Fix the ABG
Troubleshooting Alarms
Pharmacology
Oxygenation & PEEP
Liberation
100
This ventilator setting change is indicated for a patient with pH 7.25, PCO2 65, and HCO3 25.
What is increasing minute ventilation (via rate or tidal volume)?
100
A patient with fluid overload is receiving mechanical ventilation via AC PC, ETV 400. The patient received Furosemide 40 mg IV two hours ago. The RT now notes an ETV of 550 ml.
This is attributed to increased compliance.
100
- These rapid-acting induction agents are preferred in hypotensive patients during RSI, which help maintain B/P stability.
What are Etomidate and ketamine?
100
This is the best indicator of oxygenation status in a patient with ARDS.
What is the p/f ratio?
100
This is the most important clinical question to ask before attempting a spontaneous breathing trial (SBT).
Has the underlying cause of respiratory failure resolved?
200
A 70 kg patient a p/f ratio 80) receiving mechanical ventilation via AC, VC, Vt 6 mL/kg, PEEP 16, FiO2 1.0, has an ABG of pH 7.21, PCO2 60, PO2 55. The RT would now recommend.
What is administering paralytics to the patient and begin prone positioning?
200
This is the first action when the High-Pressure alarm sounds despite suctioning.
What is manually ventilating the patient to assess status?
200
This sedative-analgesic is preferred for weaning because it does not cause respiratory depression.
What is Dexmedetomidine (Precedex)?
200
This, not higher FiO2s, is the primary method to treat refractory hypoxemia.
What is therapeutic PEEP?
200
This is the maximum recommended RSBI for a successful SBT.
What is < 105?
300
In a patient with compensated respiratory acidosis, these are the expected pH and HCO3 ranges.
What is a pH of 7.35–7.39 and an HCO3 of > 26 (fully compensated)?
300
In Pressure Control mode, if the ET tube migrates to a right mainstem intubation, this parameter will change, causing a Low Tidal Volume alarm.
What is decreased compliance (less volume delivered at the same pressure)?
300
This paralytic agent is contraindicated in patients with hyperkalemia or chronic neuromuscular disease.
What is Succinylcholine?
300
This is the "lower inflection point" on a pressure-volume curve and its significance.
What is the point (PEEP Level) where recruitment begins?
300
A daily SAT and SBT has proven to reduce these.
What are ventilator days?
400
A patient on Volume Control shows a plateau pressure of 38 CWP. This strategy should be implemented to prevent barotrauma.
What is Pressure Control Ventilation?
400
A patient on AC VC has a high RR alarm, but the machine shows low tidal volumes and high peak pressures. This phenomenon is likely occurring.
What is dynamic hyperinflation (auto-PEEP)?
400
This is the primary reason to use Ketamine in a patient with status asthmaticus.
What is its bronchodilatory effect?
400
A patient with ARDS has the following data: PIP 36, Ppl 27, ETV 450, and PEEP 15 CWP. This patient has a driving pressure of
The driving pressure is 12 CWP.
400
Weaning failure usually occurs during this time.
What is the first 10 minutes of an SBT?
500
This strategy allows an ABG abnormality to persist to prevent VALI in a patient with status asthmaticus.
What is permissive hypercapnea?
500
A patient on mechanical ventilation is monitored with PETCO2. The "shark fin" waveform, along with high-pressure alarms, indicates this clinical issue.
What is bronchospasm or mucus plugging?
500
This drug is used to reverse respiratory depression caused by benzodiazepines.
What is Flumazenil?
500
- These are the four cardiovascular risks of excessive PEEP.
What are reduced preload, reduced cardiac output, hypotension, and oxygen delivery?
500
These must be ≥60 and 90 for weaning to be successfu on an FiO2 of ≤ 50%.
What are PO2 and SpO2?