Question Answer
what are the first 30-60 minutes following initiation of ventilation spent evaluating? vital signs, BS, vent parameters, CL/RAW, artificial airway, documenting pt response to therapy (vent graphics)
once the initial assessment is performed, the ____ results are evaluated; what are the 2 parts of this? ABGs; 1. ventilation (pH,PaCO2,HCO3) 2. oxygenation (PaO2,SaO2,CaO2,DO2)
what are the 3 factors that can alter PaCO2 during MV? 1. total ventilation 2. dead space 3. CO2 production
a change in _______ __________ will often be needed when a pt is first placed on MV. minute ventilation
what determines when the pt needs full ventilatory support? when the pt needs the ventilator to provide all the energy necessary to maintain effective alveolar ventilation
what determines when the pt needs partial ventilatory support? MV when machine rates are <6 breaths/min, pt participates in WOB to maintain effective alveolar ventilation
what are the initial settings for FVS? PaCO2 – 45 or normal for pt; rate – 8 or more breaths/min; VT – 6-12 mL/kg
what are the initial settings for PVS? rate – <6 breaths/min
what are causes of acute resp acidosis in the non-ventilated pt? 1. parenchymal lung problems 2. airway disease 3. pleural abnormalities 4. chest wall abnormalities 5. neuromuscular disorders 6. CNS
whether the pt is on VV or PV, increasing ______ __________ will decrease PaCO2. minute ventilation
what are the recommended guidelines for VT and plateau pressure? VT: 8-12 mL/kg IBW; Plateau: <30 cmH2O
what is the tidal volume for normal lungs? COPD? neuromuscular disorders? asthma? closed head injury? ARDS? CHF? normal: 10-12, COPD: 8-10, neuromuscular: 12-15, asthma: 4-8, closed head injury: 8-12, ARDS: 4-8, CHF: 8-10
in PCV, what also may increase if inspiratory time is increased? volume delivery, without increasing pressure
pressure determines ________. volume
what are common causes of respiratory alkalosis? hypoxia (w/ compensatory hyperventilation), parenchymal lung disease, meds, MV, CNS disorders, anxiety, metabolic problems
in MV pts, ____________ is often the cause of respiratory alkalosis. hyperventilation
how would you correct respiratory alkalosis during VV? decrease ventilation during VV by decreasing f, and VT if necessary (PV: f, then pressure)
what might reducing the VT to <8 mL/kg result in? atelectasis
what would be the 2 approaches in correcting respiratory alkalosis during spontaneous efforts if all else fails? 1. change mode (SIMV/PSV) 2. sedate pt (control breathing)
when might sedation be needed? 1. extreme agitation 2. increased WOB 3. dyssynchrony
what are common causes of hyperventilation? hypoxemia, pain, anxiety, fever, agitation, dyssynchrony
how do some pts with brain enjery tend to breathe? high VT and f (CNS lesion)
what should treatment of metabolic acidosis and alkalosis focus on? identifying metabolic factors that can cause these acid-base disturbances
pts in apparent respiratory distress may present with _________ ________. metabolic acidosis
during metabolic acidosis, what is the range of pH and HCO3? pH: 7.00-7.34, HCO3: 12-22
what are metabolic acidosis pts at risk of developing? respiratory muscle fatigue
in this situation, MV is indicated to meet the minimum goal of compensated __________. hypocapnia
what are causes of metabolic acidosis? 1. ketoacidosis 2. uremic acidosis 3. loss of HCO3 (diarrhea) 4. renal loss of base 5. overproducation of acid 6. toxins
what is the treatment of metabolic acidosis? effective therapy to deal w/ acidosis,; assessing need for reversal using alkaline agent
what is the controversy regarding metabolic acidosis? 1. benefit of using alkalinizing agents (HCO3 administration) 2. lowering arterial CO2
what is the range for pH and HCO3 in metabolic alkalosis? pH: 7.45-7.70, HCO3: 26-48
what are common causes of metabolic alkalosis? 1. loss of gastric fluid/stomach acids 2. acid loss in urine 3. acid shift into cells 4. lactact, acetate, citrate administration 5. excessive HCO3 loads
what treatment might be required in severe cases of metabolic alkalosis? carbonic anhydrate inhibitors, acid infusion, low HCO3 dialysis
metabolic alkalosis must be corrected BEFORE _____. PaCO2
what are causes of increased dead space? pulmonary embolism or low CO (low pulmonary perfusion), high PEEP
in the case of air-trapping (auto-PEEP), what may correct this problem? increasing the flow or decreasing I:E ratio
what can significantly improve gas exchange and help address the problem of air-trapping? reposition pt so disease lung receive minimal blood flow (independent position)
what is the normal ratio of dead space to tidal volume (VD/VT)? critical pts? 0.2-0.4; 0.7
