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5115151
Troubleshooting the Ventilator
Descrição
Troubleshooting the ventilator
Sem etiquetas
airway
ventilator
troubleshoot
Mapa Mental por
Kesh K
, atualizado more than 1 year ago
Mais
Menos
Criado por
Kesh K
mais de 8 anos atrás
19
0
0
Resumo de Recurso
Troubleshooting the Ventilator
Is the Patient haemodynamically unstable?
Yes - Disconnect and use BVM - can you BMV?
Yes - Circulation/ventilator problem
Causes of hypotension
Hypovolaemia
Drug Induced (e.g.Sedatives)
Raised intrathoracic pressure from dynamic hyperinflation
Tension Pneumothorax
No -
ETT problem
Manual Obstruction
Sputum plugging, kinking of ETT, Positioning of ETT, Patient biting
Suction ETT and reposition
Bronchospasm
Bronchospasm/Dynamic Hyperinflation
Pneumothorax
Is there sudden desaturation?
Assess the patient
Check rise and fall of chest
Auscultate for equal air entry
Check O2 sats
Check CXR/perform USS
Check connections
ETT Cuff & pressure
ETT Placement
Circuit to ETT
Circuit to ventilator
Causes of desaturation
Endobronchial intubation - check ETT position
Accidental extubation - check ETT position
Pneumothorax - decompress
Pulmonary Embolus
Shunting - e.g. ARDS, collapse, cardiac failure/APO
Ventilator malfunction
Circuit connection, O2 supply,
Ventilator flow connections
Kinking of circuit
Fluid in circuit
Fluid in filter
Is there high PIP alarms?
Check Pplat - Inspiratory hold gives estimate of Palveolar
Paw High, Pplat High
Reduced Lung Complicance
Endobronchial Intubation - check position
Sputum plugging - suction tube
Chest wall stiffness - paralyse
Abdominal distension - NGT
Pneumothorax - CXR/USS & decompress
Collapse/Consolidation/Oedema -> Increase PEEP, small Vt
Patient/Ventilator dysynchonry
Anotações:
Assess, treat these and paralyse
Mode - SIMV if not paralysed
Gas Trapping - dynamic hyperinflation
Pain
Under sedation/Pt coughing
Other causes
Cardiac ischaemia
Abdominal distension
Neurological deterioration (chest wall/diaphram)
Paw High, Pplat Low/Normal
Anaphylaxis
Kinked ETT
Mucous plugging
Bronchospasm/Dynamic Hyperinflation
Reduce RR
Reduce I:E time
Increase Inspiratory flow
Sedate adequately
Treat bronchospasm
Disconnect the ventilator
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