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Establishing Need For Vent Flashcards

1
Q

Normal VT range

A

400-700 mL

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2
Q

What mL/kg is considered adequate breathing

A

Greater than 5mL/kg

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3
Q

What respirations are a cause for concern

A

Greater than 35 breaths/min

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4
Q

What are causes of bradypnea

A

Excessive sedation
Anesthesia
Narcotic O.D.
Excessive alcohol
Head trauma
Increase intracranial pressure
Neurologic disease
Hypothermia
Cardiogenic shock

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5
Q

Normal range for a VE

A

5-10L/min

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6
Q

Signs of increased WOB

A

Accessory muscle

Intercostal retractions

Asynchronous CW to diaphragm movement

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7
Q

Disorders/disease that increase WOB

A

Severe pneumonia
ARDS
CHF
Pulmonary Edema
Shock
Trauma
Smoke/chemical inhalation
Aspiration
Near drowning

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8
Q

Early stage of respiratory failure (signs)

A

Increased HR
Increased RR
Increased WOB
Intercostal retractions
Nasal flaring
Diaphoresis
Oxygen Desat

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9
Q

Patient presentation for Late stage respiratory failure (hypoxia)

A

Excitement
Overconfident
Restless
Anxiety
Headache
Shallow breaths
Confused, coma, and tired
Apnea

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10
Q

Signs of severe respiratory failure

A

Slowed/irregular breathing
Reduces chest expansion
Cardiac arrhythmia
Hypotension

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11
Q

Causes of apnea

A

Cardiac arrest
Respiratory arrest
O.D.
Trauma
Cervical spine injury
Neuromuscular disease
Anesthesia

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12
Q

Explain maximum voluntary ventilation

A

Have them maintain ventilation for 12-15 secs

Should ventilate 15-20 times resting minute ventilation

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13
Q

What range should the VC be

A

3-5 liters

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14
Q

What does the maximum inspiratory pressure (MIP) test measure

A

The strength of the muscles of inspiration during forced breathing

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15
Q

What does Negative Inspiratory Force (NIF) test

A

Test normal respiratory muscle function. Usually greater than 60cmH2O

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16
Q

What MVV value indicates ventilatory support

A

Less than or equal to 2(VE)

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17
Q

What vital capacity in mL/kg indicates noninvasive support

A

Less than 20mL/kg

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18
Q

What VC in mL/kg indicates invasive ventilation

A

10-15mL/kg

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19
Q

What NIF value that indicates invasive ventilation

A

Less than 20cmH2O

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20
Q

What does Maximum Expiratory Pressure (MEP) measure

A

Strengths of expiratory muscles

21
Q

Men’s MEP maximal expiratory and inspiratory pressure

A

Expiratory
233-84 cmH2O

Inspiratory
-124 (+or-) 44 cmH2O

22
Q

Women’s MEP maximal expiratory and inspiratory pressure

A

Expiratory
152-54 cmH2O

Inspiratory
-87 (+or-) 32

23
Q

What (MEP) indicates the need for ventilation

A

Near 40 cmH2O

24
Q

Define “acute”

A

Rapid and without warning development of syndromes

25
Parameters of acute respiratory failure
Increase in arterial PaCO2 Decreased pH Bicarbonate in normal range
26
Parameters for Chronic respiratory failure
PaCO2 is elevated pH close to normal Bicarbonate elevated
27
Parameters for Acute on Chronic respiratory failure
PaCO2 is elevated pH is decreased Bicarbonate is elevated
28
How do you treat refractory hypoxemia
Many need CPAP, PEEP or MV
29
Oxygenation problems caused by poor matching of gas and blood
Pulmonary shunt Low ventilation to perfusion ratio Diffusion problem Hypoventilation
30
Common causes of hypoxemic respiratory failure
Atelectasis Pneumonia Pulmonary edema Pulmonary fibrosis ARDS
31
Goals of Mechanical Ventilation
Maintain tissue oxygenation CO2 clearance Supports/replaced the normal ventilatory pump
32
Indications for NIV
At least two of the following: RR>25 Moderate to severe acidosis 7.30-7-25 PaCO2 45-60 mmHg Moderate to severe dyspnea w/ accessory muscle use and paradoxical breathing Beneficial in cardiogenic pulmonary edema
33
From NIV to MV
Respiratory arrest RR>35 or Severe WOB pH< 7.25 or Hypercapnia > 60 mmHg Failure of NIV positive pressure Hyper-somnolence Heart Failure Nausea or Vomiting
34
Indication for mechanical ventilation
Apnea Acute ventilatory failure Impending ventilatory failure Severe O2 problem/ refractory hypoxemia
35
SaO2 wnl
98-95%
36
SaO2 with mild hypoxemia
94-90%
37
SaO2 with moderate hypoxemia
89-75%
38
SaO2 with moderate to severe hypoxemia
84-75
39
SaO2 with very severe hypoxemia
<75
40
How often can you preform NIF
Every half an hour to an hour
41
What makes up the ventilator pump
Nerves controlled by respiratory center in the brain AW Thoracic cage Respiratory muscles
42
Normal SaO2
96-98
43
Mild hypoxemia SaO2
91-95
44
Moderate hypoxemia SaO2
85-90
45
Severe hypoxemia SaO2
75-84
46
Very severe hypoxemia SaO2
<75
47
What order does SaO2 decline in severity
2-4-5-9
48
How do you treat refractory hypoxemia
Moderate to high O2 with PEEP, CPAP or Mechanical ventilation
49

Vent Support (8 decks)

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