what is a more common way to determine if dead space is changing? monitor ETCO2 (35-43), measure gradient between PaCO2 and ETCO2 (1-5)
with this way, what suggests an increase in dead space? decrease in ETCO2 and increase in PaCO2
metabolic rate and VCO2 are elevated in pts who have…? fever, burns, multiple trauma, hyperthyroidism, muscle tremors/seizures, agitation, multiple surgeries
what was iatrogenic hyperventilation used for? in pts with acute head injury and increased intracranial pressures
what might hyperventilation during the first few days following severe traumatic brain injury increase? cerebral ischemia, cause cerebral hypoxemia
_____ ___________ may be used for longer periods in situations in which increased ICP is refractory to standard treatment including sedation and analgesia, neuromuscular blockade, cerebrospinal fluid drainage, and hyperosmolar therapy. mild hyperventilation
who is at risk for ventilator-induced injury? pts w/ ARDS or status asthmaticus, COPD
_________ _________ has gained popularity as an alternative form of pt management. permissive hypercapnia (PHY)
what is PHY? deliberate limitation of ventilatory support to avoid lung overdistention and injury to lung
in PHY, _____ is allowed to be increased above normal and ____ is allowed to decrease below normal. PaCO2; pH
what is the pH range for pt who do NOT have renal failure or cardiovascular problems? younger pts? 7.20-7.25; even lower
during hypoventilation, _____ increases and _____ decreases. PaCO2; PaO2
increases in PaCO2 and decreases in PaO2 that occur in acute resp acidosis also cause a _____ shift in the oxyhemoglobin dissociation curve. right
what is important to provide for pts with ALI receiving permissive hypercapnia? sedation
extremely high levels of CO2 (>200) can result in an anesthesia effect also known as ___ ______. CO2 narcosis
CO2 is a powerful __________ of cerebral vessels. vasodilator
what are some contraindications of permissive hypercapnia? 1. head trauma/intracranial disease 2. intracranial lesions (ABSOLUTELY contraindicated) 3. preexisting cardiovascular instability
what are the circulatory effects of PHY? 1. decreased myocardial contractility 2. arrhythmias 3. vasodilation 4. increased sympathetic activity
what are common findings in pts receiving PHY? increased CO, normal SBP, pulmonary HTN
when is it particularly true to perform PHY with caution? cardiac ishemia, LV compromise, pulmonary HTN, R heart failure
when is PHY restricted? maximum target airway pressure and highest possible rates are used
what assessment is done in order to know suction is needed? breath sounds; visibly examine artifical airway
what are indications for suctioning? 1. coarse rhonchi/rales audible over large airways 2. visualization of secretions in ET
what color secretions do CHF pts produce? what shouldn’t you do with these pts and why? thin white or pink frothy; suction; heart prob, not airway problem, worsens hypoxemia
what is the suction catheter length? 22 in (56 cm) – long enough to reach mainstem bronchus
what is the normal (and maximum) suction levels for adults, child, and infant? adult: normal -100 to -120, max -150; child: normal -80 to -100, max -125; infant: normal -60 to -80, max -100
how long should suctioning be? <15 secs
what are complications of suctioning? leak in system, suction off, bad connections, full collection canister, discomfort/anxiety
in pts with reactive airways, suctioning can result in ____________. bronchospasm
what can suctioning cause to the mucosal wall? hemorrhage, airway edema, ulceration
what are complications with suctioning associated with? duration, amount, size of catheter, oxygenation/hyperventilation before procedure done correctly
what are other common occurances during suctioning? cardiac arrhythmias, tachycardia, bradycardia, hypotension, hypertension
secretion removal is more critical in pts with _____ _______. small airways (small lumenal ETS)
what is the advantage to closed-suction technique? no disconnection from vent (reduces contamination)
who might benefit for with closed-suction technique? pts with specific disorders
______ ___ have been used for years to protect the airway from aspiration. cuffed ETs
what represents the majority of ETs used in the acute care setting today? high-volume, low pressure cuffs
what might result in VAP? bacterial colonization of the TBT
what are the reasons for silent aspiration and VAP? 1. injury to the mucosa 2. interference w/ normal cough reflex 3. aspiration of contamination 4. development of contaminated biofilm around ET
what is the percentage of VAP? 10%-60%
what has been developed to reduce the incidence of silent aspiration and allows for “continuous aspiration of subglottic secretions?” hi-lo evac ET (20 mmHg continuous suction)
