Flashcards in 3. Roecker - Ventilation Devices Deck (39)
When is ventilation used?
Acute respiratory failure
Adjuncts to other therapies or diagnostic procedures to avoid complications
What are the two categories of acute respiratory failure?
1. Hypoxemic - O2 sats is 50mmHg
What are the 3 goals of therapy of acute respiratory failure?
1. Decrease metabolic burden of breathing
2. Prevent respiratory muscles fatigue
3. Keep patient alive
What are 5 causes of hypoxemic respiratory failure?
1. Acute respiratory distress syndrome
2. Heart failure w/ pulmonary edema
3. Infections causes
4. Procedure complications
What are 3 causes of hypercarbic respiratory failure
2. COPD exacerbations
3. Neuromuscular diseases
Ventilation is adjunctive therapy for...
1. Increased intracranial pressure
3. Gastric lavage
4. Prevention of respiratory failure during critical illness
When is non-invasive ventilation used?
1. Effective in pts w/ COPD exacerbations
2. Complications of pneumonia or tracheolaryngeal trauma avoided
What are 4 contraindications of non-invasive ventilation?
1. Cardiac/respiratory arrest
2. Severe encephalopathy
3. Hemodynamic instability
4. High-risk for aspiration
When is a pocket mask used?
For mouth to mouth resuscitation in non-breathing patients in a code situation
When is a bag-valve mask used?
To provide oxygen/air to non-breathing patient in a code situation
The squeeze bag to give air to an unresponsive pt
What are the 2 airway adjuncts? What is their purpose?
1. Oropharyngeal airway (OPA)
2. Nasopharyngeal airway (NPA)
Opens the airway to get air down to lungs, does not involve putting a tube down the pts throat
What dose an oropharyngeal airway do?
Keeps tongue out of the way and gets air down to the lungs
What does the nasopharyngeal airway do?
Goes up though the nose, then down though the nasal passage to get air in the body
What are the 4 advanced airways?
1. Laryngeal mask airway
3. Endotracheal tube
4. Tracheostomy tube
What is a laryngeal makes airway?
Inserts to a specific depth and inflate a cuff to isolate air down trachea and not esophagus
What is a combitube?
Two separate tubes, a blind insertion, then inflate both cuffs.
If tube ends up in esophagus, balloon blocks off esophagous
If tube ends up in tranches, good!
What is an endotraceal tube?
Similar to a combitube, but requires visualization of vocal cords with laryngoscope - most commonly seen for pts on long term ventilation.
Think of Grey's Anatomy
What is a tracheostomy tube?
A surgical procedure is needed, bypass the pharynx and then directly ventilate
What kind of air is needed for mechanical ventilation?
Conditioned, warmed, oxygenated, and humidified air
What is the goal of mechanical ventilation?
Optimize oxygenation while avoiding damage to lung tissue, over stretching and ventilation-induced lung injury
How is total volume used in ventilation?
Size of each ventilation, amount of air put into the lungs
What is ventilator rate?
Timing of each ventilating, providing the pt with a respiratory rate
What is FIO2?
Fraction of inspired oxygen; amount of oxygen given to the pt to keep their O2 levels up
What is PEEP level?
Positive end-expiratory pressure - enough pressure to keep lungs open at end of expiration
Used to keep lungs inflated so oxygen exchange can occur in blood
What is I/E ratio?
Inspiratory-to-expiratory time ratio; how much time going in vs how much time going out. Usually 1:2
What is VE?
Minute ventilation - product of tidal volume and ventilator rate
What is ABG?
Acid-blood passes to measure PaO2 and PaCO2
What are the 6 ventilator modes?
1. Assist control (AC)
2. Intermittent mandatory ventilation
3. Pressure support ventilation (PSV)
4. Pressure control ventilation (PCV)
5. Inverse ratio ventilation (IRV)
6. Continuous positive airway pressure (CPAP)
When is mechanical ventilation needed?
When an individual cannot adequately oxygenate with their own respirations