

A
  • predetermined amoutn of pressure at a set respiration rate
  • vent determines inspiratory time
  • pt has no spontaneous breathing
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15
Q

what is PEEP used to do when using pressure control

A

increase arterial oxygen, improve lung compliance

makes lungs easier to inflate

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16
Q

assist control

A

delivers specific amount of tidal volume
forces air down into lungs
pt or vent can trigger when breaths are taken

17
Q

pressure regulated volume control

A

PRVC
combines pressure and volume controlled ventilation
preset tidal volume is delivered at set rate, but with lowest possible pressure

18
Q

synchronous intermittent mandatory ventilation

A

SIMV
assist pt who have some but not sufficient breathing
used for weaning
delivers certain numbers of breath in coordination with effort of pt

19
Q

pressure support ventilation

A
  • little bit of pressure in inhalation
  • weanining off
  • pt intiates all breaths
  • delivers specific pressure
20
Q

volume support

A

tidal volume and PEEP are set
pt initiates breathing
vent delivers support in proportion to pt

21
Q

what do you need to know and document before touching pt on a vent

A

vent mode
PEEP
RR
FiO2

22
Q

red alarms for vent

A

high pressure
circuit disconnected
apnea

23
Q

yellow alarms for vent

A

low tidal volume
high RR
low minute ventilation
low inspiratory pressure

24
Q

what is weaning

A

decreasing or discontinuing mechanical ventilation

PT work with pts during this process

25
what are the five major factors to consider during weaning
1. respiratory demand and ability of neuromuscular system to cope with O2 demand - dont overexert the pt 2. adequate O2 supply during activity 3. cardiovascular performance 4. psychological factors 5. adequate rest and nutrition
26
what are the weaning signs of distress
1. tachypnea >30 2. decreased pH <7.25-7.30 3. paradoxical breathing 4. O2 saturation <90 5. HR change of >20 6. BP change of >20 7. agitation, panic, diaphoresis, cyanosis, angina, arrhythmias
27
contraindications for PT
comatose, unresponsive, does not follow commands severe agitation/combativeness PEEP > 10 H2O or FiO2 >0.60 uncontrolled active bleeding
28
what can prolonged vent support lead to
skin breakdown joint contractures deconditioning