Intesive care, intensive care rehab, mechanical ventilation, positive pressure Flashcards Preview

Physiotherapy, Cardiorespiratory > Intesive care, intensive care rehab, mechanical ventilation, positive pressure > Flashcards

Flashcards in Intesive care, intensive care rehab, mechanical ventilation, positive pressure Deck (28)
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positive ventilation

bowels law fialure, key forms of positive venitlation. invasive ventilation and non invasive, (BIPAP)


In picture there is:

haemofiltration machine
sering drivers
screen for patient info
a lines
drip stands
patient observation machines
tubing wiring


levels of care

three levels of patients we have in hospitals:
level 2 - cardiac patients, HDU style stuff, regular observations but not in multisystem failure. may needmechanical ventiliation
level 3 - at least 2 organ systems failing, RER? These patients need machanical ventilation .





why you need mechanical ventilation?

fatigue from beingin type 1 for a long time, breathing fast for long time
altered drive - drug over dose, alcohol
peri operatively - for major surgery


type of eg tubes

goes into the airway
can be nasal intubation thoguh trachea, goes below vocal chords whcih means they cant speak
inflate cuff to keep it safe.
dont want it to go too far down into the bronchus
careful when moving ptient with a tube


mechanical venitlation principles

positive pressure
type 1 and 2 resp failure.
watch vid on mech vent








aims of mechnical ventialtion

dxdbv mv=


presreu control vs volime control

volumedependant on complaince...
you can set one but you ned to check the other one


ventilation mode

SIMV - ocntrol them completly
bilevel - two pressures, set a pressure so doesnt go all the way down to 0
PEEP - not letting them breath all the way out
Trigger - set trigger low, so patient can breaht if they want to
Pressure support
Rise time

** look at notes below slides


ventilation strategies

hypervenitltion to help with brin swelling

**again lok at notes below slides on powerpoint


extubation and weaning

pressure support - everytime they take a breath the ventilatier will support them but gradually reduce that support and peep (lowest peep of 5). then just give them peep during insp and exp and gradually wean og the peep support so patient can breath on their own.

** find lecture recording for this as explanation isnt good



difficutl - may not be awake
prolonged - like covid patients that are very weak, resp and also their muscles very weak


subjective markers

are they awake?


objective markers

maximal insp pressure mip
use them to help us judge if someone is extubational or not? PCF main one


key predictors

pcf main one. as long as great than 60lpm, if less then theyll fail extubtation.
if not meeting all these markers than their 80% of failing


problem patients

more complex patients.
these things (on the slide) that make things like weaning more difficult


weaning, what is it? reasoning

look up
its a physio thing to do



icu required weakness
these notes are befreo covid so will be more icu patients affected - see in notes


muscle mass

muscle waste. icu rehab is alot on muscle mass. in order to wean patients we need that msucle mass. think about the covid patients in icu since christmas- lots of loss of mass



cip cim cinm
shows your weak presentation of muscles. so you can,



over time muscle mass will improve. muscle takes time to regenerate, need or icu follow up to check this regeneration of muscle mass


reaseach around it and evidence of icu rehab - it is very safe. treatment - photos

see and make notes on the other slides she missed.



if surgical patints check patient check fluid balance and so on then sedate them agin. if they respnd an can do all tests plus neuro tests then start the weaning process.


words to search up

delerium. benzos
type of sedations. oonly sedate patient enough to be in sinc with ventilator


make sure your clear on weaning
levels of pressure Peep breaathing half the way out then breath in again to allowing the aveoli to stay big and increase gas exchange, peep also help lung volume to increase functional risiudal capactiy. cpap, bipap

two pressure:
breathing to hlp co2
and breathing to help lung volume

when lungs collapse down - in order to get air in we do the sniffs and hold to rerecrute lungs
Peep is to stop is going all the way to 0 so its easier to
so not letting it collapse then re open then collpase again and re open, instead it stays almost open so its easier for gas exchange.

text book and look up

understaning some bsics is all you need for placements as they will expalin and ooking at the ventilators helps but make sure yuo know a bit

mechanical vent is bad
endo tube so need suction
if you do ventiat you can either control vent or volume, which ever you dontcontrol you check
PEEP and CPAP are the same and this will help them wean and get off ventilation.
there are non invasive modes

speaking valves