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Anesthesia Concepts > Ventilators And Airway Monitors > Flashcards

Ventilators And Airway Monitors Flashcards

1
Q

Modern vents
4 phases
Classified by what

A

Inspiration, transition to expiration, expiration, transition to inspiration

Inspiratory phase characteristics, method of cycling

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2
Q

Expiration depends on what

A

Doesnt depend on vent, is passive, depends on airway resistance and lung compliance

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3
Q 
Inspiratory characteristics
Constant flow 
Delivers what regardless of what 
High p gas source
Low p gas source
A

Constant ins gas flow regardless of circuit pressure
Ins flow constant despite changes w resistance or compliance
Varies to some degree w airway pressure

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4
Q

Non constant flow charac

A

Varies flow w inspiratory cycle

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5
Q

Constant pressure generators do what, flow stops when

A

Maintains constant airway pressure through inspiration regardless of insp gas flow. Flow ceases when airway pressure equals set insp pressure

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6
Q

Time cycled
What it is
How to calculate TV

A

Cycles from exp phase once time interval elapses from start of insp
Tidal volume is product of ins time and ins flow rate

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7
Q

Volume cycled
What it is
TV affected how

A

Terminates ins when preset TV is delivered. Most adult vents are set to this but have another limit on ins pressure to prevent barotrauma

%always lost to compliance of system. Usually 4-5cc/cmh2o

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8
Q

Difference between anesthesia and icu vents

A

Anesthesia: gas never reaches pt, modes are what drives vent not the gas

In icu gas that drives vent is what reaches pt

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9
Q

Power source

3 types

A

Compressed gas only
Piston power only
Compressible bellows gas and power

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10
Q

2 types of drive mechanisms

Types of bellows and what drives them

A

Double circuit bellows compressed by driving gas and pneumatically driven

Piston bellows compressed by electricity

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11
Q

Most vents are ___ cycled, ___ controlled, with a __ __ aspect

A

Timed, electronically, volume limiting

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12
Q

Bellows
Direction of bellows during __ determines classification

Ascending vs descending

A

Expiration

Ascending ascend on exp
Descending descend on exp

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13
Q

What kind of bellows aren’t safe

A

Hanging bellows, gravity

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14
Q

Volume expressed in what, what for minute volume

Avg for small or normal person

A

Mls, Ls

400-500, 600 mls

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15
Q

Pressure
Defined as what
Where its encountered
Expressed in what

A

Impedance to gas flow rate: breathing circuit, pt airway/lungs

Backpressure: airway resistance, lung-thorax compliance

Cmh20, mmhg, kpa

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16
Q 
Flow rate 
What it is 
Where it is 
Referees to \_\_\_change/time 
Expressed in what
A

Rate at which gas volume delivered to pt
Pt connection of breathing system to the pt
Volume
L/sec, LPM

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17
Q

Bellows separate what

During ins phase the driving gas enters ___ and does what

A

Driving gas from pt gas circuit

Chamber, increases pressure

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18
Q

Increase in pressure during ins phase:

What 2 things happen

A

Ventilator relief valve closes so no gas can escape into scavenger

Bellows compressed and gas in bellows delivered to pt

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19
Q

During expiration

Drive gas exits where, what happens to pressure and relief valve

A

Bellows chamber, decreases to zero, opens

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20
Q

During expiration

Exhaled pt gas fills ___ before any ___ occurs because valve ball does what, scavenging only occurs when

A

Bellows, scavenging, produces back pressure, bellows filled completely

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21
Q

Relief valve is only open when, and what happens at this point

A

Expiration, scavenging

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22
Q

How to calculate pt tv through bellows

A

TV bellow + fresh gas flow - compressed circuit volume

23
Q

Tidal volume
__ ml/kg

Rr __-__

Flow rate = what

A

10-15

8-12

4-6 x minute ventilation

24
Q

How to calc minute ventilation

How to calc time spent on inspiration

A

TV X RR

TV/flow rate

25
Q

How to calc TE

A
  1. Breaths per min, then find how many sec per 1 breath

2. Do that many seconds - ins time

26
Q

Inspiratory pause/sigh

  • does what
  • what happens
  • volume of gas to pt held in lungs until what
A

Inhalation time increased by 25%
Flow of drive gas stops, pressure in bellows stays same
Until exhalation

