Mech Ventilation

Question 1

(VE) Minute ventilation Range?

Answer 1

4-8 LPM
It’s a measurement of the volume of inhaled and exhaled air over 60 seconds. A typical adult VE ranges around 4 to 6 liters in 60 seconds.

Question 2

What is the starting Vt range?
What is the lung protective range?

Answer 2

6-8 Ml/Kg
4-6 Ml/Kg

Question 3

What is an obstructive lung patient?
What is the obstructive approach when placing a patient with an obstructive lung on a ventilator?

Answer 3

A patient with a history of Asthma, COPD,
Optimize the exhalation process by placing the I:E at 1:4 longer exhale and a rate of 10-12 Start start Vt at 6-8 ml/kg

Question 4

The injury approach is defined as?

Answer 4

Any patient needing to be placed on a ventilator that is outside the Obstructive lung category.
set the rate at 16 BPM Start Vt at 4-6 ml/kg due to injury.

Question 5

What is the normal minute ventilation formula?

Answer 5

60ml X Kg X min
amount of air that moves in and out of the lungs in one min.

Question 6

What is Vte

Answer 6

Exhaled tidal volume

Question 7

How do you calculate expected medchinal dead space?
Adult?
Pedi?

Answer 7

Adult 2ml x PIP= mechanical dead space.
PEDI= 1ML x PIP

Question 8

Your PIP is 20 what is your mechanical dead space for an adult?

Answer 8

20 x 2= 40 ML
Then subtract 40 from your VT and that = your true Vt, make adjustments as needed

Question 9

Most ventilations only deliver 50ml Vt for pediatric patients. What do you do when your calculation requires VT below 50mls for a pediatric patient?

Answer 9

Switch to pressure ventilation

Question 10

Is PIP refers to upper or lower airways?

Answer 10

PIP refers to the pressure in the upper airways and Pplat refers to the pressure in the lower airways.

Question 11

What are some causes of increased PIP?

Answer 11

upper airway obstruction
kinked tube
Patient triggering
poor sedation Asthma
COPD

Question 12

What are some causes of increased Pplat?

Answer 12

ARDS
Trendelenburg
tension pneumothorax
pregnancy
pulmonary edema
Plural effusion

Question 13

your patient is an ARDS patient of 80 Kg and was placed on a vent at 6 ml/Kg what is the Vt.
Your patient’s PIP then increases to PIP 40 Pplat 38. what is your next move?

Answer 13

480Vt
ARDS place on lung protection mode with a Vt of 4-6 ml/Kg which decreases Vt. try to bring PIP and Pplat down If you have to go below 4 lm/kg then you have to switch to Pressure control mode

Question 14

When should you clamp the ET tube?

Answer 14

On inhalation to prevent loosing PEEP. Then switch to your ventilator

Question 15

What should you keep your PIP and Pplat pressures be?

Answer 15

PIP 35
Pplat 35

Question 16

In driving pressure for ARDS you should decrease Vt and increase PEEP T/F

Answer 16

T

Question 17

What type of ventilator mode allows the patient to activate a breath and the ventilator gives a full preset Vt, has no pressure support, and can be triggered by vibration and movement?

Answer 17

AC= assist support

Question 18

Describe SIMV ventilator mode.

Answer 18

Delivers a preset Vt and RR has pressure support and allows the spontaneous breathing patient to take a breath and delivers what the patient wants.

Question 19

Any patent outside COPD or Asthma is considered an injury approach? T/F

Answer 19

True

Question 20

What is hypoxic respiratory failure?
How do you fix it on a ventilator?

Answer 20

Hypoxemic respiratory failure means you don’t have enough OXYGEN in your blood, but your carbon dioxide levels are close to normal.
B) Increase Fio2 and PEEP assuming VT is correct. Rate and volume have no effect on this type of PT.

Question 21

What is Hypercarbic Respiratory Failure?
How do you fix it on a Vent?

Answer 21

Inability to remove CO2 Increased CO2 will be seen.
Treatment: increase Vt Then Rate.