Rhyme Time
A beeping sound on the vent, a flashing light, tells you the pressure isn't right.
What is an alarm charm?
This hallmark of ARDS is a type of severe hypoxemia that does not respond to increasing concentrations of supplemental oxygen.
What is refractory hypoxemia?
Elevating the head of the bed, performing regular oral care, and using subglottic suctioning are all interventions aimed at preventing this specific, common complication of mechanical ventilation.
What is Ventilator-Associated Pneumonia (VAP)?
In an emergency situation, after a respiratory or cardiac arrest, for example, this setting is commonly set at or greater than 60%. The typical goal of therapy is to keep the Sao2 at greater than 90% to 92% and this setting at less than 60% to prevent oxygen toxicity.
What is FiO2.
the presence of a ventilator circuit leak allowing air to escape into the atmosphere or when the patient becomes disconnected from the ventilator.
What are causes of Low Pressure Ventilator Alarms.
This little cap, a clever machine, helps make the voiceless patient heard and seen.
What is a voice choice? (Passy-Muir Valve)
According to the Berlin criteria, ARDS is diagnosed when bilateral opacities on chest imaging are not fully explained by heart failure, and this specific ratio is less than 300 mmHg.
What is the PaO₂/FiO₂ ratio (or P/F ratio)?
In case of sudden ventilator malfunction or failure, this piece of equipment must always be readily available at the patient's bedside.
What is a bag-valve mask (Ambu bag)?
The amount of air that is delivered with each breath during the inspiratory phase, is prescribed by the health care provider for volume-cycled ventilators. This setting is set between 8 and 10 mL/kg of IBW to prevent lung injury. Hypoventilation occurs when this setting is set too low, whereas when this setting is set too high, it can result in ruptured alveoli, pneumothorax, and subcutaneous emphysema. Hemodynamic effects of higher VT include tachycardia and decreases in cardiac output and blood pressure.
What is Tidal Volume.
This alarm on the mechanical ventilator provides an emergency backup in the event that the patient’s breathing slows to an unacceptable level or stops. This alarm should be set for a length of time no longer than 20 seconds.
What is Apnea Alarm.
It breaks off from a DVT, causing a breathing catastrophe.
What is a clot that got hot? (Pulmonary Embolism)
In the initial, or exudative, phase of ARDS, damage to Type II pneumocytes leads to a significant reduction in this substance, causing alveolar collapse and decreased lung compliance.
What is surfactant?
After first assessing the patient, this is the most common initial nursing intervention for a high-pressure alarm on the ventilator.
What is suctioning the patient's airway?
This is left in the lungs at end of expiration to prevent alveoli from collapsing.
What is PEEP (Positive End Expiratory Pressure).
The ventilator alarm is going off. You check to be sure that the patient is connected to the ventilator. Ensure patient is ventilating adequately and is not over-sedated.
What is the low minute volume alarm.
The blood gas shows a scary sight, the lungs have given up the fight; O₂ is low and CO₂ is high, upon the vent you must rely.
What is lung function dysfunction? (Respiratory Failure)
This non-pharmacological intervention improves ventilation-perfusion matching by recruiting dependent posterior alveoli and reducing compression of the lungs by the heart.
What is prone positioning?
This formal assessment, often performed daily, involves placing the patient on minimal ventilator support (like CPAP or pressure support) to evaluate their readiness for extubation.
What is a Spontaneous Breathing Trial (SBT)?
MAX SPEED at which mechanical ventilation can deliver vital capacity.
Normal Rates: 60-100 liters/min, generally estimating the peak flow at four times the minute volume
What is Flow Rate.
Assess patient for anxiety. Check vital signs and assess patient for signs of hypoxia (tachycardia, hypertension, restlessness, cyanosis, accessory muscle use, etc.).
What is the high minute volume alarm.
A patient with a Pulmonary Embolism has this sudden feeling, it's not good.
What is doom and gloom?
A patient with ARDS has a PaO₂ of 70 mmHg while receiving mechanical ventilation with an FiO₂ of 0.70. This P/F ratio value indicates this specific severity level of ARDS.
What is severe ARDS?
(Rationale: PaO₂/FiO₂ = 70 / 0.70 = 100. A P/F ratio ≤ 100 mmHg indicates severe ARDS according to the Berlin criteria.)
A patient's ABG results show a pH of 7.28 and a PaCO₂ of 58 mmHg. To help correct this specific acid-base imbalance, the nurse would anticipate an order to increase this ventilator setting
What is the respiratory rate? (Increasing tidal volume would also be an acceptable answer.)
Used to decrease a patient's work of breathing (usually 5-10 H2O).
What is Pressure Support.
Tubing is kinked or compressed. Assess need for suctioning and check for presence of ventilator dyssynchrony and coughing.
What is the high pressure alarm.