KETTERING: MECHANICAL VENTILATION – E.
Perfect Prep for Every Paper | Precision in Every Answer!
Four variables during mechanical ventilation: - Answer: trigger variable- *starts breath*
Control or target variable- mode
Limit variable - maximum value
Cycling variable- *ends inspiration*
What is the primary variable the ventilator adjusts to achieve inspiration - Answer:
control or target variable
Volume control or target- set volume to be delivered
Pressure control or target- set pressure to be delivered
Limit variable: - Answer: establishes a maximum value that a variable (pressure,
volume, time, flow) can reach during inspiration
Cycling variable: - Answer: the variable that ends (terminates) the inspiratory phase of
a positive pressure breath
Spontaneous breath - Answer: patient controls all variables pertaining to each breath
Mandatory breath - Answer: ventilator controls all variables pertaining to the breath
Assisted breath - Answer: patient initiates the breath and the ventilator controls the
remaining variables
High pressure alarm - Answer: should be set at 10 cmh2o above peak airway pressure
Minimum exhaled volume alarm - Answer: should be set 100 ml below exhaled tidal
volume
Low pressure alarm - Answer: set 10 cmh20 below peak airway pressure
1
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,Oxygen alarm - Answer: set 5% below & above set fio2
Three phases to mechanical ventilation: - Answer: phase 1- initial setting
Phase 2- monitoring/manipulating
Phase 3- weaning
Ventilator failure to cycle, loss of power, oxygen failure - Answer: check power supply
Inline MDI should be located on the vent? - Answer: on inspiratory side of the Y-
adaptor, as close to pt as possible
Troubleshooting ventilator always - Answer: provide manual ventilation first
Low pressure alarm consider - Answer: - pt disconnect
- leak in circuit
- insufficient flow
- endotracheal/tracheostomy tube cuff leak
High pressure alarm consider - Answer: - obstruction (ETT, pneumothorax, raw,
secretions, etc)
- equipment obstruction (vent circuit)
Low exhaled volume alarm - Answer: - disconnect (vent circuit)
- low spontaneous VT
A pt who is being mech vent has received an MDI tx inline with vent circuit. Following tx
the low exhaled Vt alarm is sounding. Why would this occur & how should it be fix? -
Answer: most likely caused by leak in system causing loss volume.
Correct inspect circuit for loose connections
2
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, QC procedure for ventilator the accuracy controlled by the vent should be verified
periodically: variable- volume pressure flow - Answer: volume - spirometer
Pressure - mercury or water manometer
Flow - rotameter
Phase 1: initial settings - Answer: recommend/initiate mechanical ventilation
Recommend/select initial ventilator settings
Phase 2: monitoring/manipulating settings - Answer: monitor the pt, recommend/initiate
changes to vent settings, identify and correct problems with the patient and vent
Phase 3: weaning - Answer: assess the pt readiness for weaning, implement weaning
procedures, monitor the pt during weaning
Indications for continuous mechanical ventilation: - Answer: 1. Apnea- not breathing
(observation) absolute indication
2. Acute ventilatory failure/acute respiratory failure- insufficient spontaneous ventilation
to maintain normal physiologic parameters, including paco2 and pao2
3. Impending ventilatory failure- trend of rising paco2 and/or decreasing Vt, VC, MIP
4. Oxygenation- to reduce WOB (if pt has acceptable paco2, O2 can be fixed with
oxygen therapy
Initiating MV according to patient assessment: - Answer: 1. ABG
2. Bedside ventilatory parameters
3. Physiological assessment/calculations
Bedside ventilatory parameters:
Normals and unacceptables:
3
APPHIA - Crafted with Care and Precision for Academic Excellence.
Perfect Prep for Every Paper | Precision in Every Answer!
Four variables during mechanical ventilation: - Answer: trigger variable- *starts breath*
Control or target variable- mode
Limit variable - maximum value
Cycling variable- *ends inspiration*
What is the primary variable the ventilator adjusts to achieve inspiration - Answer:
control or target variable
Volume control or target- set volume to be delivered
Pressure control or target- set pressure to be delivered
Limit variable: - Answer: establishes a maximum value that a variable (pressure,
volume, time, flow) can reach during inspiration
Cycling variable: - Answer: the variable that ends (terminates) the inspiratory phase of
a positive pressure breath
Spontaneous breath - Answer: patient controls all variables pertaining to each breath
Mandatory breath - Answer: ventilator controls all variables pertaining to the breath
Assisted breath - Answer: patient initiates the breath and the ventilator controls the
remaining variables
High pressure alarm - Answer: should be set at 10 cmh2o above peak airway pressure
Minimum exhaled volume alarm - Answer: should be set 100 ml below exhaled tidal
volume
Low pressure alarm - Answer: set 10 cmh20 below peak airway pressure
1
APPHIA - Crafted with Care and Precision for Academic Excellence.
,Oxygen alarm - Answer: set 5% below & above set fio2
Three phases to mechanical ventilation: - Answer: phase 1- initial setting
Phase 2- monitoring/manipulating
Phase 3- weaning
Ventilator failure to cycle, loss of power, oxygen failure - Answer: check power supply
Inline MDI should be located on the vent? - Answer: on inspiratory side of the Y-
adaptor, as close to pt as possible
Troubleshooting ventilator always - Answer: provide manual ventilation first
Low pressure alarm consider - Answer: - pt disconnect
- leak in circuit
- insufficient flow
- endotracheal/tracheostomy tube cuff leak
High pressure alarm consider - Answer: - obstruction (ETT, pneumothorax, raw,
secretions, etc)
- equipment obstruction (vent circuit)
Low exhaled volume alarm - Answer: - disconnect (vent circuit)
- low spontaneous VT
A pt who is being mech vent has received an MDI tx inline with vent circuit. Following tx
the low exhaled Vt alarm is sounding. Why would this occur & how should it be fix? -
Answer: most likely caused by leak in system causing loss volume.
Correct inspect circuit for loose connections
2
APPHIA - Crafted with Care and Precision for Academic Excellence.
, QC procedure for ventilator the accuracy controlled by the vent should be verified
periodically: variable- volume pressure flow - Answer: volume - spirometer
Pressure - mercury or water manometer
Flow - rotameter
Phase 1: initial settings - Answer: recommend/initiate mechanical ventilation
Recommend/select initial ventilator settings
Phase 2: monitoring/manipulating settings - Answer: monitor the pt, recommend/initiate
changes to vent settings, identify and correct problems with the patient and vent
Phase 3: weaning - Answer: assess the pt readiness for weaning, implement weaning
procedures, monitor the pt during weaning
Indications for continuous mechanical ventilation: - Answer: 1. Apnea- not breathing
(observation) absolute indication
2. Acute ventilatory failure/acute respiratory failure- insufficient spontaneous ventilation
to maintain normal physiologic parameters, including paco2 and pao2
3. Impending ventilatory failure- trend of rising paco2 and/or decreasing Vt, VC, MIP
4. Oxygenation- to reduce WOB (if pt has acceptable paco2, O2 can be fixed with
oxygen therapy
Initiating MV according to patient assessment: - Answer: 1. ABG
2. Bedside ventilatory parameters
3. Physiological assessment/calculations
Bedside ventilatory parameters:
Normals and unacceptables:
3
APPHIA - Crafted with Care and Precision for Academic Excellence.
