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Sp: Methods 1 > 10. Adv Ventilator Modes > Flashcards

10. Adv Ventilator Modes Flashcards

1
Q

assisted breath

A

vent gives breath at BEGINNING of spontaneous breath

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2
Q

assisted breath: pro

A

help pt achieve larger tidal volume

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3
Q

stacked breath

A

vent gives breath:
in MIDDLE of spontaneous breath
or
during EXPIRATION

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4
Q

stacked breaths cause

A

coughing/bucking
overinflated lungs
barotrauma

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5
Q

spontaneously ventilating patients will better tolerate ________ breaths

A

assisted breaths

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6
Q

assist control

A

every spontaneous breath is assisted
ensures minimum respiratory rate is met

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7
Q

during assist control, the AA sets _____

A

minimum respiratory rate

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8
Q

SIMV is similar to

A

volume control
pressure control

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9
Q

is the vent sensing patient breaths in IMV?

A

no

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10
Q

IMV

A

ventilator will deliver a certain number of mechanical breaths per minute, regardless of the pt’s spontaneous rate

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11
Q

SIMV

A

set # of minimum mechanical breaths per second
vent senses spontaneous breaths

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12
Q

SIMV vs IMV

A

SIMV senses breath
IMV does not sense breath

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13
Q

are all breaths assisted in SIMV?

A

no - only the ones that occur at the same time as the mechanical breath

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14
Q

pressure support

A

every single spontaneous breath is assisted

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15
Q

PSV benefits

A

decr work of breathing
larger tidal volumes
decr atelectasis
lowers CI for SV in certain pts

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16
Q

what can you adjust in PSV

A

trigger sensitivity
amount of (+) pressure
min resp rate
PEEP
slope
inspiratory term

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17
Q

trigger sensitivity too low

A

vent wont sense spontaneous breaths

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18
Q

trigger sensitivity too high

A

vent might sense cardiogenic oscillations and may deliver breaths when pt isnt breathing

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19
Q

potential problem with high ventilator sensitivity

A

can make you think the pt is breathing faster than they really areno

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20
Q

normal inspiratory flow

A

15L/min

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21
Q

what will trigger pressure supported breaths

A

small respiratory efforts with low tidal volumes

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22
Q

increase PSV sensitivity

A

decrease trigger L/min
(lower flow)

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23
Q

decrease PSV sensitivity

A

increase trigger L/min (higher flow)

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24
Q

situation to INCR trigger sensitivity (DECR flow)

A

pt recovering from NMB and vent is not picking up spontaneous respirations

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25
situation to DECR trigger sensitivity (INCR flow)
with cardiogenic oscillations during low respiratory rates
26
inspiratory term percentage
how long the vent will support each breath
27
25% inspiratory term
pressure supported breath will be terminated once the inspiratory flow rate decreases to 2.5L/min
28
75% inspiratory term
pressure supported breath will be terminated once the inspiratory flow decreases to 7.5L/min
29
incr inspiratory term %
decr duration of assistance
30
decr inspiratory term %
incr duration of assistance
31
decr inspiratory term % allows for
a larger tidal volume without increasing positive pressure delivered
32
pt that may benefit from decr inspiratory term %
obese pt on LMA
33
mandatory minute ventilation (MMV)
minimum minute ventilation - mechanical breaths delivered if pt is not meeting minimum MV - spontaneous breaths are assited
34
during BiPAP, is the positive pressure higher during inspiration or expiration?
positive pressure is higher during inspiration in order to open the alveoli
35
BiPAP indicaation
atelectasis OSA
36
BiPAP advantages over CPAP (2)
easier exhalation reduces air trapping
37
difference between BiPAP and airway pressure release ventilation
airway pressure release ventilation intermittently stops to allow for complete exhalation
38
what 2 vent modes provide constant CPAP?
BiPAP airway pressure release vent
39
inverse ratio ventilation (IRV)
vent reverses the inspiratory and expiratory times (I>E)
40
IRV advantage
longer inspiratory time incr FRC
41
IRV disadvantage
incomplete exhalation - auto-PEEP does not allow spontaneous breathing
42
High-Frequency Positive Pressure Ventilation (HFPPV)
small tidal volumes 60-120 breaths/min
43
High-Frequency Jet ventilation
small airway cannula 120-600 breaths/min
44
High-Frequency Oscillation
600-3000 breaths/min
45
autoflow ventilation is an adjunct to _______
volume controlled ventilation modes
46
autoflow advantages
-delivers set tidal volume at lowest possible PiP -decr peak airway pressures -pt can breath spontaneous at any time
47
autoflow uses ______ flow to decrease peak airway pressures
decelerating flow
48
the vent is more or less likely to breath against the pts expiration during autoflow?
less likely
49
volume control inspiratory FLOW waveform
square
50
volume control inspiratory PRESSURE waveform
peak pressures + plateau pressure
51
autoflow inspiratory FLOW waveform
decelerating
52
autoflow inspiratory PRESSURE waveform
square
53
active scavenging
hooked up to hospital suctioning system
54
active scavenging disadvantage
vacuum system requires $$$ pipework needle valve requires adjustment
55
passive scavenging advantages
inexpensive simple
56
passive scavenging disadvantages
impractical in some facilities
57
passive scavenging waste gases can be ducted out of
open window pipe to outside wall extractor fan vented to exterior
58
active scavenging should be set to
10-15 L/min
59
charcoal canister advantages
no setup cost mobile
60
charcoal canister disadvantage
continuing replacement cost does not remove N2O

Sp: Methods 1 (15 decks)

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