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12 Cards in this Set

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STAYING OFF THE VENT
requires a balance between the imposed work of breathing and the ability of the patient to do that work
airways tumors or clogged ven filters
increase RAW
factors to be considered when someone comes off the vent
1) underlying process reveresed
2)hemodynamically stable
3)adequate cough
4)maintain the airway
5)adeqaute respiratory drive
6)
alkalemia
tends to depress the respiratory drive
weaning parameters
1) MV 4-6 liters
2)RR BETWEEN 8 and 30
3)tv >325 cc
4)NIF -20
VC requirement for weaning
1) VC at least 10-15 cc's
PaO2, FiO2, PEEP requirements for weaning
1) less than 60 mm Hg
2)FiO2 less than 50
3) PEEP less than 8
checklist for extubation
1)oxygenation
2)LOC
3)hemodynamics
4)MV, RR,TV,VITALs
5)Tobin index less than 105
typical weaning techniques
1)A/C with increased breathing
2)SIMV decreasing rate
3)SIMV, decreased R, decreased PS
4)CPAP and PS, decreased PS
5)CPAP only
6)extubation to NIV
ideal pace for spontaneous breathing trials
30-120 minutes
Signs that a patient has passed t-piece weaning
1)SpO2>88, sat above 55
2)ph >7.32, increase in PCO2 less than 10
3)HR less than 20, less than 20 BPM increase, BP 90/180, with less than a 20 percent change
Signs that a pt. has failed
1)change in LOC
2)diaphoresis
3)increased WOB
4)ischemia