What does that mean?
MV
MV (VE): Normal ~5-10L/min Minute ventilation. A combine product of set or patient driven respiratory rate and VT. Monitoring MV on IV/NIV can ensure adequate ventilation or failure.
Your patient opens their eyes to voice but doesn't focus on your face for more than 5 seconds. What is their RASS score?
-2
By what time of day should you complete the SAT and Daily Mobility Screen?
11:00 am
During an SAT, a respiratory rate greater than_____
35
What does the "C" stand for in the A-F Bundle?
Choice of analgesia and sedation
Using excessive PEEP in this disease process can worsen hyperinflation....
Asthma
PLAT
Measurement that assess lung compliance or how “stiff” the lungs are. High levels seen in ARDS.
How long should you wait between fentanyl boluses?
30 minutes
When completing the Progressive Mobility Daily Safety Screen, what should you do if the patient fails to meet one of the criteria?
Keep the patient at Level 1
During an SBT, RSBI greater than_____
105
Implementation of the A–F Bundle decreases the incidence of delirium by what percentage?
40%
In left ventricular failure, what vent settings is helpful as it increases the intrathoracic pressure and lowers preload and afterload?
PEEP
PAW
Measurement that assess lung resistance. Inspiratory breaths. Seen in pulmonary fibrosis and bronchospasms. Know how to troubleshoot.
How long should you give the fentanyl bolus to work before titrating the drip to a higher dose?
5 minutes
In Level 3 of Progressive Mobility, how many times a day should the patient get up to the chair?
2 times
If your patient fails their SAT, restart sedation at ______
Half
Both SAT and SBT daily
Hyperventilating an intubated patient can lower which targeted pressure?
Intracranial Pressure
NIF/MIP
Use those muscles! Measures the strength of you breathing muscles (diaphragm). Pt must produce an adequate negative pressure to generate a breath in.
FiO2 >70%
PEEP >10 cmh20
Sedation for active seizures
Active cooling (post-code)
Paralytics
Muscle strength in a healthy person can decrease how much for every day spent on bed-rest?
1.3-3%
An indication of SBT failure is_______
RR <8 or >35
SPO2 <88%
Distress
Mental Status Change
Acute Cardiac Arrhythmia
A patient experiences orthostatic hypotension while dangling at the side of the bed. After how many days of immobility is this condition most likely to develop?
Day 3
Auto-PEEP is usually due to....
Inadequate exhalation time. (I:E ratio). The ventilator wave form will not return to baseline.
RSBI
Rapid Shallow Breathing Index. A tool to assess if a patient can adequately and safely breathe on their own. Goal <105, <60 lowers the chance of reintubation. RR/VT
What tool is used to assess pain when a patient is ventilated?
CPOT (Critical-Care Pain Observation Tool)
When completing the Progressive Mobility Safety Screen vasopressor section, how many hours must the patient have had no new vasopressors initiated and no increases in vasopressor dosing before the box can be checked?
2 hours
What percentage of patients experience unplanned extubation when they are not routinely sedated?
0.6%
What is the number one reason for not getting patients mobilized?
"I'm having a very busy day"
When addressing ventilator dyssynchrony, which ventilator settings should be assessed and adjusted?
Auto-PEEP
Flow Starvation
Too long I-Time
Double Triggering
Ventilator issue itself or disposables