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Lab Comp
| Question | Answer |
|---|---|
| Respiratory Failure | The inability of the heart and lungs to provide adequate tissue oxygenation and/or carbon dioxide removal |
| Indications for mechanical ventilation | Apnea, Acute ventilatory failure, Impending ventilatory failure, severe/refractory oxygenation problems, Gas exchange abnormalities, depressed respiratory drive, excessive ventilatory workload, failure of ventilatory pump, airway obstruction, |
| Contraindications for mechanical ventilation | Pneumothorax without chest tubes, lack of indication for mechanical ventilation, rapid resolution of the underlying condition, intervention is futile, and mechanical ventilation is against the patient’s wishes |
| Hazards of mechanical ventilation: | barotrauma, airway injury, infection, ventilator associated pneumonia (VAP), pulmonary embolus, gastrointestinal bleeding, and ventilatory muscle atrophy and dysfunction. |
| Volume targeted ventilation: | volume and flow remain constant; pressure varies according to the compliance and resistance of the lungs |
| Pressure targeted ventilation: | pressure is constant; volume and flow vary according to the compliance and resistance of the lungs. |
| AC (Assist control): | Same as CMV; all breaths are mandatory, but may be patient or time triggered. The ventilator does the work for the patient. |
| SIMV (synchronized intermittent mandatory ventilation) | allows the patient to breathe spontaneously between mandatory breaths and the machine breaths are “synchronized” to the end of the patient's exhalation. |
| Spontaneous mode (CSV, pressure support, CPAP): | all breaths are spontaneous; pressure support augments spontaneous breaths with positive pressure; this mode can be used to determine if a patient is strong enough to be taken off of the ventilator |
| Ideal body weight | 50 + (2 x inches >60) |
| P/F ratio: | PaO2/FiO2 FiO2 will be a decimal Normal P/F ratio = 380 – 476 mmH |
| Pack year history: | #of packs smoker per day x # of years patient smoked |
| Come up with initial ventilator settings using IBW for volume assist control: | Use 5-10 ml/kg IBW for tidal volume Respiratory rate: 10 – 20 FiO2 at 100% Peak flow: 40 – 60L PEEP of 5 |
| Items needed for intubation: | Laryngoscope handle & blades, ET tubes sizes 5-9, stylet, 10 mL syringe, ET ties or holder, suction (yankauer), gloves, end-tidal CO2 detector, stethoscope, oral/nasal airways, ambu bag and mask, magill forceps, water based lubricant, tape, batteries |
| pH: | 7.35 – 7.45 lower is acidic, higher is alkalotic |
| PaCO2: | 35-45 lower is alkalotic, higher is acidic |
| HCO3: | 22-26 lower is acidic, higher is alkalotic |
| PaO2: | 80-100 is normal 60-79 is mild 40-59 is moderate <40 is severe |
Created by:
K.Moskowitz
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