Ventilator

Question 1

1 cause of iatrogenic death in us

Answer 1

Ventilator acquired pneumonia

Question 2

Hypoxia respiratory failure

Answer 2

Inability to diffuse O2
Low pO2<60
Trx: ⬆️ fio2 and peep

Question 3

Hyperbaric respiratory failure

Answer 3

Inability to remove CO2
Damage to pond or upper medulla
Trx: ⬆️ tidal volume (Pplat) and ⬆️ rate

Question 4

Tidal volume

Answer 4

4-8cc/kg of idb
Volume of air delivered on breath

Question 5

Rate

Answer 5

12-20

Question 6

Minute volume (ve)

Answer 6

Fxvt(4-8 l/m)

How much air is breathed in one min

Question 7

Inspiratory: expiratory ratio

Answer 7

1:2
Takes longer to breath out

Question 8

Fraction of inspired oxygen (fio2)

Answer 8

.21-1

Question 9

PEEP

Answer 9

0-20cm h2O
Keeps the alveoli open so that oxygen can diffuse

Question 10

Peak inspiratory pressure (pip)

Answer 10

<35 cmh20
Amount of resistance to overcome the ventilator circuit

Question 11

Controlled mandatory ventilation (cmv)

Answer 11

Used in sedated, apneic or paralyzed pt
Pt has no ability to initiate breaths

Question 12

Assisted controlled (ac)

Answer 12

Trigger for breath is pt or time
Full tidal volume regardless of respiratory drive or effort
Leads to breath stacking or auto peep

Question 13

Synchronized intermittent mandatory ventilation (simv)

Answer 13

Proffered for pt with intact respiratory drive
Ventilator senses pt taking breath and delivers breath

Question 14

Pressure support ventilation
(Psv)

Answer 14

Supports or provides pressure during inspiration to decrease pt overall work of breathing
Requires ventillary effort by pt

Question 15

Cpap

Answer 15

Use of positive pressure to maintain level of peep
Mild air pressure to keep airway open

Question 16

Bpap

Answer 16

Alternating lvls of peep to maintain oxygenation and inhalation

Question 17

DOPES

Answer 17

Dislodged
Obstructed
Pneumothorax
Equipment
Stacked breaths

Question 18

Low pressure

Answer 18

Pt disconnected from machine
Chest tube leak
Circuit leak
Airway leak
Hypovolemia

Question 19

High pressure

Answer 19

Kinked line
Coughing
secretions pt biting tube pneumothorax

Question 20

Richmond agitation - sedation scale

Answer 20

+4 = combative
-5= unarousable

Question 21

PPE for tb

Answer 21

Gloves, n95, gown and eye pro

Question 22

V/Q ratio

Answer 22

Ratio of alveolar ventilation and blood traveling through the capillaries
VQ= .08

Question 23

Asthma

Answer 23

Flattened diaphragm on chest X-ray
Shark fin wave form in CO2

Question 24

Asthma exacerbation trx

Answer 24

Increase I:E 1-4
Zero peep initially
Consider bipap
Steroids and O2

Question 25

COPD

Answer 25

chronic bronchitis (blue bloaters) Emphysema (pink puffers) Flattened diaphragm Problem is breathing out

Question 26

COPD exacerbation trx

Answer 26

Same as asthma

Question 27

Pleural effusion

Answer 27

Fluid in pleural space

Question 28

Pneumonia

Answer 28

Most often viral. Sometimes bacterial. Right middle lobe is most ccommon Patchy infiltrates

Question 29

Pneumonia trx

Answer 29

O2, iv fluids, bronchodilators, antibiotics if bacterial

Question 30

ARDS

Answer 30

Diffuse alveolar injury Causes pancreatitis Sepsis, trauma and aspiration pneumonia “Bilateral diffuse infiltrates”

Question 31

ARDS trx

Answer 31

⬆️peep, ⬆️fio2 Low tidal volume 4cc/kg Increase rate