Ventilators Flashcards
AC
Assist Control
- preset Vt/PIP
- pt triggers breaths (receives full preset breath)
- Back up rate set
CMV
Controlled Mandatory/Mode Ventilation
- early mode
- preset Vt or PIP
- Preset Rate
- pt cannot initiate (apprehension & air hunger)
- requires sedation / paralysis
AC complications
- Resp Alkalosis (pts triggers 2 breaths + Back up rate= tachypnea)
- Asynchrony machine & pt
- May worsen air trapping in COPD pts
- stacked breaths (pt’s breath immediately before scheduled breath - delivers 2 preset Vt breaths. Barotrauma)
IMV
Intermediate Mandatory Ventilation
- Preset rate, VT/PIP
- pt can initiate breath, but only delivers amount pt draws. (Does not deliver full present Vt/PIP)
IMV Complication
If pt takes breath right before schedules breath, delivers amount requested plus scheduled breath. Results in air stacking. Barotrauma.
SIMV
Synchronized Intermittent Mandatory Ventilation.
- Preset Rate Vt/PIP
- vent senses initiated breaths.
- if initiated breath close to scheduled breath, delivers preset amount. Otherwise delivers amount drawn by pt.
- can still lead to hyperventilation, respiratory alkalosis, air trapping in COPD pts.
SCOPE - high pressure alarm
Suction (mucus plug) Connections (valves on circuit/kinked) Obstructions Pneumothorax ETT dislodgement (suggests deep dislodgement)
Acute Respiratory Deterioration w/ PIP Decrease
Air leak, hyperventilation
Acute Respiratory Deterioration w/ PIP no change
PE, extra thoracic process
Acute Respiratory Deterioration w/ PIP increase & no Plateau Pressure change.
(Airway obstruction) Aspiration, Bronchospasm, secretions, tracheal tube obstruction.
Acute Respiratory Deterioration w/ PIP increase & Plateau Pressure increase
(Decreased compliance) Abdominal distention Asynchronous breathing Atelectasis Auto-PEEP Pneumothorax Pulmonary Edema
PIP=
Pplat=
PIP= airway problem Pplat= lung structure problem
Some causes of atelectasis
Tight lungs, ARDS, pulmonary edema, pulmonary contusions
Low pressure alarms
D/C o2 source, disconnection, ETT extubation, hypovolemia (chest is tissue, blood and air…take away blood: increased chest cavity size)
Methemoglobinemia and saturation
SPO2 reads high when low, reads low when high.
>40% will direct SPO2 to 85%
