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Exam 1 review

Exam 1 review. PV loop. Note over distention Patient triggers Asynchrony RAW. Flow Patterns. Constant/Square: Causes lower I-time, less MAP, higher PIP Only set in VC Can increase oxygenation Generally uncomfortable for your patients. Flow Patterns. Ramp

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Exam 1 review

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  1. Exam 1 review

  2. PV loop • Note over distention • Patient triggers • Asynchrony • RAW

  3. Flow Patterns • Constant/Square: • Causes lower I-time, less MAP, higher PIP • Only set in VC • Can increase oxygenation • Generally uncomfortable for your patients

  4. Flow Patterns • Ramp • Can be set in volume, automatic pattern in PC • Will increase MAP, and prolong I-time • When switching from constant to ramp, you may have to increase flow to maintain same I-time, I:E ratio

  5. Pressure time graph • Used to assess patient triggering • Used to assess inadequate flow rate/double breaths • Assess level of PEEP • Assess rise time • Assess Plat time

  6. Work to Trigger 30 Paw cmH2O Sec 1 2 3 4 5 6 -10

  7. Patient/Ventilator SynchronyThe Patient Outbreathing the Set Flow Air Starvation Paw Sec cmH2O 1 2 3 4 5 6 -20

  8. Plateau Time 30 Adequate Plateau Time Paw SEC cmH2O 1 2 3 4 5 6 -20

  9. Flow Acceleration Percent Rise Time Minimal Pressure Overshoot P Slow rise Moderate rise Fast rise . V Pressure Relief Time

  10. Pressure time graph • A-B Inspiratory time, B-C Expiratory time, D PEEP level, E PIP

  11. Compliance changes • Static vs dynamic • Know formula and causes for each

  12. Initial setup and manipulation • Know generic ranges • Know modified ranges (VT 5-7 ml/kg with higher rates) • Know rules for manipulation

  13. PC vs VC • PC pressure limited time cycled, volume and flow vary, volume varies with compliance, flow varies with minute volume • VC volume limited flow cycled, pressure varies with compliance, i-time varies with flow and frictional resistance

  14. SIMV vs AC vs CPAP • Know what is set in each mode • Know what PSV is and how to set it

  15. Formulas • I:E ratios • Desired CO2, PO2 formulas • VD/VT ratio • A-a gradient, aA ratio, PF ratio • VA, VE • RAW, CS, CD

  16. Auto PEEP • How do we fix it? • How do we assess it?

  17. PEEP • Indications • Uses/hazards • Optimal peep

  18. Mean Airway Pressure • Definition for mean airway pressure (mPaw) • Causes for increases MAP

  19. Definitions • Volume assured pressure support • ATC • PSV • AC • SIMV • CPAP vs PEEP • PRVC

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