Intubation
This can be damaged during Intubation
Larynx (33%) Pharynx (19%) Esophagus (18%)
The volume of gas, either inhaled or exhaled, during a breath and commonly expressed in milliliters. Generally set between 8 to 12 ml/kg, but can be set lower to prevent lung overdistension and injury.
What is tidal volume
Should be completed every 12 hours and PRN to cleanse and decrease bacteria.
What is oral care with chlorohexidine packets.
Head of bed for intubated patients unless their is medical reason contraindicating.
What is 30 degrees
Alarms with Air leaks causing volume loss
What is Low pressure alarms?
When intubating a patient, these medications should be obtained.
What are sedatives and paralytics?
The number of breaths per minute that the ventilator delivers.
What is Respiratory rate
This culture should be sent as soon as someone is intubated
What is Sputum Culture
21%-100%
What is FiO2?
Patient just received fentanyl and is on pressure support ventilation and has not triggered a breath within 20 seconds.
What is apnea alarm.
This test most helpful in determining if a patient needs to be intubated
Arterial Blood Gases (ABGs), Also ETCO2 and pulse oximetry.
The average volume of gas entering, or leaving, the lungs per minute, commonly expressed in liters per minute. This is measured by multiplying tidal volume against respiratory rate, normally at rest an adult is 5-8 L/min. Dietary uses this measurement in their assessment.
What is Minute Ventilation
Air remains in the alveoli at the end of expiration leaving the alveolar pressure to remain positive. You will see decrease in minute ventilation and an increase in airway peak pressure.
What is air trapping
Set at 14-20.
What is respiratory rate (RR) or frequency of breaths (f)?
What is high pressure alarm
After intubation you can confirm ETT placement by doing this
What is auscultating the lungs and CXR?
The amount of positive pressure that is maintained at the end-expiration. The purposes is to increase end-expiratory lung volume and reduce air-space closure at end-expiration
What is PEEP Positive end-expiratory pressure
3 of the 6 factors that could increase airway resistance during ventilation. (e.g. high pressure)
What is biting down on the tube, ETT narrowed obstructed, or displaced, cough, secretions, bronchospasm, or fast RR.
Turn this off or pause it if the HOB will be flat for extended period of time.
What is tube feeding
The cuff of the ETT/trach has a leak on full support, therefore the Vt has been between 150-250.
What is low pressure alarm?
You will need these items when intubating a patient as the ICU Nurse.
What is: full suction with yankauer, medication for intubation, call out to RT, orders for sedation post intubation, equipment for intubation
What does the Mnemonic "DOPE" stand for?
What is Dislodgement, Obstruction, Pneumothorax and Equipment.
Proper securement of the ETT or NTT.
What is to the maxilla? Never the mandible.
What is a Covered Yankauer
Your patient has increased SOB, chest pain, elevated heart rate, and abnormally rapid breathing. They have been on increased pressure settings due to ARDS.
What is high pressure alarm.