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what type of trigger does the 840 have?
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ideally, where do u want to keep the cuff pressure
< 25 cmh20 water pressure
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best measure of muscle strength
< -20 NIF
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what vent changes will you make to increase co2
- in volume ventilation:
- dec RR
- dec VT
- in pressure vent:
- dec pressure
- non-setting:
- add deadspace (every 6in = 50cc's)
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if someone has a ABG of
7.39/42/67/24
inc fio2 or peep
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if pt is off ventilator for an hour weaning and hr increases from 86 to 106 and develops PVC's, what would u do?
- increase fio2 for PVC's
- put the pt back on vent
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when is PS activated in what kinda modes?
any mode w/ a spontaneous breath
-
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what does CMV stand for
continuous/controlled mechanical ventilation
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if pt has a 1:1.2 ratio and the pt appears uncomfy, what could u do to correct?
increase flow (short the itime, longer etime)
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by increasing flow you will also increase
pressure
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if u change vent circuit and the pt exhaled vt is 300 cc's less than set, what would u do
- take pt off vent and bag pt
- and then check for leaks
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what would cause a high pressure alarm
- tension pneumothorax
- secreations
- water in the tube/circuit
- biting
- kink in circuit
- mucus plugs
-
-
-
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formula for RSBI
f/vt in liters
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ABG's of
7.49/30/88/25
what would u do?
dec rr or vt so CO2 will rise
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if u have a severe lung term COPD pt with these ABGS what would u do
7.39/53/70/31
nothing!!!!!
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if somebody is in SIMV, and they appear alil uncomfy but vital signs are stable and pt keeps getting a low exhaled vt on spont breath, what can u do to correct that?
increase PS
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if the flow sensitivity is set too sensitive, what will happen?
auto cycle (keep triggering) w/o the pt
-
medical patients vt
5-8 cc/kl
-
surgical patients vt
8-12 cc/kl
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if u increase someones peep from 3 to 9, what will you watch?
- peak pressure
- bp (increasing peep will decrease bp)
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if u did a spontaneous weaning parameter on a pt and results are
-14, vt of 500, vc of 1600, nif of -30
- wean if u haven't started weaning
- or extubate
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what is the formula of static compliance
ppl-peep/corrected vt
know how to calculate
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if u have a 80 kg pt on these settings
simv of 12, 400, .50, 15 ps
and indicating that theyre not getting enough air, what would you do?
increase vt
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pt in the ICU with
simv of 12, 750, .50, 10 of ps
w/ ABG's of
7.27/48/85.15
what would you recommend to do to the pt?
-
how would u classify this ABG
7.31/57/42/22
resp acidosis w/ moderate hypoxemia
-
7.31/57/42/22
how would you fix the problem?
- increase RR
- increase FIO2 or peep
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does the avea have a internal nebulizer?
yessssssssss
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does the avea have a PRVC
yessssssss
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how do you get ppl pressure and a compliance on the 840?
inspiratory hold
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if u put a pasemear valve (speaking valve) on a pt's tube, what do u have to do to the patient's cuff?
DEFLATE the cuff!!!!!!
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if u put a pasemear valve (speaking valve) on a pt's tube, and you don't deflate it, what will happen to the patient and their lungs?
pt WONT be able to EXHALE
pt's lungs will OVER INFLATES until they pop (barotrauma)
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is VC+ a mode available on the 840?
yes
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VC+ acts like (which mode)?
PRVC
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if you are looking for a leak on a ventilator, where are some places will you look
- circuit
- cuff
- filters
- water traps
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when u turn on the 840, what do u do? what screen will pop up?
- open atmosphere (cap off)
- new pt or same pt screen
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if patient is intubated with ett and u want to decrease their work or breathing (on vent and NOT on the vent)
- give PS
- CUT THE TUBE (will decrease resistance)
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where do you auscultate after intubation? and what should u do to verify?
- stomach
- then lungs
- check c02
- cxr (3cm above carina)
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what would u wanna take a long on a road trip?
-
if youre doing a circuit change, what do you remove first?
patient first
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if youre giving a MDI through the 840 you can give an ins pause, manuel inspiration OR?
pause time (ppl time)
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does the 840 have a sigh
NOOOOOO
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if youre doing trach care for a disposable shilley trach, what are the things you need
- inner cannula
- gauze
- saline/peroxide
- qtips
NO NEED FOR A CLEANING BRUSH (only w/ a non-disposable trach)
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when is pressure sensitivity active on the avea?
when the nebulizer is on
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if you have someone set on
simv of 6, 600, .40, 5 of peep
you want their APNEA settings on what?
- 20 seconds
- 100% fio2
- rate of 10 (no less than 10)
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what are some hazards on a in-line suction catheters
- suction button may not be locked
- pt may self extubate
- suck vt away
(peak pressure may rise; low vt)
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