Test 2 Review Flashcards
What type of criteria ALWAYS equals intubation
Paco2<60
Paco2 >50
What’s the only factor that we automatically intubate
apnea
Indications for MV
- Refractory hypoxemia
- Inadequate alveolar ventilation
- Inadequate muscle strength
- Increased WOB
What Increases in airway resistance
- ET tube size
- secretions
If p-v loop becomes widening it means
decrease compliance
Because of widening of pvloop decrease of compliance causes
increased airway resistance
As loop gets smaller compliance is
increased
Increased compliance in p-v loop means
decrease airflow resistance
If loop is shifting towards a pressure access, towards increased PIP what is happening to compliance as airway pressure gets higher?
lungs become less compliant (decrease compliance)
Dynamic compliance deals with ______________ resistance
airflow
If pt is hypoventaling ABG will be
acidotic; high Paco2, low pH
If pt is severely hypoxic, what may you observe with pts
- RR- Increased WOB
- tachypnea
- HR -increased
- Cyanosis
If pt is hypoventilating to try compensate for pH it is usually a
metabolic issue
Head trauma (neurological issue) pts may need to be intubated to monitor
Intracranial pressures (ICPS)
Spinal cord pts paralysis (Respiratory)
may need to be intubated
Intubate for airway protections
- drug overdose
- OSA
Needs to be intubated for a short amount of time, what mode should be used
Synchronized Intermittent Mandatory Ventilation (SIMV)
SIMV is used for
- weaning
- do some of the breathing on their own
- prevents breath stacking
pt trigger breath
starting the breath
examples of triggers
- pt
- cycling
examples of cycling breath
- Time cycle, after a certain amount the breath cycles (end)
High Vt increases
Peak Inspiratory Pressure (PIP)
PIP should be less than
30
Increased PIP can be b/c of
secretions
If pt is MVC trauma with neurologic problems, and needs to be sedated what mode will put pt on
Continuous Mandatory Ventilation (CMV)
Pressure control setting is used to control
pressure and allows pt to choose their own volume
Pt has to be spontaneous breathing what mode will you use
CPAP
What are CPAP parameters
- pressure support ventilation (SBT, CPAP trial)
- PEEP
3.FIO2 (low setting)
Positive end expiration pressure (PEEP) can aid to help with
oxygenation (increase pao2); keeps alveoli open
If BP is low (hypotension) caution with increasing
PEEP
Bigger tube equals
decreased airway resistance
If pt has a lot of sedation and not waking up, what can be issue with pt from stopping them from coming off sedation?
Renal issue
What is the difference between IMV and SIMV
They both are able to take breaths in-between mandatory breaths
IMV- can breath stack
SIMV- cannot breath stack
Sometimes pts with high Intracranial Pressures (ICP) sometimes we will put them in a
Alkolotic state (rr high), b/c it allows reduce of intracranial pressure b/c it restricts blood vessels.
White on X-ray
Fluid
Calcification
Black on X-ray
Air
Hyperinflation
Altered Mental Status (AMS) think
neurological problem
Sleep apnea
sleep disorders
Respiratory paralysis, what type of pt could it be
spinal cord or mvc
If Volume cycled, what’s making that breath
volume
If time cycled, what’s making that breath
time
If pressure triggered, what’s starting breath
pressure
