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Flashcards in Ventilators Deck (24):
0

CMV

Controlled Mandatory/Mode Ventilation
-early mode
-preset Vt or PIP
-Preset Rate
-pt cannot initiate (apprehension & air hunger)
-requires sedation / paralysis

1

AC

Assist Control
-preset Vt/PIP
-pt triggers breaths (receives full preset breath)
-Back up rate set

2

AC complications

-Resp Alkalosis (pts triggers 2 breaths + Back up rate= tachypnea)
-Asynchrony machine & pt
-May worsen air trapping in COPD pts
-stacked breaths (pt's breath immediately before scheduled breath - delivers 2 preset Vt breaths. Barotrauma)

3

IMV

Intermediate Mandatory Ventilation
-Preset rate, VT/PIP
-pt can initiate breath, but only delivers amount pt draws. (Does not deliver full present Vt/PIP)

4

IMV Complication

If pt takes breath right before schedules breath, delivers amount requested plus scheduled breath. Results in air stacking. Barotrauma.

5

SIMV

Synchronized Intermittent Mandatory Ventilation.
-Preset Rate Vt/PIP
-vent senses initiated breaths.
-if initiated breath close to scheduled breath, delivers preset amount. Otherwise delivers amount drawn by pt.
-can still lead to hyperventilation, respiratory alkalosis, air trapping in COPD pts.

6

SCOPE - high pressure alarm

Suction (mucus plug)
Connections (valves on circuit/kinked)
Obstructions
Pneumothorax
ETT dislodgement (suggests deep dislodgement)

7

Acute Respiratory Deterioration w/ PIP Decrease

Air leak, hyperventilation

8

Acute Respiratory Deterioration w/ PIP no change

PE, extra thoracic process

9

Acute Respiratory Deterioration w/ PIP increase & no Plateau Pressure change.

(Airway obstruction) Aspiration, Bronchospasm, secretions, tracheal tube obstruction.

10

Acute Respiratory Deterioration w/ PIP increase & Plateau Pressure increase

(Decreased compliance)
Abdominal distention
Asynchronous breathing
Atelectasis
Auto-PEEP
Pneumothorax
Pulmonary Edema

11

PIP=
Pplat=

PIP= airway problem
Pplat= lung structure problem

12

Some causes of atelectasis

Tight lungs, ARDS, pulmonary edema, pulmonary contusions

13

Low pressure alarms

D/C o2 source, disconnection, ETT extubation, hypovolemia (chest is tissue, blood and air...take away blood: increased chest cavity size)

14

Methemoglobinemia and saturation

SPO2 reads high when low, reads low when high.
>40% will direct SPO2 to 85%

15

Laminar Flow

Measured using Reynolds number (Re=pVD/u)
-considered laminar if Re is less than 2000.

Increase Velocity/flow, tubular diameter= turbulent flow.

Laminar flow requires slower gas velocity, through smaller tubes.

16

Volume Adjustments for low O2 SATs

Increase FiO2, increase PEEP

17

Volume Adjustments for high O2 SATs

Decrease FiO2" decrease PEEP

18

Volume Adjustments for ETCO2 >45

Increase RR, increase Vt

19

Volume Adjustments for ETCO2

Decrease RR, decrease Vt

20

Pressure Adjustments for low O2 SAT

Increase FiO2, increase PEEP

21

Pressure Adjustments for high O2 SATs

Decrease FiO2, decrease PEEP

22

Pressure Adjustments for ETCO2 >45

Increase PC, increase RR

23

Pressure Adjustments for ETCO2

Decrease PC, decrease RR