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RSPT Mechanical vent

mechanical ventilation slides

What is is the definition of mechanical ventilation An intervention classification defined as the use of an artificial device to assist the patient to breathe.
What are the indications of MV -apnea- acute respiratory failure- impending respiratory failure sever hypoxemia
What is considered acute respiratory failure hypercapnia and hypoxemia
What are the general goals of MV Provide adequate ALVEOLAR ventilation, provide adequate oxygenation, avoid ALVEOLAR over distention, maintain ALVEOLAR recruitment, avoid auto peep, use the lowest possible FIO2
What are the requirements for spontaneous ventilation Size of the tidal volume and rate or initiation
In phase 1 of MV what is the summary of what's going on Establish the need, connecting the patient to the vent for the first time after the first blood gas is the end of phase 1
In phase 2 of MV what is the summary of what's going on Stabilize arterial blood gases as much as possible.
In phase 3 of MV what is the summary of what's going on Weaning of the machine
What are the guidelines to EST. The need for phase 1 and acceptable values Vt= 5-8ml/kg, RR <35, Vc >15ml kg or 2x Vt, Nip or Mop < 20cmh2o -30 or -40 is better, Ve >10L
What are the initial settings on the vent Pplt pressure <30 cmh20, full support mode for the first 24 hours, Vt 5-8 ml/kg, f: 8-12/ min, FIO2 < or equal to 60
What are the things that the vent needs to know What is the oxygen requirements, what is the mandatory RR, mode, Vt, how fast and what fashion such as the I:E ratio
What are the 2 modes of ventilation Volume ventilation, pressure ventilation, pressure is most often used in neonatal due to the anatomy of the baby body not needing a cuff
What are the different types of breaths Controlled- vent respond. For both rate and volume Assisted- patient is respond for rate and initiating and vent is reps for volume, Spontaneous- patient is reps. For both rate and volume.
What are the different types of modes Control, assist, assist/control, SIMV, CPAP
CPAP Works on all spontaneous breaths, can't leave patient unless know they can intiate and provide all volume.
Strategies to improve vent. According to the NBRC Decrease dead space, increase tidal volume, increase RR, increase the spontaneous tidal volume, increase the pressure support, beware of the CO2 retainer
Strategies to improve oxygenation assure that the adequate vent., increase FIO2, add/increase PEEP
What are some causes of height alarm sounding Cough, secretions, biting the tube, pneumothorax, patient distress
What are some causes of low alarm sounding leak, cuff leak, disconnect, extubtion, patient fatigue
Different waveforms Square, sine, decelerating
Square waveform pattern: Produces a constant flow throughout insp. Used mostly in non compliant lungs
Sine waveform pattern: Flow begins slowly and increases to a peak then decrease at the end of inspiration, gives good distribution of ventilation
Decelerating flow pattern: Flow is fast during the beginning of insp peak, then gradually decreases useful for people who need high flow rates
What is dynamic compliance: identifies changes in the airway, change in volume usually Vt as the dynamic compliance decreases the airway is getting more narrow.
What is plateau pressure The pressure that is at during a inspiratory hold, once the Vt is delivered you hold the insp. And the pressure at the hold is the pplat
What is static compliance Identifies the condition of the lungs, normal is 60-100 ml/cmh2o
What is resistance This is increased as the air way grows more narrow, normal is 0.6-2.4 cmh20/l/sec
What is the formula for Tidal volume You take the IBW and times it by 5 and by 8 to get the range of tidal volume you need. 105+5(ht"-60)/2.2 for female and 106 for male.
What is the formula for dynamic compliance Cd Change in volume/PIP-PEEP Peak insp. Pressure- positive end exp. pressure
What is the formula for static compliance Cs Change in volume/Pplat-PEEP Plateau pressure- positive end exp. pressure
What is the formula for RAW PIP-Pplat/FLOW(60)
Created by: pearlekg