Transcript Mechanical ventilation

RSPT 2414 Mechanical
ventilation
Review Unit 3 classifications
By Elizabeth Kelley Buzbee AAS, RRTNPS
Question
• Your patient is on a pressure control
ventilation [PC]. This means:
1. The volume is constant but PIP and flows
can vary with patient time constants
2. The PIP is constant, but volumes and flows
can vary based on patient’s time constants
3. The flow and the VT are constant but PIP
will vary based on patient’s Time constants
Answer
• Your patient is on a pressure control
ventilation [PC]. This means:
1. The volume is constant but PIP and flows
can vary with patient time constants
2. The PIP is constant, but volumes and flows
can vary based on patient’s time constants
3. The flow and the VT are constant but PIP
will vary based on patient’s Time constants
Question
• Your patient is on a volume control
ventilation [VC]. This means:
1. The volume is constant but PIP and flows
can vary with patient time constants
2. The PIP is constant, but volumes and flows
can vary based on patient’s time constants
3. The flow and the VT are constant but PIP
will vary based on patient’s Time constants
Answer
• Your patient is on a volume control
ventilation [VC]. This means:
1. The volume is constant but PIP and flows
can vary with patient time constants
2. The PIP is constant, but volumes and flows
can vary based on patient’s time constants
3. The flow and the VT are constant but PIP
will vary based on patient’s Time constants
Question
• A patient who is on pressure control
ventilation will need the doctor to order
what parameters to deliver a VE?
1. Respiratory frequency [f] and VT
2. Respiratory frequency [f] and PIP
3. Inspiratory time and flow rate [constant
flow pattern]
Answer
• A patient who is on pressure control
ventilation will need the doctor to order
what parameters to deliver a VE.
1. Respiratory frequency [f] and VT
2. Respiratory frequency [f] and PIP
3. Inspiratory time and flow rate [constant
flow pattern]
Question
• Your patient is on a mechanical ventilator
that is gas powered. This means that the
ventilator is --- powered.
1. Electrically powered
2. Battery powered
3. Pneumatically powered
answer
• Your patient is on a mechanical ventilator
that is gas powered. This means that the
ventilator is --- powered.
1. Electrically powered
2. Battery powered
3. Pneumatically powered
Question
• Your patient is on volume controlled
ventilation. His average PIP is 20. Where
do we set the high and low pressure
alarms?
1. At 20 seconds
2. At 45 and 15
3. At 1.O LPM
answer
• Your patient is on volume controlled
ventilation. His average PIP is 20. Where
do we set the high and low pressure
alarms?
1. At 20 seconds
2. At 45 and 15
3. At 1.O LPM
question
• Your patient is resting quietly on a volume
controlled ventilator. His set respiratory f is
10 BPM and his total respiratory f is 10 BPM.
You could assume that the phase variable
that triggers each breath is:
1. Flow
2. Volume
3. Pressure
4. time
Answer
• Your patient is resting quietly on a volume
controlled ventilator. His set respiratory f is
10 BPM and his total respiratory f is 10 BPM.
You could assume that the phase variable
that triggers each breath is:
1. Flow
2. Volume
3. Pressure
4. time
Question
• Your patient is on a volume controlled
ventilator. His set respiratory f is 10 BPM
and his total respiratory f is 15 BPM. You
could assume that the phase variable that
triggers many breathes is:
1. patient
2. manually
3. time
answer
• Your patient is on a volume controlled
ventilator. His set respiratory f is 10 BPM
and his total respiratory f is 15 BPM. You
could assume that the phase variable that
triggers many breathes is:
1. patient
2. manually
3. time
Question
• You need to hyper inflate prior to
suctioning, so you push the manual breath
button. This is an example of a breath that
is:
1. Time triggered
2. Pressure triggered
3. Volume triggered
4. Manually triggered
answer
• You need to hyper inflate prior to
suctioning, so you push the manual breath
button. This is an example of a breath that
is:
1. Time triggered
2. Pressure triggered
3. Volume triggered
4. Manually triggered
question
• Your patient is on volume controlled
ventilation. The PIP rises to 35 cmH20 and
then the pressure drops to 5 cmH20 before
rising again to the PIP at the next breath.
this second pressure is called:
1. CPAP 5
2. PEEP 5
3. Pressure limiting at 5
answer
• Your patient is on volume controlled
ventilation. The PIP rises to 35 cmH20 and
then the pressure drops to 5 cmH20 before
rising again to the PIP at the next breath.
this second pressure is called:
1. CPAP 5
2. PEEP 5
3. Pressure limiting at 5
question
• Your ventilator electrical plug is pulled
out by the cleaning lady. What do you
expect to happen?
