Ventilator

Question 1

What are the two different ventilator strategies? And give examples?

Answer 1

Obstruction: Asthma, COPD
Injury: ARDs, pneumonia

Question 2

The lung injury strategy is ____ in nature and against what sort of dangers?

Answer 2

PROTECTIVE

BAROTRAUMA

Question 3

In Assist Control mode, what are the parameters that can be altered?

Answer 3

Tidal Volume
Inspiratory Flow Rate
Respiration Rate
FiO2/PEEP

Question 4

To achieve lung protection, what parameter should be addressed and how?

Answer 4

tidal volume.

low tidal volume, undershoot in the 6-8cc/kg range

Question 5

What should the plateau pressure be?

And how do you achieve that target?

Answer 5

plateau pressure <30

decrease tidal volume

Question 6

The IFR setting serves what purpose for the patient? How is the IFR quantified and what does it mean?

Answer 6

Comfort for the patient.

High IFR is fast inspiration.
Low IFR is slow inspiration.

Question 7

The patient is sucking on ET tube, what setting should be address and how?

Answer 7

Patient wants air (inspiration)

Increase the IFR

Question 8

What ventilator setting addresses ventilation?

Answer 8

Respiratory Rate

Question 9

How is the dead space affected when a patient is placed on the ventilatory? What should be addressed respectively on the settings?

Answer 9

Dead Space increases. Aim for a higher respiratory rate.

Question 10

What aim does FiO2/PEEP achieve? How should it be managed?

Answer 10

oxygenation.

Start big and titrate down.

Question 11

The FiO2/PEEP can benefit the patient in what four ways?

Answer 11

1) improve V/Q mismatch
2) decrease shunt
3) improve spont. breathing
4) decrease atelectasis/trauma

Question 12

What is the goal in the obstruction ventilator method?

Answer 12

focus on the time to breath out

Question 13

What setting is affected very little by the obstruction ventilator method? What’s the aim?

Answer 13

tidal volume.

8cc/kg

Question 14

How is IFR different when the patient has obstruction issues?

Answer 14

higher IFR.

Could be 80-100 LPM.

Question 15

Type II respiratory failure is what short of issue? What about type I? What type is obstruction?

Answer 15

Type II ventilation.
Type I oxygenation.

Type II.

Question 16

What’s a typical PEEP in the obstruction patient? What role does PEEP play in this patient?

Answer 16

Zero.

Higher PEEP works against the patient.

Question 17

What kind of respiratory rate would you expect in obstruction patients?

Answer 17

Low. It’s a good idea to start around 10 BPM.

Question 18

When addressing the respiratory rate, the I:E time can be altered. What’s the normal I:E and how does it change for the obstruction patients?

Answer 18

1: 2 is typical.
1: 4 and 1:5 is frequent in obstruction patients.

Question 19

What is the I:E affected in obstruction patients?

Answer 19

They need a longer time to breath out.

Question 20

What obstructive patient state makes sedation/analgesia so important? (two words)

Answer 20

permissive hypercapnea

Question 21

If the plateau pressure is >30 in the obstruction patient, what is happening and how can it be addressed?

Answer 21

Autopeeping so decrease the RR.

Question 22

Patient is airtrapping, what is your response?

Answer 22

decrease the RR.