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Mechanical Ventilation

Ventilator Victims

Introduction to Mechanical Ventilation

*Please take the quiz below the video to receive credit.

Objectives

Provide an overview of measured and unmeasured lung volumes along with factors that affect respiratory mechanics.
Describe how to determine airway resistance and lung compliance.
Understand the basic modes and breath types commonly used in mechanical ventilation.

Reading

Abbreviations Used in Respiratory Therapy
Understanding Abbreviations Used in Respiratory Therapy
Basic Invasive Mechanical Ventilation
Tracheotomy Training Protocol

Lecture

Intro to Mechanical Ventilation Slide Deck

Quiz

Mechanical Ventilation

Name*
First Last
1. Name the 2 most important lung volume/capacity factors that support successful liberation from the mechanical ventilator.*
- a. Tidal Volume (Vt) and Forced Vital Capacity (FVC)
- b. Inspiratory capacity (IC) and expiratory reserve volume (ERV)
- c. Functional Residual Volume (FRV) and Forced Vital Capacity (FVC)
- d. Functional Residual Volume (FRV) and Tidal Volume (Vt)
2. Ventilation without perfusion best describes:*
- a. Shunting
- b. Dead Space
- c. Ventilator Asynchrony
- d. Dynamic Compliance
3. Compliance is determined by:*
- a. FiO2/PaO2
- b. ΔVolume/ΔPressure
- c. PEEP/Tidal Volume (Vt)
- d. ΔPressure/ΔFlow
4. Ideal body weight is used to select the appropriate tidal volume (Vt) for the mechanically ventilated patient. This is calculated using the patient’s:*
- a. Height
- b. Actual body weight
- c. Growth chart
- d. Waist circumference
5. All of the following are commonly used modes of mechanical ventilation except:*
- a. Assist Control (AC)
- b. Spontaneous
- c. Synchronized intermittent mandatory ventilation (SIMV)
- d. Pressure Support (PS)
6. Pressure control breath types exhibit all of the following characteristics except:*
- a. Has an advantage over Volume Control in obtaining static measurements such as Static Compliance and Airway Resistance
- b. Exhibits a set inspiratory pressure and a set inspiratory time
- c. Promotes patient synchrony with a ventilator in a spontaneously breathing patient
- d. Exhaled volume Is variable due to the compliance variability
7. Measuring Static Airway Resistance and Compliance:*
- a. Have no clinical significance
- b. Can be obtained without constant flow if a patient is breathing spontaneously
- c. Require a set breath hold
- d. Require the patient to be chemically paralyzed
8. What mode of mechanical ventilation delivers a set number of mandatory breaths of a set breath type over time allowing spontaneous breaths to be assisted with a full mandatory breath of the same breath type making each breath the same whether it was triggered by time or by the spontaneous patient?*
- a. Synchronized intermittent mandatory ventilation (SIMV)
- b. Assist Control (AC)
- c. Spontaneous with pressure support
- d. Airway Pressure Release Ventilation (APRV)
9. Choose the incorrect statement about pressure support (PS).*
- a. It is a breath type
- b. It has a variable exhaled tidal volume
- c. It is triggered and cycles exclusively by the patient
- d. It is a component of non-invasive CPAP
10. In a patient requiring mechanical ventilation, how soon does it take for significant atrophy of the diaphragm to occur?*
- a. Within Minutes
- b. Within Hours
- c. Within a Day
- d. Within a Week

Ventilator Victims

*Please take the quiz below the video to receive credit.

Objectives

Name basic goals of mechanical ventilation.
Learn basic buttons/functions on every ventilator.
Initiate ventilator settings and know complications of common disease states.
Learn algorithms of how to deal with crisis in the ventilated patient.
Describe proper use and complications of non-invasive ventilation.
Learn and be able to utilize the BEST protocol.

Articles

Noninvasive ventilation as a weaning strategy for mechanical ventilation in adults with respiratory failure: a Cochrane systematic review
Noninvasive ventilation for acute respiratory failure
Puritan Bennett 840 Ventilator User’s Pocket Guide

Lecture

Quiz

Ventilator Victims Quiz

Name*
First Last
1. What is a normal minute ventilation?*
- a. 6-10
- b. 15-20
- c. 25-30
- d. 35-40
2. What is a normal plateau pressure?*
- a. Greater than 30
- b. Less than 30
- c. Greater than 40
- d. Less than 40
3. What is the goal PaCO2 in the patient who has suffered a traumatic brain injury?*
- a. 20-25
- b. 35-45
- c. 30-35
- d. 40-45
4. Which of the following is not a cause of a high-pressure alarm on the ventilator?*
- a. Ventilator Circuit Disconnection
- b. Airway Obstruction
- c. Agitated patient
- d. Obstructed Ventilator Circuit
5. Which of the following is not a cause of a low-pressure alarm on the ventilator?*
- a. Machine Malfunction
- b. Leak in Ventilator Circuit
- c. Damaged Balloon on ETT
- d. Airway Obstruction
6. As a general statement, which settings on the mechanical ventilator affect oxygenation?*
- a. PEEP/FIO2
- b. RR/FIO2
- c. RR/Tidal Volume
- d. FIO2/RR
7. As a general statement, which settings on the mechanical ventilator affect ventilation?*
- a. PEEP/FIO2
- b. RR/FIO2
- c. RR/Tidal Volume
- d. FIO2/RR
8. Which of the following patients would not be a candidate for non-invasive mechanical ventilation?*
- a. 54-year-old female admitted for COPD exacerbation who is awake/alert with O2 sats of 86%
- b. 19-year-old female who was involved in an altercation and has bilateral eye ecchymosis and is lethargic after receiving a dose of Dilaudid with O2 Sats 91%
- c. 79-year-old male with history of lung cancer who is being extubated. His current O2 sat is 96%.
- d. 88-year-old male who is desaturating while sleeping. His oxygen saturation improves when awakened through the night.
9. What is the first step the provider should take when assessing a patient whose ventilator is alarming without a known cause?*
- a. Listen to the patient's breath sounds.
- b. Suction the endotracheal tube
- c. Disconnect the patient from the ventilator and initiate ambubag ventilation
- d. Assess the patient's pain control
10. True or False: When looking at the waveforms on the PB840 ventilator, the red breaths are spontaneous breaths.*
- True
- False

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