why are continuous suction tubes not used with all pts? expensive
when is continuous aspiration of subglottic secretions (CASS) most effective? pts requiring intubation for >3 days
what are indications for using closed-suction catheters? 1. unstable pts on MV 2. hemodynamically unstable 3. desaturation pts 4. contagious infections 5. freq suctioning 6. inhaled gas mixture pts
ET suctioning for the removal of secretions is often preceded by instilled __-__ mL of sterile, normal saline into the airway, followed by ____________ and _____________ of the pt with 100% O2 via resuscitation bag or vent. 3-5; hyperoxygenation; hyperinflation
what is the intent of saline lavage? loosen secretions
what is the disadvantage of saline lavage? bacteria enter the airway causing nosocomial pneumonia
_____ __________ can increase the volume of secretions and potentially make airway obstruction even worse. saline instillation
what might saline instillation cause? irritation to airways, severe coughing episodes, bronchospasm
what is probably more effective than saline lavage for secretion thinning and facilitating suctioning? intratracheal lavage w/ acetylcysteine or sodium bicarbonate
what should be documented on a ventilator flow sheet after suctioning? amount, color, characteristic; breath sounds
___________ are by far the most common drug administered by aerosol to MV pts. bronchodilators
what are the most common methods used for administering aerosol? MDIs and SVNs
what are the 4 factors that must be considered when delivering aerosol to MV pts? 1. type of aerosol device 2. vent mode/settings 3. severity of condition 4. nature/type of med and gas used to deliver it
what are the drug deposition rates for aerosolized meds? 1.5%-3.0%
what is the mean mass aerodynamic diameter of aerosol particles produced by MDIs and SVNs? 1-5 um
__________ factors can affect aerosol delivery. ventilator
what are the general settings to use when given aerosol delivery? LOW flow rates, HIGH vts, LOW resp rates
what type of delivery of nebulized bronchodilators is more effective in COPD and RAW pts? intermittent delivery rather than continuous
what are factors that affect aerosol administration? larger ETs (better), heated humidifiers (bad), delivery gas
what may improve aerosol deposition in pts with asthma by reducing airflow turbulence? helium-oxygen mixture
what presents with fewer technical problems when used during MV? MDIs
which type has a greater aerosol delivery: in-line chambers and bidirectional spacers or elbow adaptors and unidirectional spacers? in-line chambers and bidirectional spacers
what are SVNs known to only deliver? mucolytics, antibiotics, prostaglandins, surfactants
what is a common method for delivery of aerosolized medications during MV? external SVN powered by a separate gas source (O2 flowmeter)
what type of ventilator comes equipped to power a small volume USN? Servo
the mass median diameter of particles produced by the nebulizer is ___ micrometers. 4.0
during NPPV, when does the greatest aerosol deposition occur? when the neb is placed close to the pt, the inspiratory pressure is high, expiratory pressure is low
what can be measured to monitor pt response to bronchodilators? lung mechanics, breath sounds, vital signs & SpO2, pressure-time curves, flow-vol/pressure-vol loops
what suggests an improvement following therapy? reduced PIP, reduced transairway pressure, increased PEFR, reduction in auto-PEEP
what are other methods routinely used to help clear airway secretions and improve the distribution of ventilation? postural drainage and CPT
what are the recommended positions for ventilated pts based on their findings? supine, 45 decgree rotation prone w/ left side up, 45 degree rotation prone w/ right side up, return to supine
what is another method for CPT because the prone position is difficult in MV pts? oscillating vest
___________ is a procedure used to visualize the bronchi. bronchoscopy
what are the 3 separate channels included in the flexible fiberoptic bronchoscopy? 1. light-transmitting channel 2. visualizing channel 3. open channel
what is bronchoscopy used for? inspect airway, remove objects, obtain biopsies, clear secretions, place devices in airway
_______ is sometimes administered 1-2 hours ahead of time to reduce secretion production and help dry the pt’s airway so that it is easier to visualize. atropine
________ _________ is used during the procedure. conscious sedation
what are the agents used during conscious sedation? opioid analgesics; benzodiazepines
what is important in pts with artificial airways? size of the fiberoptic bronchoscope
