Flashcards in Chest treatment in Critical Care Deck (58)
Donning PPE order?
1. hand hygiene
3. mask / respirator
4. eye protection
Doffing PPE order?
1. ensure you are 2 m away from pt before beginning
3. hand hygiene
5. hand hygiene
6. eye protection
7. hand hygiene
8. mask / respirator
9. hand hygiene
3 components of resp ax?
1. pt history
2. physical examination
3. lab tests and investigations
In normal lung, ventilation is best is _______ region
For pt on mechanical ventilation, ventilation is best in ________ region of lungs
non-dependent (air follows path of least resistance)
Perfusion in normal lung is a _____ pressure system and therefore responds more to _____
________ is our best position for V/Q match as it improves overall ventilation
Mechanical ventilation can limit _______ due to high pressures in thorax
______ zone of lung has best V/Q matching
Generally place bad lung ___
up (non-dependent position)
When someone has and epidural, be aware of ___ changes
Who do we prone ?
ARDS or ALI pts
Why we prone: 75% of ARDS pt's have decrease in ____ and increase in PaO2
Why we prone: generally allows for decrease in ___ and ______ levels
Why we prone: generally allows for decrease in ______
4 precautions to proning?
1. hemodynamic instability
2. active intra abdominal process
3. facial or ocular injuries
4. recent sternotomy or abdominal incisions
3 CI's to proning?
1. unstable spina injury
2.uncontrolled cerebral hypertension
3. facial trauma / burns / open chest or abdomen
When proning, head and arm position change every ___ hours, and pt is prone for __-___ hours
Lung volume recruitment techniques produce an ____ breath that is larger than the pt or ventilator delivered TV
3 indications to perform lung volume recruitment technique?
1. acute lobar collapse
2. sputum clearance
3. maintenance lung compliance and thoracic mobility
Lung volume recruitment techniques can be performed only with non-ventilated pts (T/F)
FALSE; ventilated and non ventilated
4 lung volume recruitment technique examples ?
1. breath stacking with an ambu bag +/- a one way valve
2. manual hyperinflation
3. mechanical insufflation / exsufflation machine
4. ventilator hyperinflation
5 CI's to lung volume recruitment techniques?
1. undrained pneumothorax
2. proximal tumor / obstruction
3. unstable head injury
5. recent thoracic sx (unless you have surgeons permission)
Manual hyperinflation is also known as ______
_____ ______ is usually performed on an intubated / ventilated pt to improve lung volumes and assist with secretion clearance
Manual hyperinflation consists of slow _____ phase and a week release stimulating a ____/___
With MHI, O2 flow rate of __-__ L/min is required to prevent rebreathing of CO2
When doing MHI, pt's PEEP on the ventilator should be at __ or below, otherwise opening the circuit could cause excessive de-recruitment
4 pieces of equipment needed for MHI?
2. O2 tubing
3. PEEP value
4. Pressure manometer in the circuit for safety