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When is nasal intubation used?
Facial or oral trauma
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ET tube cuff inflated for what?
ensure proper placement and formation of a seal between cuff and tracheal wall
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What does the seal in ET tube do?
adequate tidal volume is delivered by vent
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PPV does what?
- force/enhance lung expansion
- improve gas exchange
- decrease work of breathing
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Assist control (AC)
Client does what?
- preset RATE and TIDAL volume
- initiates breath and vent takes over
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SIMV
Client does what?
- preset RATE and TIDAL volume
- initiates breath and TV depends on client's effort
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Why are SIMV breaths synchronized?
To reduce competition between bent and pt
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Pressure support vent (PSV)
- used with SIMV
- spontaneous breathing and adds pressure with inspiration
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PEEP
- keeps alveoli from collapsing during expiration
- more oxygenation and less workload
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CPAP
Does what?
- + pressure during spontaneous breathing
- no breaths delivered
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CPAP used for who and risks?
- OSA
- volutrauma, ICP and decreased CO
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BiPAP
Does what?
- + pressure during spontaneous breathing
- different pressure for inhalation and exhalation
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BiPAP often used for who?
weening pts off vents
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Documentation of placement?
teeth or lips where tube is
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3 types of alarms ?
- Volume- low EXHALED volume due to disconnection, leak, or tube displacement
- Pressure- excess secretions, biting, coughing PE, bronchospams, PT
- Apnea-vent does not detect spontaneous respirations in preset time period
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Pressure cuff should be at and why?
20 and to prevent tracheal necrosis
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How to extubate?
deflate cuff and pull out during peak inspiration
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Aspiration?
- HOB up
- check for residual q4 if getting feedings
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How is baro/volu trauma caused?
- positive pressure
- due to PT, SQ emphysema, PM
volume to lung and to another
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Hemodynamic compromise
SXS
- increased thoracic pressure (+)=decreased venous return
- weak pulses, confusion,
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