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mechanical vent > ch 3 how a breath is delivered > Flashcards

ch 3 how a breath is delivered Flashcards

1
Q

During mechanical ventilation what are the two forces (pressures) that act on the respiratory system to produce transrespiratory pressure?

A
  • muscle pressure

- ventilator pressure

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2
Q

what are the 4 control variables?

A
  • pressure
  • volume
  • flow
  • time
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3
Q

the amount of volume delivered will depend on compliance and resistance to what?

A

gas flow

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4
Q

what is the Rhorer equation of motion?

A

Pmus + Ptr = V/C + (Raw x flow)

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5
Q

there are only 2 pressures that can ventilate a patient what are they?

A
  • patients muscles

- ventilator

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6
Q

The delivery of__________ is a ventilators single most important function?

A

inspiration

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7
Q

this is the primary variable that the ventilator manipulates to cause inspiration?

A

control variable

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8
Q

the volume and flow waveforms are constant pressure varies with changes in compliance and resistance?

A

volume control

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9
Q

what are 3 names used for volume ventilation?

A
  • volume targeted
  • volume controlled
  • volume limited
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10
Q

what control is used in A/C and SIMV?

A

volume ventilation

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11
Q

pressure delivered constant, volume and flow vary with changes in compliance and resistance?

A

pressure control

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12
Q

what are 3 names used for pressure ventilation?

A
  • pressure targeted
  • pressure controlled
  • pressure limited
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13
Q

pressure waveform will be unaffected by changes in compliance and resistance. The flow and volume waveforms change with comp/resist?

A

pressure controlled breath

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14
Q

what control are we in if flow usually starts out high and then tapers off?

A

pressure ventilation

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15
Q

high gas flows produce uneven distribution of gases. “slow spaces” are underventiated. at end inspiration what flows tend to ventilate better? what should the flow patter look like?

A
  • reduced flows

- decelerating

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16
Q

what is the flow control formula?

A

flow= volume / time
or
volume= flow x time

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17
Q

if changes in comp/resist do not affect volume waveform they will not effect______ waveform?

A

flow

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18
Q

when both pressure and volume waveforms are affected by changes in lung characteristics the ventilator is _______controlled?

A

time

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19
Q

many high frequency jet and oscillators are ____controlled?

A

time

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20
Q

what are the 4 basic shaped for waveforms?

A
  • rectangular (square or constant)
  • exponential (increasing ((rising)) or decreasing((decaying))
  • sinusoidal (sine)
  • Ramp (ascending, descending) ((decelerating))
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21
Q

start of breath, initiation

A

trigger

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22
Q

what is controlled during breathing. Inspiration itself. one of the 4 phases of CMV

A

limit variable

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23
Q

what terminates breath, end of breath?

A

cycle

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24
Q

expiratory phase goes to what?

A

baseline

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25
Q

what begins or triggers inspiration?

A
  • patient

- machine (time)

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26
Q

ventilator begins itself, machine is insensitive to patients efforts, rate of breathing controlled by the machine?

A

“machine” time triggered

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27
Q

if a rate was set at 12 breaths per minute how many seconds in between breaths?

A

5 sec

60/12

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28
Q

determines the amount of effort when a patient triggers?

A

sensitivity

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29
Q

how fast the machine responds. usually at 0.08 seconds. cannot be adjusted?

A

response time

30
Q

machine begins inspiration when patient starts to inspire and removes a small amount of volume from the circuit which creates negative pressure?
there will be a drop below baseline

A

-pressure triggered (assist)

31
Q

breaths may not occur at equal, timed intervals

A

(assist) pressure control

32
Q

a patient has a baseline of 10cmH20 the sensitivity is set at -2cmH20 at what pressure will the ventilator sense a patient effort and start inspiration?

A

8 from base line

33
Q

a continuous supply of low level flow is delivered past the patient during expiration is known as what trigger?

A

flow trigger (flow-by)

34
Q

flow measuring devices are positioned at inlet and outlet side of circuit to compare flow. ________ triggering occurs when the net difference reaches a pre-selected level.

