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Interventions 1 (RESP 266) > Module 3 Manual Ventilation > Flashcards

Module 3 Manual Ventilation Flashcards

1
Q

What is VAP?

A

A acquired disease from a ventilator

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2
Q

How do we know the tubes/lines are in the right place?

A

If the chest or stomach rises

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3
Q

Why would you push against the cicrothryoid ligament?

A

to collapse the esophagus

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4
Q

What indicator is there when the endotrachial tube is too deep?

A

The right lung/side rises more than the left.

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5
Q

Why do you want to keep 5cm of PEEP?

A

To keep lungs/airways/alveoli open.

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6
Q

3 important factors for humidity

Edit

A

Ensure proper temperature control, maintain adequate humidity levels, and adhere to device maintenance and sterilization protocols.

  • humidity level is important to ensure that airways don’t get irritated
  • Adequate humidity levels help prevent the drying out of mucous membranes, reduce airway irritation, and improve mucus clearance. Insufficient humidity can lead to dry, crusted secretions and increased airway resistance.
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7
Q

BLS Basics

A
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8
Q

2 types of respiratory failure

A

Type 1: oxygenation
Type 2: ventilation

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9
Q

6 Procedure steps when bagging (the process)

A
  1. Assess…alertness
  2. Position
  3. Assess…airway for patency
  4. Consider…oral or nasal airway
  5. Bag
  6. Consider…intubation
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10
Q

Which inhalers are short acting and which reduce inflammation

A

Ventolin (open airways)

flovent falls into the beta agonist group (corticosteroid) to reduce inflammation

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11
Q

VSD vs Asthma…when can a person be taken off of puffers (for VSD)

A

Vocal chords shut causing us to hear strider

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12
Q

what can help elevate a exasbaration (sob) when there is CHF

A

CPAP can help relieve exasbaration temporarily so that we can figure out what is happening.

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13
Q

Causes for: (7)
Hypoxemia Respiratory Failure Type 1

A

When things block oxygen from getting to blood.

  1. V/Q mismatch
  2. Shunt
  3. Alveolar Hypoventilation
  4. Diffusion Impairment
    5 Perfusion/diffusion impairment
  5. Decreased inspired O2
  6. Venous admixture
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14
Q

Cause of:
Hypercapnic Respiratory failure (Type II)

A

Impaired Resp. Control
Neurological disease
Increase WOB

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15
Q

5 Therapy/treatment for Type 1 heart failure?

What are the most effective

A

Increasing FiO2 and PEEP are the most effective therapy methods.

FiO2 increases MAP - how does PEEP get involved?

TLDR; oxygenation

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16
Q

Treatment/therapy methods for Type 2 Failure?

A

you manage MV - manipulate rate or Vt.

Vt
Rate
MV
pH
PaCO2

TLDR: Ventilation

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17
Q

Peak pressure must not exceed
(refer to slide 29)

A

30mmhg
what about Vt? (5-8)
humidity (no greater than 37)

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18
Q

MR. SOPA mnemonic

A

M - mask
R - reposition
S - suction
O - obstruction
P - pressure
A - airway equipment

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19
Q

PaCO2 greater than what value indicates that the patient needs ventilatory support ?

A

55

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20
Q

Inadequate lung expansion value for Vt?

A

less than 5

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21
Q

Inadequate lung expansion value for vital capacity

A

less than 10

Normal vital capacity = 65-75

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22
Q

Inadequate lung expansion value for RR?

A

greater than 35

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23
Q

Inadequate muscle strength that indicates ventilatory support

edit later

A

-Increased WOB

-Maximum inspiratory pressure (MIP) greater than or equal to -20 (its normally a small number)

VC is needed for a good cough

-Normal VD = 2.2 ml/Kg

Minute ventilation (MV) = 100m x Kg increase due to amount of deadspace ventilation (swapping the use of negative pressure to positive pressure bc forcing air in)

Vt = 5-8ml/kg
= 6 (80 (bw)) = 480ml
= 8000/480ml = RR
->8000 = Mv (100 * kg)

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24
Q

MV is equal to what?

Aka how do you calculate

A

Vt x RR?

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25
Q

Respiratory failure is a life threatening impairment of Oxygenation, CO2 elimination, or both.

What is it caused by (usually)?

A

Impaired gas exchange

Decreased ventilation

or both

26
Q

Symptoms of respiratory failure?

A

(add dx and tx later)

27
Q

Situations requiring airway control: emergencies

A
28
Q

Situations requiring airway control: urgencies

A
29
Q

What is the purpose of the Sniffling position?

