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CCP-C/FP-C Certification Review > Ventilator Management > Flashcards

Ventilator Management Flashcards

1
Q

Tidal Volume (Vt)

A

How much air the patient breathes in a normal breath.

(Excessive Vt can cause ventilator-induced lung injury)

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2
Q

Inspiratory Reserve Volume (IRV)

A

The amount of air that can be forcefully inhaled in addition to a normal tidal volume breath

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3
Q

Expiratory Reserve Volume (ERV)

A

The amount of air that can be forcefully exhaled after a normal tidal volume breath.

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4
Q

Vital Capacity (VC)

A

Vt + IRV + ERV

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5
Q

Residual Volume (RV)

A

The amount of air left in the respiratory tract following forceful exhalation.

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6
Q

Total Lung Capacity (TLC)

A

IRV + Vt + ERV + RV

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7
Q

Dead Space

A

The surfaces of the airway that are not involved in gas exchange

Dead Space = 2mL/kg

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8
Q

Central Chemoreceptors

A

Located in the medulla/pons

Driven by CO2 and H+ levels

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9
Q

Peripheral Chemoreceptors

A

Located in the aortic arch/carotid bodies

Response is driven by O2, CO2 and H+

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10
Q

Fick Formula

A

Used to tell how much O2 a person is using. Cardiac ouput measurement based on the principle that oxygen uptake by the lungs equals oxygen delivery.

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11
Q

V/Q Scan

A

Nuclear medicine study used to evaluate circulation of air and blood within the lungs to determine the V/Q ratio.

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12
Q

Hypercarbic Respiratory Failure

A

Inability to remove CO2

Indicated By - Respiratory Acidosis

Treatment - Increased Vt then rate

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13
Q

Hypoxic Respiratory Failure

A

Inability to Diffuse CO2

Indication - Low PaO2

Treatment - Increased Vt, O2 concentration, then rate

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14
Q

Apneustic Breathing

A

Abnormal breathing pattern characterized by a deep, gasping inspiration with a pause at full inspiration, followed by a brief, insufficient release.

(Associated with decerebrate posturing)

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15
Q

Ataxic Respirations

A

Abnormal pattern of breathing characterized by compolete irregularity of breating, with irregular pauses and increasing periods of apnea.

(Caused by damage to the medulla)

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16
Q

Biots Breathing

A

Abnormal pattern of breathing characterized by groups of quick, shallow inspirations followed by regular or irregular periods of apnea.

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17
Q

Cheyne-Stokes Respirations

A

Progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in temporary apnea.

(Brainstem herniation, decorticate posturing)

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18
Q

Kussmaul’s Respirations

A

Respirations gradually become deep, labored and gasping. Associated with DKA.

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19
Q

Controlled

A

The patient’s breathing rate (F) and tidal volume (Vt) is controlled completely.

20
Q

Intermittent

A

The patient can take intermittent breaths (between the controlled breaths).

21
Q

Synchronized

A

The ventilator synchronizes delivery of breath with the patient’s inspiratory drive.

22
Q

Assist

A

The ventilator assists the patient with their breathing (must have intact respiratory drive).

23
Q

Ventilator Acquired Pneumonia (VAP)

A

1 cause of iatrogenic death in the US

24
Q

Curare Cleft

A

Tick marks seen on capnography, patient is choking. Check ETT. Patient needs to be resedated and reparalyzed.

25
Q

Tidal Volume (Vt) Setting

A

6-8mL/kg

26
Q

F (Rate)

A

8-20 breaths/min

27
Q

Minute Volume (Ve)

A

F x Vt (4-8 L/min)

28
Q

Inspiratory: Expiratory Ratio (I:E)

A

1:2

29
Q

Fraction of Inspired Oxygen (FiO2)

A

0.21-1.0

30
Q

Plateau Pressure (Pplat)

A

< 30 - respresents the static ensd inspiratory recoil pressure of the respiratory system, lung and chest wall respectively.

31
Q

Positive End Expiratory Pressure (PEEP)

A

Keeps alveoli so that oxygen can diffuse, prevents atalectasis.

32
Q

Peak Expiratory Flow Rate (PEFR)

A

500 to 700 L/min for males, 380 to 500 L/min for females.

A person’s maximum speed of expiration, as measured with a peak flow meter.

33
Q

Controlled Mandatory Ventilation (CMV)

A
  • Used in sedated, apneic or paralyzed patients
  • All breaths are triggered, limited, and cycled by the ventilator
  • Patient has no ability to initiate own breaths
34
Q

Synchronized Intermittent Mandatory Ventilation (SIMV)

A
  • Assisted mechanical ventilation synchornized with the patient’s breathing
  • Ventilator senses the patient taking a breath, then delivers a breath.
  • Spontaneous breathing by the patient occurs between the assisted breaths which occur at preset intervals
  • Preferred in patients with an intact respiratory drive
35
Q

Assist-Control Ventilation (AC)

A
  • The trigger for delivery of a breath can be either the patient or elapsed time
  • Ventilator supports every breath, whether it’s initiated by the patient or the ventilator
  • Used in ARDS, paralyzed or sedated patients
  • Anxious Patient - can breath-stack/auto-PEEP - Can cause VILI
36
Q

Pressure Support Ventilation (PSV)

A
  • Makes it easier for the patient to overcome the resistance of the ETT and is used during weaning
  • Reduces work of breathing
  • Patient determines tidal volumes, rate (minute volume)
  • Requires consistent ventilatory effort by the patient
37
Q

CPAP/BIPAP

A

Similar to SIMV because they are all spontaneously triggered by the patient

38
Q

CPAP

A

The use of continuous positive pressure to maintain a continuous level of PEEP. Mild air pressure to keep an airway open.

39
Q

BiPAP

A

Uses alternating levels of PEEP to maintain oxygenation, commonly used in pneumonia, COPD, asthma, etc.

40
Q

Low Pressure Alarm Causes

A
  • Patient disconnection from machine
  • Chest tube leaks
  • Circuit Leak
  • Airway Leak
  • Hypovolemia
41
Q

High Pressure Alarm Causes

A
  • Kinked Line
  • Coughing
  • Secretions
  • Patient biting the tube
  • Reduced lung compliance
  • Increased Airway Resistance
42
Q

DOPE Mnemonic

A

Displacement

Obstruction

Pneumothorax

Equipment

43
Q

“Blue Bloaters”

A

COPD patients with chornic bronchitis

44
Q

“Pink Puffers”

A

COPD patients with emphysema. Color is pink due to polycythemia vera.

45
Q

COPD CXR Findings

A

Flattened diaphragm, chest cavity is over expanded due to air trapping.

46
Q

Pneumonia

A
  • Often viral, sometimes bacterial
  • CXR shows pleural effusions, lobar consolidation
  • Right middle lobe pneumonia is most common site
47
Q

ARDS

A

Acute Respiratory Distress Syndrome

  • CXR - ground glass appearance, patchy infiltrates, bilateral diffuse infiltrates
  • Swann-Ganz - increased PAWP (high pressure because right heart is pumping against increased pressure in the lung vasculature)
  • Tx: High PEEP, High Vt

CCP-C/FP-C Certification Review (15 decks)

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