A

flow

35
Q

patient has access to continuous flow during “response time” which lowers work of breathing what trigger is this?

A

flow triggered

36
Q

for flow trigger the base flow must be at least twice the _____ flow

A

trigger

37
Q

flow triggering can cause _______breaths due to leaks or movement caused by turbulent gas flow through circuit

A

spurious (auto trigger)

38
Q

what does bias flow mean?

A

constant flow through machine

39
Q

don’t forget to look over important slide on page

A

11 of power point slide

40
Q

the machine cycles when a preset volume has been removed from the circuit. what are 2 machines that have this cycle capability? (volume cylcle)

A
  • dragger babylog

- cardiopulmonary ventrui

41
Q

a ______ button on the machine, when pushed, will initiate a positive pressure breath?

A

manual

42
Q

one of the four physical parameters that can be reached but not exceed during a breath?

A

limits of ventilation

43
Q

reaching a limit does not _____ the breath?

A

end

44
Q

the volume is held in the airway until a pre-set time, then time will end the breath

A

volume limited

45
Q

the machine signal the i -time display and will not permit patient to trigger a breath till a set time

A

time limited

46
Q

what is a example of a ventilator that is time limited?

A

bear cub

47
Q

during PSV and PCV the pressure is increased to pre-set level at the beginning of inspiration and is held at the airway until the breath ends is known as ?

A

pressure limit

48
Q

can be used as a pressure pop-off to limit the amount of pressure in the airway but if reached will not terminate the breath is know as what?

A

pressure limit

49
Q

what is a example of a pressure limit ventilator ?

A

NC humidifier

50
Q

what is more comfortable of a patient pressure control or volume control?

A

pressure control because patient gets to pick there breath

51
Q

vents begin inspiration( pressure limit) and achieve the set pressure as quickly as possible, this can cause discomfort in patients. what is the setting in ventilators that allow a more gradual rise?

A

rise time (PRAMP)

52
Q

if you lengthen the rise time (Pramp) what will go away if pressure is to fast?

A

spike

53
Q

if your rise time (Pramp) is too high what could happen?

A

patient will not receive a full lung volume before E time kicks in.

54
Q

what is statics asthmatics

A

have trouble exhaling

55
Q

decrease flow by decreasing the _____ _______?

A

pressure gradient

56
Q

if flow reaches a constant value before the end of inspiration then the ventilator is considered what?

A

flow limited

57
Q

prevent excessive pressure from going to the patient. If this control also ends inspiration the ventilator is considered to be _____ _______

A

pressure cycled

58
Q

if the ventilator limits the amount of pressure that can be delivered to the patient but does not end the breath only limits more pressure from being applied is considered what?

A

pressure limited

59
Q

what I:E ratios are best to set a patient on?

A

1:2 or 1:3

60
Q

what is the pause, plateau or inflation hold used?

A
  • therapeutically

- diagnostically

61
Q

what parameter is responsible for terminating the breath for a single breath?

A

cycle parameter

62
Q

volume delivered from machine is not all entering patients lungs. Positive pressure expands circuit and some of the gas is used up is known as ?

A

tubing compressibility

63
Q

most circuits have how many mL/cmH20 lost to tubing compressibility?

A

3-4 mL/cmH20 more volume will be lost at higher pressures

64
Q

if a vent is volume cycled it will continue to cycle even though it may be disconnected from the ventilator is known as a ________?

A

system leak

65
Q

exception: if vents driving pressure is _____then it may lose volume at high pressure

A

low

66
Q

what cycle would a patient be in if there end inspiration reaches 25% of peak flow?

A

flow cycle

67
Q

if in this mode careful monitoring of waveforms is required?

A

flow cycled

68
Q

machine starts breath, and machine controls and ends the breath. vent does all the work?

A

mandatory breaths

69
Q

patient starts the breath, and machine controls and ends the breath?

A

assisted breath

70
Q

patient starts the breath, patient controls and ends the breath. Machine augments breath?

A

spontaneous breath

mechanical vent (4 decks)

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