what is the rationale for turning immobilized ventilated pts freq during the day? prevent pulmonary complications (atelectasis, hypoxemia)
________ ____ automatically turn the pt from side to side on a continuous rotation up to a 45- to 60-degree lateral position. kinetic beds
what two lung pathologies is positioning particularly important? ARDS and unilateral lung disease
what does the prone position do for ARDS pts? improve oxygenation and decrease degree of shunt
what helps distinguish pts who are responders from nonresponders of prone position? improvement of 10 mmHg in PaO2 within 30 mins
within lung tissue, the distribution of the interstitial water and intravascular blood and the anatomical configuration of the lung are all influenced by _______. gravity
in a supine pt, _________ _______ is higher in the dependent regions where blood tends to flow. _____ ______ formation is likely higher too. hydrostatic pressures; lung edema
what is an important difference between normal subjects and those with ARDS in the nondependent portion? ARDS pts have increased tissue mass
how does blood move from supine position to prone position? not well ventilated areas in supine to better ventilated areas in prone position (results: better V/Q ratio)
what does the prone position change? position of the heart/great vessels so they’re no longer pressing on lungs
what is a side effect of prone positioning? facial and eyelid edema
what is the recommendation range of time in the prone position? 2-24 hrs
patient feeding by the __________ enteral route may reduce the risk of vomiting and aspiration associated with gastric compression caused by the prone position. transpyloric
what are some indications for the prone position? improve oxygenation in ARDS; pts who fail to respond to lung recruitment maneuvers; high inspired O2
what are the 2 methods that are typically used to manage the ventilatory status of pts with unilateral lung disease? 1. independent lung ventilation (2 vents/double-lumen ET) 2. lateral position, “good” lung down
________ positioning dramatically improves gas exchange by improving V/Q matching without causing any hemodynamic complications, thus potentially allowing a decrease in FiO2. lateral
how long are adult vent circuit corrugated tubing? pediatric circuits? 22 mm-diameter; 9-13 mm-diameter
what are the objectives for changing a vent circuit? 1. limit nosocomial infections 2. vent circuit in tact 3. clean circuit 4. minimize risks
what do must vent circuits use to humidify? HMEs (passive), heated passover or heated wick
during a patient-vent system check, what should be checked? the ventilator circuit and the water level in the humidifier
how can fluid input/output be monitored? comparing daily fluid intake with output and by measuring body weight daily
what is normal urine production? ______ is a urine output of less than 400 mL/day or less than 20 mL/hr and _______ is a urine output of more than 2400 mL/day or 100 mL/hr. 50-60 mL/hr; oliguria; polyuria
what are 3 reasons for a decrease in urine output? decreased fluid intake/low plasma vol; decreased renal perfusion; renal malfunction
what is one of the most common causes of sudden drops in urine flow, which can be quickly reversed by irrigating the catheter? blocked foley catheter
what are common causes of decreased urine production in critically ill pts? renal failure or malfunction
what is one of the primary problems in the vast majority of ICUs? no method for communicating w/ pts
what is one possible tool to use in discovering if pts experience dyspnea? visual analog or number intensity scale (brog scale during exercise test)
what is the approach to reduce pt distress and fear referred to as? pt-centered mechanical ventilation
what are the 2 questions therapists might pose to pts who are conscious and able to respond? 1. are you short of breath right now? if yes.. 2. is your shortness of breath mild, mod, or severe?
what is the average duration of pt transport (one way)? and the avg time spent at the destination? 5-40 mins; 35 mins
what are the 3 options available for providing ventilation during transport? 1. manual ventilation 2. transport ventilator 3. most current generation ICU vents can be used for transport
what is a major disadvantage of pneumatically powered ventilators? they consume large vols of O2 during operation
Question Answer
What usually helps to minimize the adverse effects of PPV on cardiovascular function? SHorter Itime and longer Etime
Paw can be increased by adding what 2 things? Adding PEEP and inspiratory pause
Define Auto-PEEP. Unintentional PEEP that occurs during mechanical ventilation when a new inspiratory breath begins before the expiratory flow has ended.
