Podcast
Questions and Answers
The pneumatic ventilator requires a gas source to power itself.
The pneumatic ventilator requires a gas source to power itself.
True (A)
You can lower Ve by reducing _____ _____
You can lower Ve by reducing _____ _____
mandatory rate
Which of the following are causes of increased PIP?
Which of the following are causes of increased PIP?
- Secretions in the ETT (correct)
- Right mainstream intubation (correct)
- Kink in the ETT (correct)
A 70kg patient with emphysema should have an initial set Vt of how many mL?
A 70kg patient with emphysema should have an initial set Vt of how many mL?
In VC, with a set Vt of 500 mL, increasing the flow will cause what?
In VC, with a set Vt of 500 mL, increasing the flow will cause what?
Increased Pplat will always increase PIP.
Increased Pplat will always increase PIP.
In NIPPV, to increase Vt, you must increase what?
In NIPPV, to increase Vt, you must increase what?
ICU ventilators are compatible in MRI.
ICU ventilators are compatible in MRI.
Which of the following are contraindications for NPPV?
Which of the following are contraindications for NPPV?
What is the GCS (Glasgow Coma Scale) score for a patient who opens their eyes to pain, makes incomprehensible sounds, and withdraws from pain?
What is the GCS (Glasgow Coma Scale) score for a patient who opens their eyes to pain, makes incomprehensible sounds, and withdraws from pain?
Given VC at 10mL/kg, MIP -15cmH2O, SpO2 90%, what should you do?
Given VC at 10mL/kg, MIP -15cmH2O, SpO2 90%, what should you do?
Vital capacity =
Vital capacity =
Normal vital capacity for adults is how many liters?
Normal vital capacity for adults is how many liters?
Set Vt 750mL, PEEP 15 cmH2O, PIP 45 cmH2O. How can you reduce PIP?
Set Vt 750mL, PEEP 15 cmH2O, PIP 45 cmH2O. How can you reduce PIP?
When initiating AC/PC mode, what parameters do you set?
When initiating AC/PC mode, what parameters do you set?
What mode can you guarantee minute ventilation?
What mode can you guarantee minute ventilation?
How can you extend E-Time?
How can you extend E-Time?
Permissive hypercapnia (PHY) allows for pH of 7.10-7.30.
Permissive hypercapnia (PHY) allows for pH of 7.10-7.30.
Normal Vital Capacity for adults
Normal Vital Capacity for adults
Flashcards
Pneumatic ventilator powered by gas source?
Pneumatic ventilator powered by gas source?
False
How to lower Ve?
How to lower Ve?
Reducing mandatory rate
Causes of increased PIP
Causes of increased PIP
Right mainstream intubation, Secretions in the ETT, Kink in the ETT
Initial Vt for 70kg emphysema patient?
Initial Vt for 70kg emphysema patient?
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Increased flow in VC causes what?
Increased flow in VC causes what?
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Increased Pplat always increases PIP?
Increased Pplat always increases PIP?
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Increase Vt in NIPPV by...
Increase Vt in NIPPV by...
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ICU ventilators compatible in MRI?
ICU ventilators compatible in MRI?
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Contraindications for NPPV
Contraindications for NPPV
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GCS: Eyes to pain, sounds, withdrawl?
GCS: Eyes to pain, sounds, withdrawl?
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VC 10mL/kg, MIP -15, SpO2 90%. What to do?
VC 10mL/kg, MIP -15, SpO2 90%. What to do?
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Vital Capacity =
Vital Capacity =
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Normal Vital Capacity for adults
Normal Vital Capacity for adults
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Vt 750mL, PEEP 15, PIP 45. Reduce PIP?
Vt 750mL, PEEP 15, PIP 45. Reduce PIP?
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Set in AC/PC mode?
Set in AC/PC mode?
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Mode guarantees minute ventilation?
Mode guarantees minute ventilation?
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How to extend E-Time?
How to extend E-Time?
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Permissive Hypercapnia pH 7.10-7.30?
Permissive Hypercapnia pH 7.10-7.30?
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Fish tail on pressure volume loop?
Fish tail on pressure volume loop?
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Study Notes
- Pneumatic ventilators do not power themselves using a gas source.
Lowering Minute Volume (Ve)
- Ve can be lowered by reducing the mandatory rate.
Causes of Increased Peak Inspiratory Pressure (PIP)
- Right mainstream intubation.
- Secretions in the endotracheal tube (ETT).
- Kink in the ETT.
Initial Tidal Volume (Vt) for Emphysema Patient
- For a 70kg patient with emphysema, the initial set Vt should be 560 mL.
Volume Control (VC) and Flow
- In VC, if Vt is set to 500 mL, increasing the flow will cause a longer expiratory time (E-Time).
Plateau Pressure (Pplat) and PIP
- Increased Pplat will always increase PIP.
Non-Invasive Positive Pressure Ventilation (NIPPV) and Vt
- In NIPPV, to increase Vt, inspiratory positive airway pressure (IPAP) must be increased.
ICU Ventilators and MRI
- ICU ventilators are not compatible in MRI.
Contraindications for NIPPV
- Copious amounts of secretions.
- Altered mental status (AMS).
- Unconscious patient.
Glasgow Coma Scale (GCS)
- Eyes open to pain, incomprehensible sounds, withdrawal from pain corresponds to a GCS of 8.
Clinical Scenario: Intervention Needed
- VC 10mL/kg, MIP -15cmH2O, SpO2 90% indicates the need to intubate and ventilate the patient.
Vital Capacity
- Vital Capacity = Expiratory Reserve Volume (ERV) + Tidal Volume (Vt) + Inspiratory Reserve Volume (IRV).
Normal Vital Capacity
- Normal vital capacity for adults is 3-5 liters.
Reducing PIP
- With a set Vt of 750mL, PEEP of 15 cmH2O, and PIP of 45 cmH2O, PIP can be reduced by lowering PEEP and Vt.
Initiating Assist Control/Pressure Control (AC/PC) Mode
- When initiating AC/PC mode, set inspiratory pressure and respiratory rate.
Mode Guaranteeing Minute Ventilation
- Volume Control (VC) is the mode that guarantees minute ventilation.
Extending Expiratory Time (E-Time)
- E-Time can be extended by decreasing I-Time, decreasing RR, or increasing flow.
Permissive Hypercapnia (PHY)
- Permissive Hypercapnia allows for a pH of 7.10-7.30.
Pressure Volume Loop "Fish Tail"
- A fish tail on a pressure volume loop indicates an assisted breath.
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