NASAL CANNULA

ADULT/PEDS MAKE SURE YOU GRAB RT SIZE

GREEN CAPILARY TUBE IS FOR HIGH FLOW

CLEAR CAPILIARY TUBE FOR LOW FLOW

0.5 LPM - 6 LPM  SET FLOW ON FLOW METER

CAN HUMIDIFY AT ANY LPM RATE

 ALWAYS HUMIDIFY ↑4 LPM

SIMPLE MASK - LOW FLOW

0.35 & 0.50 Fi02. INFANT/ADULT SIZE

MUST RUN AT MIN. OF 5LPM TO FLUSH OUT CO2

SEEN MOSTLY IN TRANSPORT PATIENTS

VENTI MASK IS HIGH FLOW

WORKS BY AIR ENTRAINMENT/JET MIXING USING BERNOULLI'S PRINCIPLE RANGES FROM 24% TO 55% EVERY % HAS ITS OWN RATIO AND LPM

THERE ARE VARYING FIO2 AND LITER FLOWS ON PORT

CAN BE HUMIDIFIED BUT NOT DONE SO NORMALLY

GOOD FOR COPD'ERS WHO REQ HIGH CONCENTRAION OF 02 AT A PRECISE RATE

LARGE VOLUME NEBULIZER CAN BE USED WITH A TRACH COLLAR ON A FAIRLY STABLE TRACH PATIENT

FACE MASK FOR PATIENT COMFORT PED/ADULT

FACE TENT- PATIENT IS CLOSTERPHOBIC, FACIAL INJURY, POST FACIAL SURGERY

T-PIECE - PT ON ENDO TRACH TUBE W/O VENTILATOR, 

ULTRA SONIC NEBULIZER

USED FOR BRONCHO HYGIENE/THIN SECRETIONS  DELIVERY OF BLAND AEROSOL/HUMDITY, FINE AEROSOLIZED PARTICLES,   PIEZOELECTRIC CRYSTAL AT BOTTOM OF UNIT

CARE/MONITOR PATIENT FOR OVER HYRDRATION

BRONCHOSPASM

UNIT PULLS IN AMBIENT AIR, CAN BE USED WITH NASAL CANNULA FOR O2 ADMIN SIMULATIONOUSLY

AMPLITUDE/FREQUENCY

FIO2 OVER 50 SET UP TANDEM OR USE MYSTI OX

CONTINUOUS NEBULIZER - MED CUP UP TO 20ML

PROVIDES TX /MEDS OR HIGH HUMIDITY

TX ARE ABOUT ONE HOUR LONG

LARGEST VOLUME MED CUP (USED MAINLY IN ED AND NICU 240ML/4-8HR TX

MONITOR PATIENT DURATION OF TX,  USUALLY PT IS WIRED TO EKG FOR MONITORING AND SPO2, TACHYCARDIA IS A POTIENTIAL PROBLEM, ALSO MEASURE SERUM POTASSIUM LEVELS Q4H

NON REBREATHER MASK - RESERVOIR BAG ATTACHED TO MASK TO PROVIDE 100% (DEPENDS ON PT Vt)  MUST BE RUN AT 5 LPM BUT CAN RUN UP TO 15 LPM.

LITER FLOW RANGE  8-15LPM-A LOW FLOW DEVICE

VALVES ARE EIHER ALL IN PLACE OR ALL OFF,

IF TAKEN OFF, TAPE THEM TO THE BAG ANS SAVE

RESEVIOR BAG REQUIRES A GOOD PULSATION WITH INSPIRATION AND EXPIRATION

WEANING STEPS

NRB

PRB

VENT

NC

NONE

IF YOU ENCOUNTER A PT IN TROUBLE, EX:

CYANOSIS, SHALLOW RESPS AND OUT OF IT,

DON'T LEAVE THE PT'S ROOM!

CHECK THE PULSE/CALL RN- HIT THE LIGHT OR YELL FOR SOMEONE) AND GET THE PTS CODE STATUS,  IF YOU HAVE A SAT MONITOR YOU CAN APPLY THAT.

true or false

there are two types of pneumatically powered ventilators: pnuematic and fluidic

false

unintelligent ventilator systems are the open loop systems

a drive mechanism for positive pressure ventilators includes all of the following except:

a. rotary drive piston

b. spring-loaded bellows

c. flow-controlling solenoid

d. chest cuirass vacuum

d. chest cuirass vacuum

this is a negative pressure system

the major advantage of negative pressure vents is:

a. easse of patient trigger

b. tidal volume control

c. an endotracheal tube isn't required

d. access to patient chest

d. access to patient chest

there is no easy access with negative pressure systems

TRUE/FALSE

the exhalation valve in most icu ventilators is mounted inside the ventilator where it is not visiible.  An internally mounted exhalation valve is usually controlled by a mechanical device such as a solenoid valve

ventilator compressors are capable of reducing or increasing internal volumes, resulting in a change in pressure.  These compressors can use any of the following mechanisms except

a. piston-driven mechanisms

b. rotating blades, vanes

c. moving diaphragms or bellows

d. all of the above

TRUE/FALSE

modern icu ventilators use flow control valves.  These valves control or direct gas flow by opending and closing either completely or in small increments

proportional solenoid valves

sepper motors with valves

digital valves with on-off configurations

(they do not include piezoelectric valves)

this is a mandatory breath.