Explain the effects of O2 and CO2 in the brain during positive pressure ventilation, and when would we want to use more CO2? When O2 is present in the vessels of the brain it acts as a vasoconstrictor, causing less blood flow into the brain. CO2, however, acts as a vasodilator and promotes blood flow. A good time for increased CO2 is closed head injuries.
Explain what affect PPV has on blood flow to the kidneys. What three fuctions of the kidneys are changed and how? PPV decreases blood flow the kidneys. This causes: -decrease in drug and waste clearance -decreased filtration -decreased urine output (BH)
What does PPV do to CVP and what is it normally? PPV increases CVP which is normally 2-8 mmHg
What is it a sign of when your patient has puffing under the skin on their neck, face, chest, feet, or abdomen? This is a sign of subcutaneous emphysema.
What is cardiac tamponade and what can it lead to? Cardiac tamponade is the compression of the heart by fluid or air in the pericardial sac; can also be caused by PPV in the lungs around the outside of the heart. If air isn’t removed it can lead to cardiopulmonary arrest. (CZ)
What are some signs and symptoms of hypokalemia? Cool skin, decreased PaCO2, twitching, and tetany.
How does auto-PEEP affect ventilator function? The presence of auto-PEEP will slow the beginning of gas flow during inspiration due to the pressure gradient created between the mouth and the ventilator.
Four days after being placed on MV, a post-op abdominal surgery pt has indications of low urine output, and a weight gain of 1 kg. What is the potential cause? possible kidney failure, PPV, and fluid loading
What effect does malnutrition have on a patient’s body? It affects their ability to fight infection, heal wounds, and reduces the ability to maintain spontaneous ventilation because of their weak respiratory muscles.
When adding positive pressure, does it increase or decrease blood flow in each system? decrease
If there is a too big drop in cardiac output, what would you do with the FiO2? decrease
If positive pressure increases the ICP, it will do what to the cerebral blood flow? and is CO2 a dilator or constrictor in the brain? decrease, constrictor
What does Positive Pressure Ventilation do to the metabolism of drugs? Decrease
What type of people do we want to watch when on PPV since it decreases metabolism and why? The elderly–they already have a slow metabolism
What does CO2 do in the brain, O2 in the brain and how long can we want this to happen? CO2 dilates, O2 constricts–1st 48 hours
adding positive pressure what does that do to blood flow throughout the body decreases
how does the kidney function relate to positive pressure. decreases
what functions of the kidney will decrease in positive pressure. dug/waste clearance, filtration, urine output.
During PPV, does the intrathoracic pressure increase, decrease, or stays the same? What does this do to other closed chambers in the body? Increase. This causes pressure on other closed chambers.
What happens to the cardiac output when administering PPV? What else will change in the same direction as C.O.? Why? Cardiac output decreases, and stroke volume will have the same change as C.O. This is because the pressure on the great vessels and heart so it can’t pump as hard.
When weaning a COPD’er off the vent after 2-3weeks, what do we need to do to their caloric need? Increase so they have the energy to breathe on their own.
PEEP increases what? FRC and Paw, improves oxygenation
PPV can decrease what? What does this cause? Cardiac output and mean arterial blood pressure which causes an increase in ICP
A pt on PC-CMV has initial ABG of 7.30/60/101. What should an RT do? Increase minute ventilation to the pt
When does sheer stress occur? When an alveoli the is normal expands adjacent to one that is collapsed.
What is atelectrauma? Injury to the lungs that occur because of repeated opening and closing of alveoli at lower lung volumes.
With PPV, does it increase or decrease the amount of anatomical dead space and alveolar dead space? increases both.
How can a decreased PaO2 in a patient with respiratory failure affect the renal function? it can reduce renal function and decrease urine flow
What is the term that is described by the injuries to the lungs that occur because of repeated opening and closing of the lung units at lower lung volumes? Atelectrauma
What are clinical signs and symptoms associated with Respiratory Alkalosis and Hypokalemia? Cool skin, Twitching, and tetany
Name 4 potential complications from PPV? AC reduced cardiac output reduced urine output decreased blood pressure increased ICP
Define auto-peep An unintentional PEEP that occurs during mechanical ventilation when a new inspiratory breath begins before the expiratory flow has ended.
What is one of the simplest ways to reduce WOB for our patient? Use the largest possible ET tube that is appropriate for the patient.
What can positive-pressure ventilation (PPV) significantly alter? positive-pressure ventilation (PPV) can significantly alter cardiovascular, pulmonary, neurologic, renal, and gastrointestinal
What is cardiac transmural pressure (PTM)? The effective filling and emptying of the heart is determined, in part, by the pressure difference between the inside of the heart and the intrathoracic pressure.
