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Interventions 1 (RESP 266) > Module 3 Manual Ventilation > Flashcards

Module 3 Manual Ventilation Flashcards

1
Q

What is VAP?

A

A acquired disease from a ventilator

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2
Q

How do we know the tubes/lines are in the right place?

A

If the chest or stomach rises

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3
Q

Why would you push against the cicrothryoid ligament?

A

to collapse the esophagus

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4
Q

What indicator is there when the endotrachial tube is too deep?

A

The right lung/side rises more than the left.

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5
Q

Why do you want to keep 5cm of PEEP?

A

To keep lungs/airways/alveoli open.

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6
Q

3 important factors for humidity

Edit

A
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7
Q

BLS Basics

A
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8
Q

2 types of respiratory failure

A

Type 1: oxygenation
Type 2: ventilation

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9
Q

6 Procedure steps when bagging (the process)

A

Assess…alertness
Position
Assess…airway for patency
Consider…oral or nasal airway
Bag
Consider…intubation

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10
Q

Which inhalers are short acting and which reduce inflammation

A

Ventolin (open airways)

flovent falls into the beta agonist group (corticosteroid) to reduce inflammation

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11
Q

VSD vs Asthma…when can a person be taken off of puffers (for VSD)

A

Vocal chords shut causing us to hear strider

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12
Q

what can help elevate a exasbaration (sob) when there is CHF

A

CPAP can help relieve exasbaration temporarily so that we can figure out what is happening.

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13
Q

Causes for: (7)
Hypoxemia Respiratory Failure Type 1

A

When things block oxygen from getting to blood.

  1. V/Q mismatch
  2. Shunt
  3. Alveolar Hypoventilation
  4. Diffusion Impairment
    5 Perfusion/diffusion impairment
  5. Decreased inspired O2
  6. Venous admixture
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14
Q

Cause of:
Hypercapnic Respiratory failure (Type II)

A

Impaired Resp. Control
Neurological disease
Increase WOB

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15
Q

5 Therapy/treatment for Type 1 heart failure?

What are the most effective

A

Increasing FiO2 and PEEP are the most effective therapy methods.

FiO2 increases MAP - how does PEEP get involved?

TLDR; oxygenation

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16
Q

Treatment/therapy methods for Type 2 Failure?

A

you manage MV - manipulate rate or Vt.

Vt
Rate
MV
pH
PaCO2

TLDR: Ventilation

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17
Q

Peak pressure must not exceed
(refer to slide 29)

A

30mmhg
what about Vt? (5-8)
humidity (no greater than 37)

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18
Q

MR. SOPA mnemonic

A

M - mask
R - reposition
S - suction
O - obstruction
P - pressure
A - airway equipment

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19
Q

PaCO2 greater than what value indicates that the patient needs ventilatory support ?

A

55

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20
Q

Inadequate lung expansion value for Vt?

A

less than 5

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21
Q

Inadequate lung expansion value for vital capacity

A

less than 10

Normal vital capacity = 65-75

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22
Q

Inadequate lung expansion value for RR?

A

greater than 35

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23
Q

Inadequate muscle strength that indicates ventilatory support

edit later

A

-Increased WOB

-Maximum inspiratory pressure (MIP) greater than or equal to -20 (its normally a small number)

VC is needed for a good cough

-Normal VD = 2.2 ml/Kg

Minute ventilation (MV) = 100m x Kg increase due to amount of deadspace ventilation (swapping the use of negative pressure to positive pressure bc forcing air in)

Vt = 5-8ml/kg
= 6 (80 (bw)) = 480ml
= 8000/480ml = RR
->8000 = Mv (100 * kg)

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24
Q

MV is equal to what?

Aka how do you calculate

A

Vt x RR?

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25
Q

Respiratory failure is a life threatening impairment of Oxygenation, CO2 elimination, or both.

What is it caused by (usually)?

A

Impaired gas exchange

Decreased ventilation

or both

26
Q

Symptoms of respiratory failure?

A

(add dx and tx later)

27
Q

Situations requiring airway control: emergencies

A
28
Q

Situations requiring airway control: urgencies

A
29
Q

What is the purpose of the Sniffling position?

A

Open airways

30
Q

why is PEEP (on cpap) helpful for someone with CHF

A

helps push fluid out of the lungs
-decreases the amount of fluid that backs up into the heart because of the changes in pressure

31
Q

Crackles is a indicator of what?