1. Loss of power alarm goes off
2. Loss of pressure alarm goes off
3. Disconnect alarm goes off
answer
• Your ventilator electrical plug is pulled
out by the cleaning lady. What do you
expect to happen?
1. Loss of power alarm goes off
2. Loss of pressure alarm goes off
3. Disconnect alarm goes off
question
• In the event of a loss of electrical power,
once the appropriate alarm goes off, what
do we expect to happen next?
1. The battery will start working to keep the
ventilator going
2. The high pressure alarms will go off
3. If the ventilator is plugged into
emergency power source
4. Both 1 and 3
answer
• In the event of a loss of electrical power,
once the appropriate alarm goes off, what
do we expect to happen next?
1. The battery will start working to keep the
ventilator going
2. The high pressure alarms will go off
3. If the ventilator is plugged into
emergency power source
4. Both 1 and 3
question
• Your patient is on pressure control
ventilation and the high pressure alarm
goes off. What happens?
1. It will pressure cycle off
2. The breath will continue at that pressure
till it is time cycled off
Answer
• Your patient is on pressure control
ventilation and the high pressure alarm
goes off. What happens?
1. It will pressure cycle off
2. The breath will continue at that pressure
till it is time cycled off
question
• Your patient is on a volume controlled
ventilator. His set respiratory f is 10 BPM
and his total respiratory f is 15 BPM. You
could assume that the phase variable that
triggers many breathes is:
1. patient
2. manually
3. time
answer
• Your patient is on a volume controlled
ventilator. His set respiratory f is 10 BPM
and his total respiratory f is 15 BPM. You
could assume that the phase variable that
triggers many breathes is:
1. patient
2. manually
3. time
question
• Your patient is on pressure controlled
ventilation and you see that the preset PIP
is 35 cmH20. when the patient reaches this
PIP, you will see what happen?
1. The breath will stop immediately and
high pressure alarms sounds
2. Inspiration will continue at a pressure of
35 until the inspiratory time is completed
answer
• Your patient is on pressure controlled
ventilation and you see that the preset PIP
is 35 cmH20. when the patient reaches this
PIP, you will see what happen?
1. The breath will stop immediately and
high pressure alarms sounds
2. Inspiration will continue at a pressure
of 35 until the inspiratory time is
completed
question
• Your patient is on volume controlled
ventilation; when the PIP reaches the high
pressure alarm at 45 cmH20, you will see
what happen?
1. The breath will stop immediately and
high pressure alarms sounds
2. Inspiration will continue at a pressure of
25 until the inspiratory time is completed
answer
• Your patient is on volume controlled
ventilation; when the PIP reaches the high
pressure alarm at 45 cmH20, you will see
what happen?
1. The breath will stop immediately and
high pressure alarms sounds
2. Inspiration will continue at a pressure of
25 until the inspiratory time is completed
question
• When the breath is ended by the high
pressure alarm, we say that inspiration
was:
1. Pressure limited
2. Pressure cycled
3. Time cycled
answer
• When the breath on PC or VC is ended by
the high pressure alarm, we say that
inspiration was:
1. Pressure limited
2. Pressure cycled
3. Time cycled
question
• When the breath is ended when the
patient’s preset VT of 700 is reached we
stay that inspiration was:
1. Time cycled
2. Pressure cycled
3. Volume limited
4. Volume cycled
Answer
• When the breath is ended when the
patient’s preset VT of .700 Liters is
reached we stay that inspiration was:
1. Time cycled
2. Pressure cycled
3. Volume limited
4. Volume cycled
question
• When you see that the patient’s peak flow
rate is set at 60 LPM and in a constant
flow we see that the flow is always 60
LPM, we can say that this inspiration is:
1. Flow limited
2. Flow cycled
answer
• When you see that the patient’s peak flow
rate is set at 60 LPM; and in a constant
flow we see that the flow is always 60
LPM, we can say that this inspiration is:
1. Flow limited
2. Flow cycled
question
• When we have a volume controlled
volume cycled ventilator, we expect that :
1. The PIP will be exactly the same for every
breath
2. The set VT and the return VT will be very
close together
answer
• When we have a volume controlled
volume cycled ventilator, we expect that :
1. The PIP will be exactly the same for every
breath
2. The set VT and the return VT will be
very close together
question
• Your patient is on volume controlled
ventilation and during a inspiratory hold
we would be seeing an example of :
1. Flow limit
2. Pressure limit
3. Volume limit
4. Time limit
answer
• Your patient is on volume controlled
ventilation and during an inspiratory hold
we would be seeing an example of :
1. Flow limit
2. Pressure limit
3. Volume limit
4. Time limit
question
• When you see that the patient’s peak flow
rate is set at 55 LPM; in a descending flow
pattern that goes all the way to zero and
we see that the flow never exceeds 60
LPM, we can say that this inspiration is:
1. Flow limited
2. Flow cycled
answer
• When you see that the patient’s peak flow
rate is set at 55 LPM; in a descending flow
pattern that goes all the way to zero and
we see that the flow never exceeds 60
LPM, we can say that this inspiration is:
1. Flow limited
2. Flow cycled
question
• Your patient is on Assist/control
ventilation and after the PEEP is
increased you notice that the patient
cannot trigger the ventilator. This implies
that this patient is on:
1. Time triggering
2. Flow triggering
3. Pressure triggering
answer
• Your patient is on Assist/control
ventilation and after the PEEP is
increased you notice that the patient
cannot trigger the ventilator. This implies
that this patient is on:
1. Time triggering
2. Flow triggering
3. Pressure triggering
question
• Your patient’s average PIP is 34 cmH20.
