10: Common Vent Settings/controls

Question 1

If your patient is in a spontaneous mode of ventilation with no set rate, which alarm would you see if the pt was to stop breathing?

Answer 1

Apnea

Question 2

Which alarm would you see if the ventilator loses medical gas supply

Answer 2

Vent inoperative (A/C)

Question 3

Which modes of ventilation can we support a pt’s spontaneous breathing with pressure support?

Answer 3

PSV SIMV CPAP + PSV

Question 4

Which monitored value would you utilize to assure the preset tidal volume is being delivered to the pt?

Answer 4

Exhaled Vt (end-tidal volume)

Question 5

Which alarm would you monitor during CPAP ventilation to assure preset CPAP pressure is being maintained?

Answer 5

Low pressure alarm

Question 6

What are some possible causes for the low exhaled minute volume (VE) alarm to sound?

Answer 6

Leak/disconnect, pneumo, bradypnea,air trap, asynchronous etc

Question 7

What occurs when the ventilator loses electrical power?

Answer 7

Battery operation alarm use battery backup

Question 8

What would you do if all electrical power to the ventilators in the ICU is lost?

Answer 8

Call sup
Bag

Question 9

After a vent circuit change, where would you discard the vent circuit?

Answer 9

Biohazard/trash

Question 10

Possible causes for the high pressure alarm to sound?

Answer 10

Cough
Kink/occlusion
Water in circuit
Secretions
Bronchospasm
Pneumo
Decreased LC
Increased Raw

Question 11

What value would you be obtaining if you pressed the inspiratory hold button?

Answer 11

Plateau pressure

Question 12

What value would you be obtaining if you pressed the expiratory hold (pause) button

Answer 12

Total PEEP

Question 13

Contraindications for use of HME

Answer 13

Hemoptysis
Copious/thick secretions
Ve <5 or >10
Vte<75%
Hypothermia
Uncorrectable large leak

Question 14

When to perform SST, EST or pre-use check?

Answer 14

Between pt’s
Circuit change
HME -> heated circuit

Question 15

Type of neb best for pt on vent?

Answer 15

Vibrating mesh

Question 16

What should always be done prior to suctioning a pt while on mech ventilation?

Answer 16

Hyperoxygenat/silence alarms

Question 17

What does “air hungry” mean and how to correct problem?

Answer 17

Unable to breathe in sufficient air/dyspnea
Increase flow

Question 18

Reasons for high respiratory rate alarm to sound?

Answer 18

Trigger sensitivity too low
Anxiety/fear/agitation
Pain
Respiratory distress
Tachypnea

Question 19

Pt in PC, what are some possible causes for pt’s exhaled Vt to trend down?

Answer 19

Decreased LC
Increased Raw

Question 20

When to replace a pt’s vent circuit?

Answer 20

PRN/when soiled
Per hospital policy

Question 21

What is high pressure cycling and why could it occur?

Answer 21

When certain pressure reached, vent cycles to exhalation
Asynchronous/cough

Question 22

What valve opens if the ventilator loses or becomes disconnected from gas source

Answer 22

Safety valve -> pt breaths spontaneously room air

Question 23

High minute ventilation alarm should be set at

Answer 23

10-15% above baseline/set

Question 24

Low minute ventilation alarm should be set at

Answer 24

2 L below baseline

Question 25

High RR alarm should be set at

Answer 25

2x set rate

Question 26

Low RR should be set at

Answer 26

2 below set

Question 27

Low Vt alarm should be set at

Answer 27

100-200 ml below set/measured

Question 28

Low peep alarm should be set at

Answer 28

2-3 below set

Question 29

High pressure alarm should be set at

Answer 29

10-15 cmH20 above baseline PIP

Question 30

Low pressure alarm should be set at

Answer 30

5-10 below baseline PIP

Question 31

Cstat = And normal values

Answer 31

Measured Vt / Pplat - PEEP 60-100 (non vented) 40-60 (vented)

Question 32

Cdyn = And NV

Answer 32

Measured Vt / PIP - PEEP 50 -80 (non vented) 30 - 50 (v)

Question 33

Raw = And NV

Answer 33

PIP - plat / flow in L/sec 0.5-2.5

Question 34

How should you dispose of excessive vent circuit condensation form the vent circuit

Answer 34

Away from pt, not back to vent, in trash

Question 35

Vent tubing condensation is considered

Answer 35

Infectious waste

Question 36

You have a pt on active Passover humidification with the temp set at 31C and secretions still thick, how to correct?

Answer 36

Increase temp