Anesthesia Machine 2 Flashcards
(41 cards)
What are the 7 Common Ventilator Settings
- Tidal Volume (Vt)
- Respiratory Rate (RR)
- Peak Inspiratory Pressure (PIP) or Pmax
- Positive End Expiratory Pressure (PEEP)
- Continuous Positive Airway Pressure (CPAP)
- Inspiratory:Expiratory (I:E) ratio
- Inspiratory time (Ti)
This is the lung volume representing the normal volume of air displaced between normal inhalation and exhalation when extra effort is not applied.
tidal volume
What is the traditional normal tidal volume for a patient?
5-10mL/kg
What is the new normal tidal volume for a patient?
6-8mL/kg and to supplement with higher respiratory rates
Whenever we breathe for patients and force air into their lungs, it generates ______ inside the lungs
pressure
Is the pressure generated inside a patient’s lungs DIRECTLY PROPORTIONAL OR INVERSELY PROPORTIONAL to how much volume we deliver when we give the breath
DIRECTLY PROPORTIONAL
higher tidal volumes will generate ______ inspiratory pressure
higher
Using the RR, what is the equation to find how many seconds each breath takes?
**60sec/RR
–ex. RR=12
length of breaths is
60/12 =5secs
If the respiratory rate is slower, each breath will be _____?
longer
The inspiratory time will be longer if ___?
the RR is slower
ie. the breaths are longer
What do we not generate when the inspiratory time is longer and we breath for the patient?
as high of a pressure inside the lungs…..because we’re delivering the breath over a longer period and aren’t forcing the breath in as fast
The faster the respiratory rate, the _____ each breath (and the ____ the inspiratory time) will be
shorter
When do we generate a higher pressure inside the lungs when we breath for patients because we’re delivering the breath over a shorter period and are forcing the breath in faster
When the inspratory time is shorter
What is PIP or Pmax?
This is the maximum amount of pressure you’re willing to give in order to expand a patient’s lungs with a ventilator breath
What pressure should anesthetists should stay under on intubated patients in order to avoid barotrauma?
35-40cmH2O
8 Common Causes Of High Peak Inspiratory Pressure
- Right mainstem intubation
- bonchoconstriction/bronchospasm
- Coughing/bucking while on the ventilator
- Trendelenburg
- Insufflation pressure from laparoscopic surgery
- Increased resistance through the endotracheal tube
- Too high of a tidal volume
- Too fast of a respiratory rate (too short of an inspiratory time)
What is the first sign of right mainstem intubation is elevated peak inspiratory pressure
Right mainstem intubation
What does delivering a breath through a smaller diameter generate?
a higher inspiratory pressure
What are some things you could do to decrease the inspiratory pressure during Bronchoconstriction/bronchospasm?
give more propofol because pt may be too lightly anesthetized or albuterol
Besides Bronchoconstriction/bronchospasm, what else can be caused from the pt being too lightly anesthetized that will increase PIP?
Coughing/bucking while on the ventilator
If patients are coughing/bucking while on the ventilator, what else could they experiencing?
bronchospasm
What position creates resistance to diaphragm expansion, due to gravity and all of the abdominal contents pressing against the diaphragm?
Trendelenburg
What can cause Increased resistance through the endotracheal tube?
- muscus plug
- smaller diameter of ETT
- kinked ETT
If your patient will be in Trendelenburg position for a surgery, what size ETT should you use and why?
A larger diameter because it creates less resistance and thus less PIP in the lungs since the patient will already have increased PIP from their positioning.
