Patient Assessment Flashcards
What should the sensitivity be set at
No more than -1 or -2 cmH2O
Flow triggered 1-10L/min
How much dead space is in alveolar ventilation
1mL/lbs (IBW)
Another name for PEEP
End Expiratory Pressure (EEP)
What does mean AW pressure influence
Tissue oxygenation
Lung volume
Cardiac output
How do you reduce auto-PEEP
Increase flow
Decrease Ti
Decrease RR
Use modes that use spontaneous breathing
Add PEEP
When should you stop raising PEEP
When Pplat increase
PIP increases
Accessory muscle use decreases
Why and when would we use neuroblockers with ARDS patients
If the patients work of breathing is fighting the ventilator
<48hrs on MV
P/F <100
When do we use ECMO
P/F <80
Or
7.25 w/ PaCO2 > or equal to 60
Use of prone positioning for ARDS
To take the weight of the heart off the lungs
When is the use of corticosteroids harmful
When patient has been on the MV for greater than 14 days
Which ARDS patients get corticosteroids
Those with a P/F of < or equal to 300
When should a patient receive high PEEP
P/F less or equal to 200
What is the theory behind the ARDSnet lung protective ventilation
Aims to give smaller tidal volumes to ventilate healthy alveoli’s rather than forcing the damaged ones
Targeted Pplat according to ARDsnet
25-30 cmH2O
Target PaO2 according to ARDsnet
55-80mmHg or SpO2 88-95%
Target pH according to ARDsnet
7.3-7.45
How do you calculate driving pressure
Pplat-PEEP
What is the target driving pressure for ARDS
Less than or equal to 15cmH2O
Decease delta P
what does RACE stand for according to ARDsnet
Repeated alveolar collapse and expansion
Theory of open lung strategy
Keep the alveoli’s open to prevent recruitment and derecruitment trauma
How can you reduce auto-PEEP
Increase flow
Decrease Ti
Decrease RR
Change mode to include spontaneous breaths
Add PEEP
How much mL can a healthy person move per cmH2O
50-60 mL
Formula for Raw
PIP-Pplat/flow in sec
Why do we look for ascites when examining the chest
Fluid can push on diaphragm
When should you update documentation
Every 1-4 hours
