Ventilators

Question 1

To change CO2 level

Answer 1

Respiratory rate

Increase rate to decrease CO2

Question 2

To change pt comfort

Answer 2

Inspiratory flow rate

If pt appears to be sucking on the tube or air hungry, increase the flow rate

Question 3

To protect the lungs

Answer 3

Tidal volume

Decrease tidal volumes to protect the lung from injury

Question 4

Average tidal volume

Answer 4

6-8 cc/kg

70 kg = 420-560 = ~500 cc

Question 5

Minute ventilation requirement

Answer 5

Normally 60 cc/kg/min
Intubated is 120 cc/kg/min (due to dead space, etc)
120 –> 8400 cc/min = 16-17 (500 cc) breaths/min

Question 6

How to adjust FiO2

Answer 6

Intubate –> place on 100% FiO2 to correct hypoxia from intubation –> wait 5 minutes –> drop immediately to 40%

Question 7

Goal SpO2 on vent

Answer 7

88-95% (avg 90%)

Titrate FiO2 and PEEP together to achieve this with PEEP scale

Question 8

To change SpO2

Answer 8

Change FiO2 and PEEP together

Question 9

Ideal plateau pressure

Answer 9

<30 cm H2O

Question 10

What causes barotrauma?

Answer 10

Too high plateau pressure (NOT PEEP, NOT PIP)

Question 11

How do you find the plateau pressure on a vent?

Answer 11

Inspiratory hold button

Question 12

How do you decrease plateau pressure

Answer 12

Decrease tidal volume (to protect the lungs!)

Question 13

I:Wc ratio in obstructive patients

Answer 13

1:4 or 1:5

Question 14

What do you do when your patient is breath stacking?

Answer 14

Decrease the respiratory rate (prolong the I:E ratio)

Question 15

How do you know if your patient is breath stacking?

Answer 15

Plateau pressure > 30

Find plateau pressure by performing inspiratory hold