A

Fluid in the lungs (or consolidation)

32
Q

Suction pressure for Adults, Children, and infants?

A

Adult: 120-160

Children: 100-120

Infants: 80-100

33
Q

Indicators for a partial obstruction

A

wob, strider, and snoring

34
Q

Contraindications for OPA use

A

Conscious or semiconscious patient
-gag reflex (opa)
-vomiting
-laryngeal spasm
-trauma to oral cavity (OPA)
-trauma to mandibular or maxillary areas of the skull

35
Q

What does the acronym RODS tell us?

A

Difficult supraglottic device placement

R: restricted mouth opening
O: Obstruction (at or below glottis)
D: distorted/ displaced airway radiation/ trauma
S: stiff lungs,chest,neck etc.

36
Q

what are some functions of oral pharyngeal airways (opa)

A

Relieving a soft tissue obstruction

facilitate sunction

prevents patient biting on the tube

37
Q

Advantages of NPAs over OPAs?

A

patients are less likely to gag

oral care on the patient is viable (like intubation)

more comfortable via nose

38
Q

How does sizing work for NPAs?

A

Tip of the nose to the tragus (ear)

39
Q

What does the acronym MOANS indicate?

A

how hard it is to bag someone

40
Q

MOANS acronym?

A

M: Mask seal
O: Obstruction/obesity
A: Age
N: No teeth
S: stiffness of snores

41
Q

What does the acronym bones measure?

A

difficulty to bag a person

42
Q

Safety checks for the bagger

A

The reservoir inflates

If the valve moves

If it holds pressure

Does the bag re-inflate

43
Q

What is a LMA?

A

Laryngeal mask airway

edit refer to slide 60 on insertion

44
Q

Why would LMA be used before a endotracheal tube?

A

if you can’t get it in, or…

LMAS are more secure than an endotracheal tube.

45
Q

Advantages of Laryngeal masks

A

easy to insert

no special equipment

46
Q

Disadvantages of Laryngeal mask?

A

short term use

danger of aspiration (if they vomit it could go into their lungs)

Low ventilation pressures only

Not used on conscious or semi conscious patients due to gag reflex

47
Q

Key points Manual ventilation: O2 delivery?

Edit

A
48
Q

Key points Manual ventilation: Rate?

Edit

A
49
Q

Key points Manual ventilation: volume?

Edit

A
50
Q

What would you do when there is low SpO2 but adequate chest rise?

A

Consider using PEEP
-+5 cmH2O

Increases the amount of time held under pressure aka inspiratory time.

51
Q

what does Positive pressure ventilation cause when minute ventilation (MV) is low?

A

Increase deadspace.

You want to keep MV high.

52
Q

why would you intubate someone?

A

They can’t breath on their own (poor ventilation)

or

They have too many secretions that they can’t get out on their own (blockage)

53
Q

Assessment of pt after suction (outcomes)

A

Improved breath sounds

Removal of secretions

Increase SpO2

Decreased WOB

monitor pt for changes

54
Q

What is type I resp. failure?

A

Hypoxemic resp. failure where oxygenation fails, causes could be:

-V/Q mismatch
-Shunt
-Alveolar hypoventilation
-perfusion/diffusion impairment
-decreased inspired O2
-venous admixture

55
Q

What is type II failure?

A

hypercapnic resp. failure, causes could be:

-Impaired resp. control
-Neurologic disease
-Increased WOB

56
Q

Key concepts that affect oxygenation (type I failure)

A

FiO2
PEEP
MAP
PaO2
(one more but slide cut if off, check later)

57
Q

Factors that affect ventilation (type II failure)?

A

Vt
Rate
MV
pH
PaCO2

58
Q

Indications to clear upper airways (suction)?

A

Auscultation -> crackles

Visual WOB
-Accessory muscle use
-indrawing
-Stridor
-heart failure
-RR

59
Q

What do you want to improve from suction?

A

O2 saturation
Color and perfusion
effective cough

60
Q

Suction settings (vacuum pressures) for adults?

A

120-160 mmHg

61
Q

Suction settings (vacuum pressures) for children?

A

100-120mmHg

62
Q

Suction settings (vacuum pressures) for infants?

A

80-100 mmHg

Interventions 1 (RESP 266) (16 decks)

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