A

Open airways

30
Q

why is PEEP (on cpap) helpful for someone with CHF

A

Helps push fluid out of the lungs

  • Decreases the amount of fluid that backs up into the heart because of the changes in pressure
31
Q

Crackles is a indicator of what?

A

Fluid in the lungs (or consolidation)

32
Q

Suction pressure for Adults, Children, and infants?

A

Adult: 120-160

Children: 100-120

Infants: 80-100

33
Q

Indicators for a partial obstruction

A

wob, strider, and snoring

34
Q

Contraindications for OPA use

A

Conscious or semiconscious patient
-gag reflex (opa)
-vomiting
-laryngeal spasm
-trauma to oral cavity (OPA)
-trauma to mandibular or maxillary areas of the skull

35
Q

What does the acronym RODS tell us?

A

Difficult supraglottic device placement

R: restricted mouth opening
O: Obstruction (at or below glottis)
D: distorted/ displaced airway radiation/ trauma
S: stiff lungs,chest,neck etc.

36
Q

what are some functions of oral pharyngeal airways (opa)

A

Relieving a soft tissue obstruction

facilitate sunction

prevents patient biting on the tube

37
Q

Advantages of NPAs over OPAs?

A

patients are less likely to gag

oral care on the patient is viable (like intubation)

more comfortable via nose

38
Q

How does sizing work for NPAs?

A

Tip of the nose to the tragus (ear)

39
Q

What does the acronym MOANS indicate?

A

how hard it is to bag someone

40
Q

MOANS acronym?

A

M: Mask seal
O: Obstruction/obesity
A: Age
N: No teeth
S: stiffness of snores

41
Q

What does the acronym bones measure?

A

difficulty to bag a person

42
Q

Safety checks for the bagger

A

The reservoir inflates

If the valve moves

If it holds pressure

Does the bag re-inflate

43
Q

What is a LMA?

A

Laryngeal mask airway

edit refer to slide 60 on insertion

44
Q

Why would LMA be used before a endotracheal tube?

A

if you can’t get it in, or…

LMAS are more secure than an endotracheal tube.

45
Q

Advantages of Laryngeal masks

A

easy to insert

no special equipment

46
Q

Disadvantages of Laryngeal mask?

A

Short term use

  • danger of aspiration (if they vomit it could go into their lungs)
  • Low ventilation pressures only
  • Not used on conscious or semi conscious patients due to gag reflex
47
Q

Key points Manual ventilation: O2 delivery?

Edit

A
48
Q

Key points Manual ventilation: Rate?

Edit

A
49
Q

Key points Manual ventilation: volume?

Edit

A
50
Q

What would you do when there is low SpO2 but adequate chest rise?

A

Consider using PEEP
-+5 cmH2O

Increases the amount of time held under pressure aka inspiratory time.

51
Q

what does Positive pressure ventilation cause when minute ventilation (MV) is low?

A

Increase deadspace.

You want to keep MV high.

52
Q

why would you intubate someone?

A

They can’t breath on their own (poor ventilation)

or

They have too many secretions that they can’t get out on their own (blockage)

53
Q

Assessment of pt after suction (outcomes)

A

Improved breath sounds

Removal of secretions

Increase SpO2

Decreased WOB

monitor pt for changes

54
Q

What is type I resp. failure?

A

Hypoxemic resp. failure where oxygenation fails, causes could be:

  • V/Q mismatch
  • Shunt
  • Alveolar hypoventilation
  • perfusion/diffusion impairment
  • decreased inspired O2
  • venous admixture
55
Q

What is type II failure?

A

hypercapnic resp. failure, causes could be:

  • Impaired resp. control
  • Neurologic disease
  • Increased WOB
56
Q

Key concepts that affect oxygenation (type I failure)

A

FiO2
PEEP
MAP
PaO2
(one more but slide cut if off, check later)

57
Q

Factors that affect ventilation (type II failure)?

A

Vt
Rate
MV
pH
PaCO2

58
Q

Indications to clear upper airways (suction)?

A

Auscultation -> crackles

Visual WOB

  • Accessory muscle use
  • Indrawing
  • Stridor
  • Heart failure
  • RR
59
Q

What do you want to improve from suction?

A

O2 saturation
Color and perfusion
effective cough

60
Q

Suction settings (vacuum pressures) for adults?

A

120-160 mmHg

61
Q

Suction settings (vacuum pressures) for children?

A

100-120mmHg

62
Q

Suction settings (vacuum pressures) for infants?

A

80-100 mmHg

Interventions 1 (RESP 266) (16 decks)

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