Modes of Ventilation

Question 1

Continuous Mandatory Ventilation (CMV) modes

Answer 1

Assist Control (AC) includes Pressure Controlled (PC), or
Volume Controlled (VC) ventilation.

Question 2

Pressure controlled ventilation is

Answer 2

when a patient has a pressure setting on the ventilator and when the ventilator cycles a breath the pressure will continue to rise on the ventilator until the pre-set pressure limit is reached.

Question 3

With Pressure controlled ventilation, When the pressure setting is reached the

Answer 3

ventilator will then cycle off and the patient will then exhale.

Question 4

With pressure controlled ventilation, How much the patient’s tidal volume is

Answer 4

determined on how high the pressure limit is set.

Question 5

If the lungs are stiff or non-compliant the pressure will build

Answer 5

more slowly and the inspiratory time will have to be adjusted to accommodate the need of the patient.

Question 6

A longer inspiratory time will allow the

Answer 6

patient to obtain a full tidal volume with each breath.

Question 7

If the lungs are very pliable such as a

patient with

Answer 7

COPD a shorter inspiratory time will be needed because the lungs will inflate very quickly.

Question 8

Inspiratory time on the ventilator is a

Answer 8

critical factor when using pressure control ventilation.

Question 9

Although inspiratory time can be
controlled with its own setting on the vent
most of time

Answer 9

it is determined by the

dialed in rate set on the ventilator.

Question 10

Usually the inspiratory/expiratory ratio for ventilator patients is .

Answer 10

1:2

Question 11

A patient with a rate of 10 breaths per minute would be

allowed

Answer 11

6 seconds for a cycled breath which would contain 2 seconds for inspiration and 4 seconds for expiration.

Question 12

Volume Controlled ventilation is exactly as

it sounds. what is it?

Answer 12

A pre-determined volume is dialed in and every time the ventilator cycles on the patient receives that tidal
volume.

Question 13

For Volume controlled, Inspiratory time is

Answer 13

also a factor with volume control but not as critical when using pressure control.

Question 14

These modes are classified as control

modes because they do

Answer 14

100% of the work

for the patients while on the ventilator.

Question 15

Controlled mode: These modes

Answer 15

are the most efficient for the patient in complete respiratory failure.

Question 16

Triggering a breath in AC can be achieved by

Answer 16

Pressure trigger

Timed trigger

Question 17

Pressure trigger

Answer 17

Pressure triggering for the patient is achieved by
either flow or negative pressure against the endotracheal tube to initiate the breath supplied
by the machine.

Question 18

Timed trigger

Answer 18

The breath is given at a set time according to what the rate of the machine is, such as a rate of 10 breaths a minute means every 6 seconds a breath is initiated by the machine

Question 19

AC: Patients that are

Answer 19

sedated, paralyzed or need to rest will need to be in this mode for proper ventilation.

Question 20

AC This mode

Answer 20

allows the patient’s breathing to be “controlled”.

Question 21

AC If the patient begins to actively participate

in breathing this mode will

Answer 21

become less effective and could lead to the patient

over breathing.

Question 22

AC mode will give the.

Answer 22

full tidal volume of the breath every time it is triggered

Question 23

in AC mode, If the tidal volume is set for 500 ml for each breath the waking patient will get
This can lead to

Answer 23

500 ml of air with each triggered breath. Can lead to “air trapping”. Air trapping results when the lungs can not fully expel the air before another breath is
initiated.

Question 24

In AC mode, If the patients rate increase from 10 to 15

breaths per minute due to p

Answer 24

Possible poor sedation the patient has drastically

changed his I:E ratio which will accommodate air trapping.

Question 25

In AC If the patient is

Answer 25

waking up then the mode of ventilation should change from assist control to SIMV

Question 26

SIMV (Synchronized Intermittent Mandatory Ventilation) is

Answer 26

the most common mode of ventilation used for conscious patients who don’t require 100% of the work being done for them.

Question 27

SIMV This mode allow the patient to

Answer 27

breathe on their own between the set rate of breaths

given by the machine

Question 28

SIMV If the patient has a ventilator rate of 10
breaths a minute and the patient is able
to spontaneously breathe on his own

Answer 28

he can take small breaths between the cycles of the ventilator.

Question 29

In SIMV, once the patient start taking breaths The machine will

Answer 29

sense the patient’s effort and will time the next breath around the patient’s effort thus preventing air
trapping.

Question 30

SIMV The patient is not

Answer 30

forced a pre-set tidal volume and can have a small one of it’s own.

Question 31

SIMV This can also decrease the anxiety of the

patient

Answer 31

by not forcing a full breath on him each time he tries to breathe on his own

Question 32

If a patient is successful in the SIMV

Answer 32

mode he may then be placed on CPAP.

Question 33

CPAP (Continuous Positive Airway Pressure) this mode of ventilation uses

Answer 33

pressure support and peep to allow the patient to

spontaneously breathe on his own without any mechanical breaths being given.

Question 34

CPAP If a patient in this mode can maintain his

own respiratory effort without excess work,

Answer 34

if the ABG’s are good, and the patient has good respiratory mechanics then extubation is at
hand.

Question 35

Alveolar pressure (PA) highest in which lung zones

Answer 35

1

Question 36

Sum of all volume in one minute

Answer 36

minute volume

Question 37

Most common used in the OR is

Answer 37

Volume control

Question 38

1st respiratory muscle to recover NMB

Answer 38

Diaphragm

Question 39

“if surgeon saying patient is tight”

Answer 39

Check TOF

NMB wearing off.

Question 40

First sense to return

Answer 40

Hearing