Respiratory Support Flashcards
What are the indications for Mechanical Ventilation?
Airway protection ARDS Shock Acute NM Dz Resp or Cardiac Arrest Acute rise in IC pressure Tachypnea or Bradypnea Resp Acidosis
What are the goals of Mech Vent?
Improve Hypercapnia and Hypoxemia Relieve suffering (effort) Support if impaired drive Promote survival and timely recovery Diagnostic Tool
What is the difference between spontaneous breath and Positive pressure ventilation?
Whole lung involved mechanically in Spon Breath
Pos Pressure Vent only the anterior portion of the lung is ventilated and is succeptible to damage.
WHat are the components of Vol/Pressure targeted breaths?
Target: vol or pressure
Trigger: signal to initiate breath
Termination: signals the end of the breath
What are the components of mandatory breaths?
Guarunteed number and volume/pressure
Target
Controlled
Effort initiates breath.
What is the most common mode of mechanical ventilation?
Assist control mode
Pressure or volume targeted
What are the drawbacks to Assist control mode
May result in high minute ventilation and Resp alkalosis
Dynamic hyperinflation from breath stacking.
What is “Auto-Peep”?
Dynamic hyperinflation from breath stacking.
What Mode is used when you are assessing a Pt’s readiness to come off the ventilator?
Spontaneous Ventilation
with just enough Pos pressure to overcome resistance of equipment.
How can oxygenation be improved?
Increase FiO2
Adjust Airway pressure
-PEEP(keeps lungs partially open)
-Increased inspiratory time
How do we choose the correct Tidal Volume for Mech Ventilation?
Based on height
What is the Cause of ARDS in mech Ventilation?
Too much volume in each breath
What are the different settings to be set on a ventilator?
Mode: VACV, PACV RR: 16-28 Tidal Volume PACV: PC above PEEP PEEP: 5-10 to start FiO2: adjust to keep SpO2 >90%
What is the criteria for taking someone off the ventilator?
Need has subsided Off pressors, HR controlled, etc Awake and interactive Secretion control O2 requirement Swelling gone down(cuff leak)
What type of Pts need to be Re-intubation after it’s taken out.
Older, weaker, Cardiac issues
worse outcomes
