Flashcards in Mid Term Lab Stuff Deck (32):
What is IPPB?
Intermittent Positive Pressure Breathing
What are the indications of IPPB?
-need to improve lung expansion (only when other devices dont work)
-inability to clear secretions adequately because of pathology that severely limits the ability to ventilate or cough
-short term ventilation
-need to deliver aerosol medications
What are contraindications of IPPB?
-ICP greater than 15mm Hg
-recent facial/oral/skull surgery
What are the hazards and complications of IPPB?
-increased airway resistance (Raw)
-impendence of venous return (cut of blood supply, low BP)
-air trapping, auto-PEEP, over distended alveoli
How does IPPB work?
The patient triggers the IPPB machine by inhaling, pressure and flow move into the pts lungs from the device. When the pressure reaches a preset limit the IPPB machine shuts off and the patient can exhale.
What is the name of one of the IPPB machines?
Bird Mark 7
What are indications for a endotracheal intubation?
-patients where complete obstruction of the airway is imminent (respiratory burns, anaphylaxis)
-inability of the conscious patient to breath adequately
-inability of the unconscious patient to protect their airway (overdose,coma)
What are contraindications for endotracheal intubation?
-severe airway trauma or obstruction that does not permit safe passage of an endotracheal tube.
-cervical spine injury, in which the need for complete immobilization of the cervical spine makes endotracheal difficult
-Mallampati Classification of class III/IV or other determination of potential difficult airways
Side effects of Endotracheal intubation
-accidental intubation of the esophagus
-broken teeth or dentures
-endobronchial intubation, ETT inserted too far
What equipment will you use for endotracheal intubation?
-laryngoscope, curved (Macintosh) or straight (miller) blades, assorted ET tube sizes, 10 cc syringe, water soluble lubricant, securing device, BVM, suction equipment, capnometer, and stethoscope
What is the purpose of the capnometer?
It is used to determine if the ET tube is in the lungs or the esophagus. If it is in the lungs, it will turn yellow and if it is in the esophagus it will be purple.
Assist Control (AC)
-flow controlled during inspiration
Intermittent mandatory ventilation (IMV)
is a combination of periods of control mode and period of spontaneous breathing
Synchronized Intermittent mandatory ventilation (SIMV)
is specific (limited) number of assist control breaths interdispersed with spontaneous breathing
Pressure synchronized intermittent mandatory ventilation (P-SIMV)
is a combination of mechanical and spontaneous breaths. The mechanical breaths are time/patient triggered, pressure limited, and time cycled.
-pressure controlled during inspiration
With in-line suctioning, how long should you pre-oxygenate a patient?
for more than 30 seconds
How long do you have when you have the suction catheter in place?
10-15 seconds to completely withdraw the catheter.
Identify bedside methods of assessing tube placement.
Identify maximum safe cuff pressure.
25-35 cm H2O (20-25 mmHg)
identify the amount of water in mg/L that should be provided by the humidification device.
Identify tube and carnia on the chest x-ray and confirm proper distance between the two.
-tube should be about 2 to 3 cm (4-6cm) about the carina in adults or between the 2nd and 4th tracheal rings.
Describe 2 purposes or uses of the cuff.
to seal the airways for mechanical ventilation or to prevent or minimize aspiration.
Describe the difference between low volume and high volume cuffs. (think about high heel shoe lol)
-increase in volume, decrease in pressure perseveres airway.
-decrease in volume, increase pressure may damage airways
Identify proper gas flow rate for manual resuscitator
-FiO2 100% (flush on the flowmeter)
Identify appropriate vacuum pressure.
80-120 mmHg not to exceed
What are the proper tube size for male and female?
Identify proper suction catheter size appropriate for a variety of endotracheal tube size?
-multiply ET tube inner diameter by 2. then use the next smallest size. (7 X 2 =14, so you would take a 12)
Identify indication for suctioning
-acute respiratory distress syndrome (ARDS)
-inability to cough
-deterioration of O2 saturation or blood gas values.
Identify potential complications associated with suctioning.