Here is a sample of the answers for Chapter 47 of the Egan’s Workbook. For rest of the answers, check out our Workbook Helper. We have both the 10th and 11th Edition available.

1. A. Auto-PEEP
B. Decreasing tidal volume to the 4 to 6 ml/kg PBW range generally eliminates the auto-PEEP.

2. A. Double triggering is most commonly observed in volume ventilation when the set tidal volume and inspiratory time are less than the patient’s demand.
B. Increasing tidal volume or inspiratory time, or changing to pressure-targeted ventilation can correct double triggering.

3. A. Setting the sensitivity control to be overly sensitive will cause autotriggering. In addition, autotriggering can be caused by the movement of water accumulated in the ventilator circuit. Leaks in the ventilator circuit are the most likely cause of autotriggering.
B. New ventilator circuit, remove water from the circuit, and appropriate setting of sensitivity.

4. A. Reverse triggering is a form of double triggering that occurs during controlled ventilation. It has primarily been described in patients with ARDS in which a controlled mechanical breath stimulates the respiratory center via stretch receptors to attempt a spontaneous breath.
B. If reverse triggering occurs, alteration of tidal volume or inspiratory time should be attempted. Since the patient is already sedated, sedation is not the solution. More research is needed to determine the potential harm of reverse triggering, its causes, and treatment.

5. A. Trigger delay is caused by an inappropriately set sensitivity and auto-PEEP insufficient to cause mistriggering.
B. Adjusting the sensitivity, setting the tidal volume appropriately, and/or applying PEEP should correct delayed triggering unless there is a true malfunction of the ventilator.


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