Ventilation

Question 1

If Peak pressure alarm goes off ? Now what

Answer 1

Inspiratory hold to check Plateau pleasure <30

If PP is normal then increased resistance at beginning of airways
- ET kinked or biting
- mucus plug
- bronchospasms

If PP increased = decreased compliance at airways
- pneumothorax
- oedema
- right bronchus intubation
- abdo distension
- auto PEEP

Question 2

Patient sudden deteriores on vent ?
DOPES

Answer 2

Disconnect from vent then check - can I bag?

Displaced
Obstruction
Pneumothorax
Equipment
Stacking/suction

Question 3

Oxygenation problem ? Decreased O2

Answer 3

Change =>
FiO2
PEEP
I:E

Question 4

Ventilation problem ? Increased CO2

Answer 4

Change =>
RR
I:E

Question 5

Vent settings for
- normal
- COPD
- ARDS

Question 6

De winters formula
Expected PaCO2

Answer 6

Formula
(1.5x serum HCO3) +8 (+~2)

Minute ventilation expected L
PaCO2 40 = 6-8L
PaCO2 30 = 12-16L
PaCO2 20 = 18-20L

Question 7

Recruitment maneuver?

Answer 7

1. PEEP 30-40 for 30sec
   Or
2. Staircase 2min increments to PEEP to 55 then back down again

Question 8

A-line graph

Answer 8

dicrotic notch - aortic valve closes, begins of diastole

Damping
Over
Under
Fast flush test / Square wave test/ dynamic response test
MAP same however in all situations