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36 Cards in this Set
- Front
- Back
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total Lung capacity
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volume of air the lungs can hold with max inspiration 5500-6000 ml
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tidal volume
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volume of air moved in and out to the lungs with each breath. 7ml/kg
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inspiratory reserve volume
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volume of air that can be max inspired above normal inspiration. 3 liters.
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expiratory reserve volume
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air volume that can be max exhaled after normal expiration. 1 liter
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vital capacity
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amount of air forced out of lungs after max respiration. 4.6-4.8 liters
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residual volume
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air remaining in lungs after max expiration. 1 liters
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functional residual capacity
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volume of air remaining in lungs at the end of normal expiration. 2 liters
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minute volume
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amount of air expired in one minute. (RR x TV) 5-10 liters
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alveolar ventilation
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air that is involved in alveolar gas exchange. 350ml
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compliance
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measure of expandability of the lungs and thorax.
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extrinsic compliance factors
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kyphoscoliosis
chest trauma obesity ventilator tubing |
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intrinsic compliance factors
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atelectasis
pneumonia pulmonary fibrosis ARDS |
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resistance
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the opposition to flow caused by the forces of friction.
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extrinsic effecting resistance
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ET tube size and length
ventilator tubing |
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intrinsic effecting resistance
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airway diameter
secretions bronchospasm foreign body aspiration |
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4 goals of mechanical ventilations
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maintain adequate PaO2 and PaCO2
abg to acceptable lvl for patient improve ventilations decrease work of breathing |
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typical clinical indicators for mechanical ventilation.
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PaCO2 > 50mmHg
PaO2 <60 with inspired o2 conc. > 60 RR> 35/min |
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critical blood gases
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ph <7.2
paco2> 55 pao2 <60 |
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Positive pressure ventilators:
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creates inspiration by positive pressure being pushed into lungs.
3 types: trigger, target/limit, cycle |
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trigger ppv:
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patient trigger: goes off when patient starts to take a breath.
time trigger: vent initiate breath at preset times |
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target/limit vent:
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controls gas delivery during the breath.
can be pressure, volume, or flow limited. |
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cycle ppv:
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terminates the breath after certain volume, I time, or set PIP is reached.
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Which vent is best suited for short term support:
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pressure cycled ventilator.
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high frequency ventilators:
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use small TV: 1-3ml/kg
RR>100BPM |
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NIPPV BiPAP advantages
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-improves Lung compliance
-increases FRC -reduces need for sedation and med assisted intubation -decreases infection risk |
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CMV defined:
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Controlled mandatory ventilation: triggered only by time and cannot be used with spontaneous breathing patients or non paralyzed patients.
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AC vent defined:
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-preset volume or pressure delivered for each patient inspiratory effort.
-if patient fails to initiate set amount of breaths, the ventilator will initiate the preset volume/rate. |
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PRVC defined:
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-pressure regulated volume control: form of AC ventilation with a constant pressure applied throughout inspiration.
- can be vent initiated or patient assisted. |
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SIMV defined:
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synchronized intermittent mandatory ventilation:- preset volume or rate delivered at preset time.
- patient may take additional breaths of any TV without interference from ventilator. -spontaneous breaths DO NOT trigger ventilator |
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initial RR in A/C mode:
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typically 2-4 bpm below the patients spontaneous rate
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initial RR in SIMV mode:
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typically set close to patients spontaneous rate.
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oxygen toxicity causes:
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exposure to >50-60% FiO2 for prolonged periods (greater than 48 hours)
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3 signs/symptoms of oxygen toxicity:
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-V/Q mismatch
-Diffuse pulmonary infiltrates on chest x-ray. -oxygen saturation falling despite increase FiO2 |
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conjunctivitis
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air leak around the bridge of the nose and into the eyes
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causes of high pressure alarms:
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-airway obstruction due to secretions
-patient holding breaths -kinked tubing of ET tube -patient biting tube -right main stem intubation -bronchospasm -decreased lung compliance -cough/gaging |
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low pressure alarm:
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-disconnect from vent
-unintended extubation -leak in system/cuff -tracheal/esophageal fistula -patient becomes apneic |
