Transcription of Respiratory Therapy Pocket Reference P
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Respiratory Therapy Pocket Reference P
AC Assist Control; AC-VC, ~CMV (controlled mandatory ventilation = all modes with RR and fixed Ti)SettingsRR, Vt, PEEP, FiO2, Flow Trigger, Flow pattern, I:E (either directly or via peak flow, Ti settings)FlowSquare wave/constant vs Decreasing Ramp (potentiallymore physiologic)I:EDetermined by set RR, Vt, & Flow Pattern ( for any set peak flow, Square ( Ti) & Ramp ( Ti); Normal Ti: ; to airtrapping& asynchrony-Increase flow rate will decrease inspiratory time (Ti)-Example: Vt 500/RR20/Flow 60--Cycle time = 3s; Ti = = ( )(60s per minute)--Texp = = I:E = = 1:5 ProsGuaranteed MV regardless of changing Respiratory system mechanics; Precise control of Vtto limit lung injuryConsDelivers Vt at all cost = PIPs vary with C breath stacking; fixed flow and Ti can increase asynchrony when pt Vt and flow demand > vent settingsBreath InitiationControl: Time trigger (60s/set RR): fixed VEAssist: Pt effort triggers full breath at set Tiand fixed VT and flowrateIf no pt triggerDelivers full set Vt at set rateBreath terminationTime cycled= breath ends at Tilimit; Alarms if VT not achieved; flow is set, breath ends once Vt deliveredPressure cycled= (safety mechanism); breath termination by clinician set high pressure limit; pop-off breath ends; Default set to 50 cmH2 ONotesInspiratory pause (~ ) can be built into each breath, will increase mean airway pressureDisclaimer: This card is int)
Heliox Pros: Possibly decrease density = better ventilation Cons: Requires special device; Caution w/ 80/20 mix in severe hypercarbic failure; not all NIPPV or IPPV can use FiO2: 20% or 30% mixes available; $$$ NIPPV Pros: May avoid intubation (COPD, cardiogenic pulmedema, mild ARDS, upper airway obstruction) by decrwork of breathing & adding PEEP
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