Mechanical Ventilation 1B

Question 1

How do you calculate IBW?

What’s the Kettering shortcut?

Answer 1

Males: (2.3 x inches over 5 feet) + 50
Females: (2.3 x inches over 5 feet) + 45.5

Shortcut: 2 x inches over 5 feet. Males, round up. Females, round down.

Question 2

When you first set initial settings, what mode should you choose?

Answer 2

Any non-rescue mode is fine.

PC, VC, AC, or SIMV are fine.

Question 3

How much tidal volume should you use during initial vent set-up? (___ mL/kg or as much as ___ mL/kg)

Answer 3

6 mL/kg IBW or as much as 10 mL/kg

Start at 6, then look at the answer that’s next closest but not lower than 6 ml/kg

Question 4

When setting alarms, the high pressure limit should be set to ___.

Answer 4

+10

Question 5

To set initial settings on PC, set it the same as the patient’s ___. If you don’t know this number, set it to ___.

Answer 5

Use Pplat.

If you don’t know Pplat, use less than 35 ch H2O

Question 7

When deciding what rate to set initial settings at, consider what the ___ will be.

Answer 7

Minute ventilation.

Question 8

When setting alarms, the minimum exhaled tidal volume should be set to ___.

Answer 8

-100 below exhaled tidal volume

Question 9

When caring for an ARDS patient and you have a choice between underventilating the patient or allowing Pplat greater than 30, which should you do?

Answer 9

Underventilate the patient. Allow permissive hypercapnea.

Question 10

How do you set the FiO2 when setting initial settings?

What if there are two acceptable choices in FiO2?

Answer 10

Set FiO2 to 40%, but never more than 60%.

If there are two choices between 40% and 60%, go with the lowest one.

Question 11

When setting alarms, the low pressure limit should be set to ___.

Answer 11

-10 below peak airway pressure

Question 12

For initial settings, how much PEEP should you set?

Answer 12

0 to 6

Question 13

How do you calculate initial tidal volumes for an ARDS patient?

Answer 13

Start at 6 mL/kg. Correct answer may be as high as 8 mL/kg or as low as 4 mL/kg.

Question 14

When caring for an ARDS patient, you may consider ___ and subsequent ___ when setting tidal volumes.

Answer 14

Permissive Hypercapnea

Respiratory Acidosis

Question 15

When setting initial settings on an asthma patient, use ___ mL/kg.
Consider ___ and subsequent ___.

Answer 15

4 mL/kg IBW to decrease air trapping.

Consider permissive hypercapnea and subsequent respiratory acidosis.

Question 16

How do you convert pounds to kilograms?

What’s the NBRC shortcut?

Answer 16

Divide by 2.2

NBRC shortcut: just divide by 2

Question 16

What’s a general guideline for determining if it’s time to intubate a myasthenia gravis patient?

Answer 16

If vital capacity looks like a high tidal volume