What does shorter inspiratory times and the longer expiratory times usually help? It will usually help to minimize the adverse effects of PPV on cardiovascular function.
What effect does the endocrine system have when using PPV? It increases the release of ADH which results in less output of fluids compared to intake (I/O). A reduction in ANF due to low atrial filling pressure cause water and sodium retention.
What patients are susceptible to barotrauma? Patients with high levels of PEEP and high Vt, ALI/ARDS, high peak airway pressures and low end-expiratory pressures, aspirating gastric acids, necrotizing pneumonias, and bullous lung disease (TB or emphysema).
Does a pt’s thoracic pressure decrease or increase when they are placed on a mechanical ventilator? Increase
A pt has a closed head trauma and is placed on a mechanical ventilator, what type of ventilator should you place them on and what should you be aware of? Volume ventilation but be cautious of the pt’s ICP.
Why is it important to pay attention to a pt’s I/O’s and other metabolic assessments? because the work of the kidneys and liver are decreased while on PPV and should be assessed to make sure they receive proper dietary needs to help the body heal.
If we have positive pressure ventilation what would be the effect on the O2 delivery? You would have increased O2 delivery, providing increased FiO2, which also will increase the surface area
What happens to the kidneys blood flow with positive pressure? Increase, decrease, or stay the same? The blood flow will decrease
What are some organs we would want to watch in elderly patients and why? Keep an eye on the liver and kidneys because this will affect a patients metabolism
Explain the effects of O2 & CO2 in the brain during PPV, and when would permissive hypercapnia be a good thing? O2 is a vasoconstrictor, so less blood gets the brain, and CO2 is a vasodilator, it causes blood to flow to the brain. Permissive hypercapnia is useful for closed head injuries.
Why is it important to watch for cardiac tamponade? It is important to watch for this because the heart is being compressed by fluid or air. If untreated this could lead to death.
What does PEEP do to FRC? It increases it.
PPV does what to cardiac output? it will reduce cardiac output
what are does PEEP increase when applied? increases FRC but also increases Paw aka airway pressure
what does an inspiratory do? improves oxygenation but also measures Pplat.
What will auto-PEEP do to the pt if present? will make it more difficult for spontaneously breathing pts to trigger a breath
Hyperventilation results from what? Lower than normal PaCO2 and rise in pH.
Ventilator-associated lung injury can be caused by what? shear stress, damage to pulmonary, alteration of surfactant
If renal arterial pressures decrease below 75mmHg what will happen to the pt’s urinary output? The pt’s urinary output will decrease.
When pulmonary cells, are over stretched during mechanical ventilation chemical mediators/inflammatory cells are released causing a distinct lung appearance on a CXR. What might that look like & what disease process might this resemble? Ground Glass Appearance – ARDS
What are some causes of hyperventilation? hypoxemia, pain, anxiety syndromes, circulatory failure, & a/w inflammation
When you have an I:E ratio, what are some of the benefits of this? And how do you calculate this? I:E ratio tells us the shorter the inspiration time and the longer the expiratory time (Itime should always be shorter than Etime) the less harmful effects from PPV. Equation: Etime/Itime
Injuries to the lungs that happen due to repeated opening & closing of the lung units are called _____? And what is an example of this type of issue? Atelectrauma. ALI/ARDS is an example of this.(KJ)
What is the main cause of barotrauma on a ventilator? High peak pressures, high levels of PEEP with high Vt, etc.
What is Oliguria? A diminished output of urine relative to fluid intake.
The level of reduction in cardiac output that occurs with PVV depends on what factors? Lung and chest wall compliance, airway resistance and the duration and magnitude of the positive pressure.
You give your pt a PEEP of 5 and you find that their total PEEP is 12, what is their auto peep and what effect does it have on flow. Auto peep is 7cmH2O and it will decrease the flow to the pt.
What is it called when gas under pressure causes alveolar rupture? Barotrauma.
If the RR is set too low on the vent, how will this affect the patient’s PaCO2 level? How will this change in PaCO2 affect the pH? The PaCO2 will rise. The pH will lower.
A patient comes into the ER with a closed head injury. What pressure do you need to be aware of when selecting your settings on the vent? What setting can you raise to try to reduce this pressure? ICP. RR