Asynchronies
In this asynchrony, the ventilator breath initiates a patient effort, potentially causing breath stacking, most often in heavily sedated individuals.
What is reverse triggering?
Patient can be on this FiO2 throughout percutaneous tracheostomy procedure.
What is 100%?
If you are having trouble calibrating the mask, you can do this.
What is remove the mask and block the flexitrunk to calibrate?
This one difference shows the distinction between arteries and veins on ultrasound
What is the artery doesn't collapse when pressure is put on the wrist with the probe?
This is the recommended cuff pressure to prevent microaspirations and VAP.
What is > 25cmH20?
This asynchrony shows beaking on the F/V loop and usually indicates high tidal volumes
What is overdistention?
To optimize delivery of nebulized medications through an Aerogen in a patient on high flow, flow should be decreased to this.
What is 30 Lpm?
These two alarms should be turned off when baby on nCPAP.
What is apnea ventilation and respiratory rate?
This is one benefit of moving the art line placement up that arm.
What is improved vessel size and stability?
These two measurements should be done on the vent every shift to ensure lung protection (especially in hypoxemic patients).
This occurs commonly in traumas, creates increased risk of baro/volutrauma and prolongs MV and ICU stay. RT must pay close attention to vent settings and tolerate permissive hypercapnea/hypoxemia.
What is an air leak?
This can cause inflammation, absorptive atelectasis, extended ICU stay, increased chance of VAP and vasoconstriction to name a few.
What is hyperoxia?
If mask or prongs are calibrated, but no value is showing up under PIF, you should do this.
What is go back into settings and make sure the mask or prongs are selected?
This structure is “bright white with black dots or honeycomb” on ultrasound.
What is nerve tissue?
This is the optimal range for P0.1 (airway occlusion pressure) which measures respiratory drive.
What is -2 to -5 cmH2O?
This is the most common cause of ineffective efforts on a ventilator.
What is over-assistance by the ventilator?
Decrease PS first, if that doesn't work, try increasing Esens % to shorten cycling criteria
This is the dose for inhaled nitroglycerine in ER
What is 5mg? (5 mg = 1ml, dilute with 3 mls of NS)?
What is ask someone else (RN or RT) to hold CPAP with mask while you calibrate?
The acronym SAC stands for this.
What is short axial cannulation?
This practice reduces VAP and VILI, decreases days on the ventilator and LOS potential and prevents de-recruitment.
What is minimizing disconnections (ie. flusso valve)?
This is one way to correct double triggering on the ventilator.
What is increase tidal volume or pressure or increase inspiratory time?
You can also adjust sensitivity and try changing to PSV or increase sedation.
What is 20-30 minutes?
When the ventilator is repeatedly alarming circuit disconnect, this setting needs to be increased.
What is Dsens?
It should be set higher than the leak. This can create a more turbulent flow but will not harm the baby. A good setting is around 20 Lpm
This structure is anechoic on ultrasound.
What is the artery lumen?
On ultrasound, a structure that is anechoic (completely black, with no internal echoes) is typically fluid-filled, because fluid does not reflect sound waves. EG. Blood vessels (arteries and veins) when filled with blood, Cysts, Urinary bladder, Gallbladder
When measuring Pocc, you read this on the waveform after an expiratory hold.
What is the lowest point on the pressure tracing to find Delta P (Normal = -10 to -20 cmH2O)?