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3 indications for BiPAP - correct answer-
COPD
Short term use (24-48hrs) to tx issue
Pulmonary edema
A 27-year-old man is admitted to the ICU with a
subarachnoid hemorrhage after a motor vehicle crash. On
examination, his initial Glasgow Coma Scale score was 8
with labored respirations. He was intubated in the
emergency department and placed on a ventilator.
Shortly after arrival to the unit, his pulse oximeter (SpO2)
reads 57%, with heart rate of 46 beats/min and no pulse.
Which of the following is the safest and most immediate
method to verify correct endotracheal tube placement?
A. Palpation over the epigastrium for abdominal
distension
, B. Manual bag-mask breathing
C. Qualitative exhaled carbon dioxide monitor or detector
D. Portable chest radiograph - correct answer-
C exhaled CO2 monitor/detector
A 35-year-old man develops acute respiratory distress
syndrome from smoke inhalation injury. He is receiving
invasive mechanical ventilation in volume assist control
mode. His ventilator settings are: tidal volume 350 mL (6
mL/kg ideal body weight), respiratory rate 28
breaths/min, gas flow rate 80 L/min, and positive end-
expiratory pressure (PEEP) 10 cm H2O. His plateau
pressure on these settings is 26 cm H2O. Arterial blood
gas analysis reveals: pH 7.28, PCO2 50 mm Hg, PO2 50
mm Hg, bicarbonate 26 mmol/L, and oxygenation
saturation 82%. Which of the following is the most
appropriate next step in management?
A. Increase PEEP to 14 cm H2O.
B. Increase the respiratory rate to 35 breaths/min.
C. Start a bicarbonate infusion.
D. Lower the tidal volume to 5 mL/kg ideal body weight. -
correct answer- A increase PEEP to 14