ppt课件-mechanicalventilationbasicsfornursing.pptVIP

* Laryngoscope is always held in the left hand and is used to displace the tongue to the left so that the epiglottis may be seen. * An easy trick to use is tube size X 3 – works almost all the time. * You must rule out an esophageal intubation with capnography or by BS. Always listen over the epigastrium after listening to the chest. These are bedside procedures that must be done immediately after intubation prior to an XRAY. * Can be done with tape or a commercially available ETT stabilizer. Always tape above the ETT and never to the chin. * * * * * * * * * * * * * * * * Notice how the patient’s breath reflects the ventilator breath. Not for conscious patients! * * Please note that the patient has to be spontaneously breathing to use this mode! Often used in conjunction with weaning the patient from the ventilator. * Used for patient’s that cannot be oxygenated. * This is the primary reason for using a HFV. * 9 minute video – I just want to show how the oscillator sounds and what it looks like. * Flow Trigger allows the patient to pull a spontaneous breath from the vent whenever he wants. Tidal Volume is the amount of air the patient is given with each breath (10-12 ml/kg IBW) Rate is normally set at 10-12 bpm (adults) and then changed via ABG Flow – most new vents set the flow to deliver a set I:E ratio. Flow of 40-80 L/min to achieve an I:E of approximately 1:2. PEEP – 3-5 cmH20 is physiologic peep Pressure Limit – set at 10 – 20 cmH20 above pt’s own PIP Humidification – heated to 35-37°C to provide humidification due to bypassed upper airways * * Any variance in these values will require a change made to this patient’s ventilator. Assist/Control Mode Delivers pre-set volumes at a pre-set rate and a pre-set flow rate. The patient CANNOT generate spontaneous volumes, or flow rates in this mode. Each patient generated respiratory effort over and above the set rate are delivered at the set volume and flow rate. A/C cont. Negative deflection, trigger