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Anesthesia Equipment > Mechanical Ventilation > Flashcards

Mechanical Ventilation Flashcards

0
Q

What are the 2 different driving mechanisms for ventilators?

A
  1. Bellows - pneumatic

2. Piston - electric

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1
Q

What is the waste gas scavenging system?

A
  • Prevents atmospheric contamination
  • Collects all the extra gas and vapor from the system so you don’t get contamination of the air with volatile agents, etc.
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2
Q

The Bellows type ventilator is pneumatically driven. What does this mean?

A
  • a pneumatic force compresses the bellows, which empties its contents (gas from flowmeters and vaporizer) into the circuit
  • Gas goes into the bellow and fills it up and then gas comes outside the bellows and drives it down.
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3
Q

For the bellow type ventilator, what drives the bellows?

A
  • Have to have an external gas source to drive the bellows

- The driving gas is oxygen, air, or a venturi mix of O2 and air

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4
Q

What drives the piston type ventilators?

A
  • They do not need a driving gas

- They are electronically controlled and pneumatically driven

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5
Q

Bellows ventilators will not work without…?

A

Electrical power

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6
Q

All ventilators have backup batteries, how long will they last?

A

30 min

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7
Q

For ascending bellows, they go ______ during exhalation and _______ during inhalation.

A

up, down

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8
Q

Describe “hanging bellows” or descending bellows.

A
  • Same concept as ascending bellows except they are upside down
  • During exhalation they fall down due to a weight.
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9
Q

What is a possible safety hazard with “hanging bellows” or descending bellows?

A
  • The bellows fall no matter what because of the weight, so if you have a disconnection or leak in the system you would not know
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10
Q

In ascending bellows, filling is dependent on ______…?

A
  • exhaled gases from a tight circuit
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11
Q

Piston ventilators do not require _____…?

A
  • A driving gas
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12
Q

Piston ventilators are driven by ________…?

A
  • Compression from an electric motor
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13
Q

In regards to piston ventilators, tidal volume =?

A
  • The surface area of the piston X the distance the piston moves to ventilate the patient
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14
Q

What are 4 advantages/disadvantages of piston type ventilators?

A
  1. Quiet
  2. No baseline PEEP
  3. Greater precision
  4. No gas needed to drive it
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15
Q

What is an advantage of bellow type ventilators?

A
  1. Able to see and detect disconnection from bellows falling
16
Q

What is physiological PEEP?

A

3 or so

17
Q

What does mandatory ventilation mean?

A
  • Means that the patient will get ventilated no matter what, it doesn’t sense what the patient is doing
18
Q

What are the 3 modes of mandatory ventilation?

A
  1. Volume control
  2. Pressure control
  3. Pressure control volume guarantee
19
Q

What do you set for Volume Control?

A
  • you set the tidal volume and respiratory rate
20
Q

What varies in Volume Control?

A

Peak pressures (due to patient compliance)

21
Q

What remains constant in Volume Control?

A

Minute ventilation remains constant

22
Q

How should tidal volume be calculated?

A

8-10 cc per Kg of the ideal body weight

23
Q

What do you set for Pressure Control Ventilation?

A
  • You set the peak pressure and RR
24
Q

What varies in Pressure Control?

A
  • Tidal volume

- Minute ventilation

25
Q

What is Pressure Control - Volume Guarantee?

A
  • “Smart mode” that delivers the desired tidal volume with the lowest possible pressure using a decelerating flow pattern
  • The ventilator automatically adjusts the pressure to achieve the volume that you would like to achieve
26
Q

Specifically, how does Pressure Control - Volume Guarantee work?

A
  • The first breath is a volume control breath, the patients compliance is determined and then the inspiratory pressure level is established for the subsequent breaths.
  • It is anesthesia ventilation tailored to the patient’s compliance
27
Q

What is Synchronized Intermittent Mandatory Ventilation (SIMV)?

A
  • Combination of spontaneous breathing and mandatory ventilation
  • Machine breathes are delivered to the patient at set intervals
  • Meant to supplement patient’s own respiratory efforts - mechanical breaths are “synchronized” with respiratory effort
28
Q

What are the 2 SIMV modes?

A
  • SIMV - VC: you set the TV and RR

- SIMV - PC: you set the pressure and RR

29
Q

What is Pressure Support Ventilation (PSV)?

A
  • Used for patients who are spontaneously breathing
  • You set the pressure support for the machine to deliver during spontaneous breathing
  • Once the ventilator senses an inspiratory effort from the patient, the ventilator provides constant pressure to the airway to relieve work of breathing.
30
Q

What is PSV- Pro?

A
  • Back up ventilation incase patient stops breathing (30 sec apnea alarm)
  • Back up mode is SIMV-PC + PS
  • You set a minimum mandatory RR and pressure
  • In between mandatory breaths, the patient receives pressure support

Anesthesia Equipment (14 decks)

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