27
Q

Set inspiratory pressure limit to what

A

35-40

28
Q

Fio2

How to calc oxygen delivery

A

Co x o2 content

29
Q

How to calculate oxygen content

A

Hgb x%sat x 1.39 ml o2

+ pa02 x .0031 ml 02

30
Q

Hypoventilation: reduces ___ except when pt breathes oxygen

Pao2= \_\_\_-\_\_\_/ \_\_+\_\_
R= what 
F= what
A

Pao2

Pio2- paco2/ r + f

R= extraction ratio (0.8)
F= correction factor, small
31
Q

Every time you increase ___ by __% you increase pao2 by ___mmHg

A

FiO2, 10

50

32
Q

Low pressure alarm detected by a drop in __ __ pressure

Sub atmospheric pressure alarm of ___ cm h20

A

Peak circuit

-10

33
Q

Alarm for sustained pressure alarm of ___ cm h20 for more than __ secs

A

-15, 10

34
Q

High peak airway pressure alarm detects excess pressure in system activated by ___ cm h20 or set by practitioner. What if kid

A

60, 35

35
Q

Low ___ __ alarm

Ventilator setting alarm, vents inability to deliver desired __

A

Oxygen supply

MV

36
Q

What is best for revealing a disconnect, and gold standard for how much you’re ventilating

A

ETCO2

37
Q

Etco2 ___ what’s happening in blood

A

Underestimates

38
Q

What is most imp monitor on the machine, calibrate at what

A

Oxygen analyzer

21% o2

39
Q

Respirometer
___ __ and tidal volume __ __
Gas flow converted to what
Cartridge in which limb

A

Transducer cartridge, sensor clip

Electrical pulses

Expiratory

40
Q

Exhaled vt to expect to measure is

Vt= ___ + ____ - ___

A

Vt set on vent
+ vt fresh gas flow
- vt lost in system

41
Q

Which monitor activated once breaths sensed, always active while mechanically venting

A

Exhaled volume

42
Q

Reverse flow alarms when

Apnea alarms when

A

Flow toward pt

If insufficient breath based on TV setting not achieved in 30 sec

43
Q

ICU vents more ___ than OR ones. Allow for greater __ __ and ___ __

Other changes

A

Powerful

Inspiratory pressures and tidal volumes

Co2 absorber, more modes, gas supplied by vent directly vents pt in icu

44
Q

Icu vents: ___ essential in anesthesia ones and not as much in icu

A

Bellows

45
Q

Modes of ventilation

2

A

CV- controlled vent

IMV- vent delivers preset volume at specific interval, continuous flow of gas for spont vent

46
Q

AC mode does what

A

Intermittent positive pressure. Pts insp effort creates sub baseline pressure in insp limb of vent that triggers vent to deliver a predetermined TV

47
Q

AC- all breaths are what, can be controlled how

A

Full assisted vent breaths

Pressure or volume

48
Q

How pressure support did from IMV

What goal of PS is

A

Airway pressure held constant in inspiratory pressure

Increase pt spont TV by delivering pressure to achieve 10-12 ml/kg volumes. Decreases WOB and muscle fatigue

49
Q

High frequency vent
Low __ __, less than __ __, rate __-__

Typical settings

A

Tidal volumes, dead space, 60-300

100-200 BP
IT 33%
15-30 PSI drive pressure

50
Q

Goal of high freq vent

A

Maintain pulm gas exchange at lower means airway pressures

51
Q

Pressure control vent

__ or __ triggered, __ limited, __-cycled

A

Pt or time, pressure, time

52
Q

Pressure control vent
__ __ decreases as airway pressure rises and creases when airway pressure = the set peak __ __

__ not fixed
When its used

A

Gas flow, inflation pressure

TV
Pressures can be high, neonate and premies

53
Q

CPAP

In 1 lung anesthesia, giving CPAP to which lung and PEEP to which

A

Cpap to up lung, peep to down lung

54
Q

If pressures greater than what cpap can cause regurg and aspiration

A

15 cm h2o

Anesthesia Concepts (12 decks)

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