• Where do you set the alarm limits for this
parameter?
1. 35 and 33
2. 32-36
3. 24 and 44
4. 20 seconds
answer
• Your patient’s average PIP is 34 cmH20.
• Where do you set the alarm limits for this
parameter?
1. 35 and 33
2. 32-36
3. 24 and 44
4. 20 seconds
question
• Your patient is on CPAP. His RR is 12
BPM and his average VT is .60Liters.
Where do you set the VE alarm high and
low limits?
1. 500 ml or .5 liters
2. 9.2 and 5.2 LPM
3. 2 and 22
answer
• Your patient is on CPAP. His RR is 12
BPM and his average VT is .60Liters.
Where do you set the VE alarm high and
low limits?
1. 500 ml or .5 liters
2. 9.2 and 5.2 LPM
3. 2 and 22
question
• Your patient is on pressure control
ventilation with a PIP of 24 and a PEEP of
7. where do you set the high pressure
alarm?
1. At 4
2. At 44
answer
• Your patient is on pressure control
ventilation with a PIP of 24 and a PEEP of
7. where do you set the high pressure
alarm?
1. At 4
2. At 44
question
• Your patient is on volume control
ventilation. A/C 12 BPM. His average PIP
is 20 and his PEEP is 5. where do you set
the apnea alarm?
1. At 2
2. At 15
3. At 20 seconds
answer
• Your patient is on volume control
ventilation. A/C 12 BPM. His average PIP
is 20 and his PEEP is 5. where do you set
the apnea alarm?
1. At 2
2. At 15
3. At 20 seconds
question
• What will happen if the low gas pressure
alarm goes off?
1. The disconnect alarm goes off
2. The apnea ventilation starts
3. The machine switches to battery
4. The machine attempts to ventilate with
the remaining gas.
answer
• What will happen if the low gas pressure
alarm goes off?
1. The disconnect alarm goes off
2. The apnea ventilation starts
3. The machine switches to battery
4. The machine attempts to ventilate with
the remaining gas.
question
• Where do you set the Fi02 alarms when
your ventilator patient is on Fi02 30%?
1. 21% and 40%
2. 25% and 35%
3. 50%
answers
• Where do you set the Fi02 alarms when
your ventilator patient is on Fi02 30%?
1. 21% and 40%
2. 25% and 35%
3. 50%
question
• Your patient is on pressure control
ventilation. Her PIP is 25 and her PEEP is
5. Where do you set the low PEEP alarm?
1. At 15
2. At 2
answer
• Your patient is on pressure control
ventilation. Her PIP is 25 and her PEEP is
5. where do you set the low PEEP alarm?
1. At 15
2. At 2
question
• Your patient goes apnea on CPAP. His
IBW is 60kg. At what parameters should
your apnea parameters be set?
1. rate 8 & VT 600 ml with Fi02 100%
2. rate 10 & VT 600 ml with Fi02 100%
answer
• Your patient goes apnea on CPAP. His
IBW is 60kg. At what parameters should
your apnea parameters be set?
1. rate 8 & VT 600 ml with Fi02 100%
2. rate 10 & VT 600 ml with Fi02 100%
question
• What will happen if your CPAP patient is
getting apnea parameters and he starts to
breath again?
1. The apnea rate drops by one breath
2. The apnea setting stop and the patient is
allowed to continue with CPAP
answer
• What will happen if your CPAP patient is
getting apnea parameters and he starts to
breath again?
1. The apnea rate drops by one breath
2. The apnea setting stop and the patient is
allowed to continue with CPAP
question
• Your patient is on volume controlled
ventilation and you see that the
descending flow during inspiration
reaches a very low number [above zero]
then suddenly drops to zero. This is an
example of :
1. Flow cycling
2. Flow limiting
3. Volume cycling
answer
• Your patient is on volume controlled
ventilation and you see that the
descending flow during inspiration
reaches a very low number [above zero]
then suddenly drops to zero. This is an
example of :
1. Flow cycling
2. Flow limiting
3. Volume cycling