Objectives for Respiratory Distress

Question 1

Vital Capacity

Answer 1

< 15 (normal 65-75)

Question 2

Inspiratory force

Answer 2

< 25 (normal 75-100) cm/H2O

Question 3

PaO2 on room air (21%)

Answer 3

< 55 (normal >72)

Question 4

Alveolar to arterial gradient (21% FiO2)

Answer 4

> 55 (normal < 10 - 15)

Question 5

PaO2 on 100% FiO2

Answer 5

< 200 ( normal > 400)

Question 6

Alveolar to arterial gradient on 100% FiO2

Answer 6

> 450 (normal < 100)

Question 7

PaCO2

Answer 7

> 60 (normal 35 - 45)

Question 8

Respiratory Rate

Answer 8

> 40 or < 6 (normal 10-25)

Question 9

what are subjective signs of respiratory distress

Answer 9

PUPIL DIALATION / DIAPHORESIS (SNS stimulation)
anxiety
restlessness
dyspnea
accessory muscle use
nasal flairing
mouth breathing 
PURSED LIP BREATHING or self PEEP (grunting, groaning)
lip cyanosis

Question 10

what is the goal of mechanical ventilation

Answer 10

to NORMALIZE arterial blood gas levels and acid base imbalances in pts unable to

Question 11

what are the objectives of initiation of mechanical ventilation

Answer 11

reversing hypoxemia and acute acidosis, relieving respiratory distress and decrease work of breathing

Question 12

what factors must be accounted for when determining the type of ventilatory support

Answer 12

1. patients physiological status
2. goal of treatment
3. types of ventilators and ventilator modes available

Question 13

pH requiring intubation

Answer 13

< 7.32

Question 14

tidal volume requiring intubation

Answer 14

< 5 ml/kg

Question 15

FEV requiring intubation

Answer 15

< 10 ml/kg