not an assisted, not spontaneous and not synchrionized

this is an assistad breath

not controlled (pt locked out)

not spontaneous and  not pressure supported

spontaneous breath,

not assisted, not controlled, not synchronized

the tidal volume will decrease

pressure will be unaffected,  the pressure is a preset unfluctuating level of cmh2o

an I:E ratio that will provide the greatest amouont of time for exhalation is

a. 1:2

b. 1:3

c. 3:1

d. 1:4

the inspiratory pause is occasionally used to help

false

peep increases surface area in the alveoli, improving gas exchange

i:e ratio if

rr 15bpm

Ti: 1.5 secs

increase in patients' paco2 and decrease in alveolar ventilation

rr will decrease/causing co2 to rise

increase co2 causes decrease in alveolar ventilation

during vc-cmv which will increase peak pressure

1. increased airway resistance

2. decreased airway resistance

3. increased lung compliance

4. decreased lung compliance

5. increased inspiratory flow rate

6. decreased inspiratory flow rate

1:2

33% is 1/3, there are 3 thirds in a whole, 

one for Inspiration and two for exhalation

psv modes of ventilation include all of the following except:

a. vc-simv

b. vc-cmv

c. psv

d. mmv

b. volume control - controlled mandatory ventilation

all other modes are spontaneous

TRUE/FALSE

\dual control pressure ventilation, with a breath by beath volume target is currently available on the majority of nwer genteration ventilators.  This mode ocmes in two forms: pressure-regulated volume control and volume support both are entirely spontaneous

psv, when appropriatedly set, results in all of the folowing advantages except

a. the inspiratory phase ends when a preset minimal flow is reached

b. the resulting Vt remains constant

c. each breath is patient triggered

d. the peak flow is determined according to patient inspiratory demand

TRUE/FALSE

psv should be avoided in patients with ventilatory muscle fatigue and when a patient has a high work of breathing

female 3.5 x bsa - Ve

male  4.0 x bsa - Ve

placing asthmatic on mv, according to pilbeam and nbrc what Vt rages would you choose and are there any other considerations (hint there are two)

Vt 8-10 ml/kg/ibw

RR:

Te: exhalation time longer tan normal for better more adequate exhaling, reduces airtrapping

60/20=3tct

i:.75

e=2.25sec

ratio 1:3

Itime is 20%+5% = 25% (.35 x 3sec)

if the pressure waveform of a ventilator remains the same when a patient's lung mechanics change then what is the ventilator?

which of the following are caracteristics of a ventilator that functions as a true volume controller:

a. its pressure waveform changes with changes in lung mechanics

b. it measures and uses volume to control the volume waveform

c. its volume waveform stays constant with changes in the lung mechanics

which of the following are characteristics of a ventilator that functions as a true volume controller

1. its pressure waveform changes with changes in lung

2. it measures and uses volume to control the volume waveform

3.  its volume waveform stays constant with changes in the lung

which of the following are characteristics of a ventilator that functions as a true volume controller

1. its pressure waveform changes with changes in lung mechanics

2.  it measures and uses volumes to control the volume waveform

3.  its volume waveform stays constant with changes in lung mechanics

sensitivity

normally set -1cmh2o to -2cmh2o

I time and E time

volume and flow

indications for mechanical ventilation include all of folowing except

a. apnea

b. acute ventilatory failure

c. severe oxygenation deficit

d. metabolic acidosis

d. metabolic acidosis

hazards of mechanical ventilation include all of the following except

a. o2 toxicity

b. volutrauma and barotrauma

c. permissive hypercapnea

d. compromised cardiac output and right heart venous return

TRUE/FALSE

reducing wob for a short period of time may be a secondary indication for mechanical ventilation

TRUE/FALSE

hypoxemic ventilatory insufficiency accompanied by hypocarbia and tachypnea should not be an indication for mechanical ventilation

decrease FIO2 and monitor patients ventilation

calculate Ve if Vt is 500ml and rr is 12

1. change from exhalation to inspiration

2. inspiration

3. change from inspiration to exhalation

4. exhalation

reverse acute respiratory failure

reverse respiratory distress, reverse hypoxemia, prevent or reverse atelectasis, maintain FRC, reverse respiratory mucle fatique, permit sedation or paralysis, reduce myocardial o2 consumption,

PSV is often used when attempts are made to wean a partient off the vent, two modes of PSV are SIMV & PSV

mandatory breath

spontaneous breath

assisted breath

continuous mandatory ventilation

SIMV and spontaneous mode

what is volume targeted cmv

vc-cmv

when volume is set as the control variable, the pressure (PIP) will change with changes in the lungs compliance