Mayo Protocols A

Question 1

What should you do if you need an AeroNeb set-up for continuous medication delivery?

Answer 1

Call dispatch.

They will also need to know if you want an adult, pediatric, or neonatal set-up.

Question 2

What is dispatch’s phone number at St. Mary’s?

Answer 2

5-5969

Question 3

Aeroneb Continuous delivery: What is the rate of delivery for all meds?

Answer 3

15 ml/hr

Question 4

Can you use a BAN for Pentamidine?

Answer 4

No

Question 5

If heart rate increases by ___ bpm, terminate the breathing treatment.

Answer 5

25

Question 6

Do not fill the aerogen nebulizer more than ___ mL.

Answer 6

6 mL

Question 7

Assess and treat protocol:
0-5 points
Meds given how often?
How often should you re-assess?
What modality should be used?

Answer 7

Q2 PRN or home medication regimen
No re-assessment needed
No modality needed

Question 8

Assess and treat protocol:
6-10 points
Meds given how often?
How often should you re-assess?
What modality should be used?

Answer 8

Meds TID and Q2 PRN
Modality BID and PRN
Re-assess q72 hours with VC

Question 9

Assess and treat protocol
11-15 points
Meds given how often?
How often should you re-assess?
What modality should be used?

Answer 9

Medications QID and Q2PRN
Modality TID and PRN
Re-assess q72 hours

Question 10

Assess and treat protocol
16-20 points
Meds given how often?
How often should you re-assess?
What modality should be used?

Answer 10

Medications Q6 and Q2 PRN
Modality QID and PRN
Re-assess q72 hours with VC

Question 11

Assess and treat protocol
More than 20 points
Meds given how often?
How often should you re-assess?
What modality should be used?

Answer 11

Medications q4 and q2PRN
Modality QID and PRN
Re-assess q24 hrs

Question 12

Rib fracture protocol: What do you need to measure?

Answer 12

FVC and NIF

Question 13

Bedside muscle strength protocol: What do you need to measure?

Answer 13

FVC, NIF, and MEP

Question 14

Rib fracture protocol and bedside muscle strength protocol: How often should you collect data? When should you contact the provider?

Answer 14

Collect every 6 hours even if you have to wake the patient up.
Call provider if FVC is less than 50% of predicted.

Question 15

What are initial vent settings?

Answer 15

SIMV 6-8 ml/kg
12-20 breaths
PEEP 8 cm H2O (May go up to 12)
O2sat to remain greater than 92%
Press Support 5 cm H2O

Question 15

When you start a patient on a ventilator, you must remember to do these two things (Not vent settings)

Answer 15

Keep HOB 30 degrees unless contraindicated

Get an ABG in 20 min

Question 15

To begin weaning the patient from the vent, first check these 5 things (Hemodynamic Status)

Answer 15

Systolic BP >90
Heart rate within 30 BPM from post-operative baseline
Urine output more than 0.5mL/kg/hr
Temp greater than 35.5 degrees
Cardiac index >2.2

Question 15

When weaning a patient from anesthesia, check these three things:

Answer 15

Strong grip bilaterally and/or 5 sec head lift
Patient response to voice
Moves all extremities

Question 15

When weaning a patient with post-operative bleeding or chest tubes, check these three things:

Answer 15

Subcutaneous emphysema
Air leak
Hemoglobin 8g/dL or greater

Question 15

When beginning SBT, set pressure support to maintain a TV between ____ and _____ ml/kg.
Titrate FiO2 to maintain SpO2 __% or greater.

Answer 15

Between 4 and 10

SpO2 92% or greater

Question 15

Extubation criteria for pH

Answer 15

7.32 and 7.5

Question 16

Extubation criteria: PaCO2

Answer 16

Between 30 and 50

Question 17

Extubation criteria: PaO2

Answer 17

Greater than 70 with FiO2 0.5 or less

Question 18

Extubation criteria: Resp rate and TV

Answer 18

8-25

Spont TV greater than 4 mL/kg PBW