Mechanical Ventilation Flashcards
T/F: Lung compliance is typically reflected in lower airway pressures.
True
Which of the following is an extrinsic factor that will affect resistance?
a) Airway diameter
b) Endotracheal tube size and length
c) Bronchospasms
d) Secretions
b) Endotracheal tube size and length
Your patient is being mechanically ventilated. The patient receives a consistent 14 breaths per minute. This is an example of what type of mechanical ventilation?
Time triggered breath
This ventilator mode delivers a preset pressure of gas to the lungs over a given amount of time.
Pressure Cycled aka Pressure Controlled
What is a particularly important variable to monitor when a patient is being ventilated using volume cycled mode?
Plateau pressure. A high plateau pressure can result in barotrauma.
What is a particularly important variable to monitor when a patient is being ventilated using pressure cycled mode
Tidal volume delivered or exhaled tidal volume since the tidal volume varies breath-to-breath.
T/F: In pressure cycled mode, the tidal volume is set and does not vary breath-to-breath.
False
What ventilator mode is best suited for long-term ventilatory support?
Volume mode
T/F: CPAP is a true mode of ventilation because it provides additional pressure during inspiration.
False
T/F: NIPPV typically reduces the need for sedation and medication assisted intubations.
True
This ventilation mode delivers a preset volume or pressure at a preset rate. The patient may take additional breaths of any tidal volume without interference from the mandatory breaths.
Synchronized Intermittent Mandatory Ventilation (SIMV)
This ventilation mode delivers a preset volume or preset pressure that is delivered at a preset rate. The patient has no active role in the ventilatory cycle and is “locked out” from triggering a breath.
Control (Controlled Mandatory Ventilation) aka CMV
This ventilation mode applies a constant pressure throughout inspiration, and the ventilator makes pressure adjustments based on patient airway resistance and respiratory system compliance.
Pressure Regulated Volume Controlled (PRVC)
This ventilation mode delivers a preset volume or pressure for the patient based on their inspiratory effort. If the patient fails to take a breath, the ventilator will administer a breath at a preset volume or pressure.
Assist Control (AC)
If a patient is breathing spontaneously, should the Controlled Mandatory Ventilation mode be used on their ventilator?
No, it will cause patient discomfort as they “fight” the ventilator.
In this ventilator mode, the ventilator can adjust pressure from breath-to-breath in order to deliver a preset tidal volume. (If the delivered volume was too low on the previous breath, the ventilator will increase the pressure for the next breath.)
Pressure Regulated Volume Controlled (PRVC)
T/F: Spontaneous breaths will trigger a ventilator cycle in SIMV mode.
False
What ventilator mode is typically best for weaning a patient off of the ventilator?
Synchronized Intermittent Mandatory Ventilation (SIMV)
T/F: You are transporting a patient who is being ventilated with an inverse ratio ventilation (IRV). You would expect this patient to have decreased cardiac output.
True
You have been asked to place a patient on 70% oxygen concentration. What is the correct FiO2 number?
0.7
What is the typical weight-based range for tidal volume?
6 - 10 mL/kg
What is the typical I:E ratio?
1:2
On the ventilator, what setting helps prevent alveolar collapse and increases alveolar gas exchange?
PEEP
What is the typical initial PEEP setting?
5 cmH2O
You are setting the “sigh” function on the ventilator. This is a volume that is ________ times the inspired tidal volume.
1.5 - 2
T/F: Positive-pressure ventilation van induce hypotension.
True
What are the three classical signs and symptoms of oxygen toxicity?
1) V/Q mismatch
2) Diffuse pulmonary infiltrates on chest x-ray
3) Falling oxygen saturations
What does the mnemonic “DOPE” (that is used to troubleshoot airway problems in an intubated patient) stand for?
Displaced ET-tube
Obstructions (secretions, biting the tube, etc.)
Pneumothorax
Equipment
You are transporting a patient on a ventilator. You see an alarm indicating “circuit tube disconnect”. It appears the circuitry is hooked up appropriately, however the alarm continues. What should you do?
Ensure the circuitry is connected, and then increase the rate and volume.
You observe a low pressure alarm on the ventilator. What is the most common cause of this alarm?
Patient was accidentally disconnected from the ventilator.
What condition could develop that would cause a sudden increased peak airway pressure in a ventilated patient?
tension pneumothorax
T/F: A displaced ET-tube could cause a decrease in peak airway pressures.
True
T/F: Tidal volume is fixed in the pressure cycled ventilator mode.
False
