Modes Of Ventilation Ronald S. Levy, M.D Assistant Professor of Anesthesiology UTMB - Galveston Overview * Compare different ventilator control modes * Review different modes of ventilation * Compare and contrast CMV, AC, SIMV and PS modes of ventilation Pressure Cycled Ventilation * Terminates inspiratory phase at a preset PIP * TV varies directly with lung compliance and inversely with airway resistance. * Advantages: reduced barotrauma which has been implicated secondary to high PIP. * Disadvantages: if compliance ? or airway resistance ? then TV ?, MV ?, PaCO2 ?
Checking ventilator functions ,such as tubing connections ,water in the tubing ,the water trap or filter,ventilator settings -mode appropriate to clinical status and size(neonatal,paediatric or adult),trigger,rate,volumes and alarms is useful to exclude causes of changes. (Hazinski,1999) Changes in ventilation can also be induced by increases or decreases in resistance and compliance. Reference: * Davies, J and Hassell,L (2003) : Children in intensive care -A nurse's survival guide London :Churchill Livingstone *Hazinski, M
Exam Question Dr. Tom O`Dwyer 9th April 2009. Write a detailed essay on the use of respiratory protection in limiting occupational exposure to vapours and particulates in the workplace. If you plan to have your employees use respirators, you should ensure that the appropriate respirator is selected for the type of work being performed and the types of respiratory hazards present. By learning when and why respirators should be used and by familiarizing yourself with the different types of respirators available you can provide your employees with appropriate protection and reduce losses from accidents and illnesses. Respirators are devices used to reduce workers exposure to respiratory hazards such as fumes, mists, gases, vapours or harmful dusts.
Life support may begin with basic CPR. Subsequently, the most common technique to secure an airway is by the insertion of an endotracheal (ET) tube through the mouth or nose into the windpipe. If an ET airway cannot be established then a tracheotomy is performed, which is a surgical procedure in which a tube is inserted into the windpipe through an incision made in the base of the throat (Berniker). When the patient cannot breathe sufficiently on his or her own, the physician will use a ventilator, a machine that pumps air in and out of the patient’s lungs to aid in respiration. Circulation refers to the flow of blood around the body from the heart to vital organs.
“Preventing complications in the application of Non-Invasive Ventilation” Noninvasive ventilation (NIV) is using a ventilator support without administering an invasive artificial airway (endotracheal tube or tracheostomy tube). Noninvasive ventilation is used as a replacement for invasive ventilation. Complications of noninvasive ventilation include; Facial and nasal pressure injury and sores. This occurs due to the result of tight mask seals used to attain adequate inspiratory volumes. Pressure can be minimized by intermittent application of noninvasive ventilation, Scheduling breaks (30-90 min) to minimize effects of mask pressure.
Team D * Assessment As the assessment is what all the following nursing skills and interventions are built on a quick and thorough nursing assessment is critical. A quick assessment focuses on the patient diagnosis is a focal assessment. Assessment skills include * Assessing vital signs, especially respiratory and heart rate, oxygen saturation (noting if it is on room air , if not, current oxygen settings), skin color, and mental status as well as determining the relevance of your findings (Burgess, 2009) * Lung auscultation (including assessing for retractions, shortness of breath and breathlessness with talking and activity) (Burgess, 2009) * Checking for edema; looking at and listening to the patient (Burgess, 2009)
The patient is also receiving multiple courses of respiratory treatment, including vest therapy, cough assistance and nebulizer treatments. Hypoxemia: Abnormally low levels of oxygen in the blood. Hypoxemia may be mild to severe and leads to shortness of breath. Low blood oxygen can result from a variety of conditions that affect either the ability of the heart to pump blood to the lungs to receive oxygen or the function of the lungs themselves. Cerebral hypoxia can be caused by any event that severely
NURSING MANAGEMENT OF PATIENTS WITH CHEST DRAINS Chest drains are one-way draining medical devices that allow fluid or air accumulations to be drained from the chest cavity. Normally the chest drains are inserted following an x-ray report that confirms the presence of air or fluid in the chest cavity. The rationale for the chest drain insertion is that the drain will help restore the normal function of the lungs, by allowing the drainage of the air or fluid collected in the pleural space. There are a number of indications for drains insertions such as: pneumothorax, pleura effusions, haemothorax or post cardio-thoracic surgery. To understand completely the importance of inserting chest drains, when required, we have to look closely at the entire mechanism of breathing.
When plaque builds up in the arteries, it reduces, or eventually blocks where blood can flow. CAD over time can weaken the heart muscle, cause an irregular heartbeat, cause heart failure, or lead to death. Treatment and prevention are vital to caring for a patient with CAD. Treatment occurs after a patient has been diagnosis with CAD. They have either suffered a myocardial infarction or simply had angina (chest pain) that was evaluated with coronary angiography.
Indicator of health: Peak Flow Peak flow is a way a GP, nurse or health practitioner can monitor how well the respiratory system is working. Peak flow means that the maximum rate that can person can blow out air of their lungs. A client that has a good respiratory system will have a higher peak flow then someone that has a poor respiratory system, such as bronchitis, asthma, or smoking problems. Peak flow is measured using a peak flow meter. The picture below shows what a peak flow meter looks like.