QoW – 2016 – Q4 – 001 – The Consummate Respiratory Therapist – Thinking Outside the Box

You are called for a patient who is agitated & having a desaturative event  >  you see the following as you enter the room :

monitor-spo2-69pct

pvroute006

uryll

avsv

chtb

The Intensivist meets you at the patient bedside to discuss the patient.  His SBAR report :

S – Situation :  Patient agitated & demonstrating oxymetric desaturation to 69%.

B – Background :  Cardiogenic shock  > Post-op day #3 ; Hospital day #4.

A – Assessment :  Patient agitated but looks comfortable.

P – Plan :  Increase FiO2 from 35% to 50%.

Do you concur?

QoW – 2016 – Q3 – 003

mri02

The patient was on the following ventilator parameters in the CTICU :  SIMV-VCV,  RR(set)=8,  Vt(set)=700,  FiO2=50%,  PEEP=5.

The patient will be in the MRI suite for the next 75 minutes.

a) what will the settings be on this ventilator ?

b) how do you set patient trigger ?

c) how do you set Vt(set) on this ventilator (the “cheat sheet” was ripped off of the side of this ventilator).

d) if you use the vent with the settings that are currently dialed in, what will the ventilators translate to in standard ventilator parameters.

 

IABP – intra-aortic balloon pump – the device

The IABP is a common device seen often in the CTICU, CCU, or not so frequently in other ICUs.

iabp-infl vs defl

Above, the balloon that is in inflated vs. deflated position.

It resides in the Descending Aorta (proper positioning to be discussed later).

iabp - dvc

Above : the IABP console.

iabp - dvc scrm

Above : the IABP control.

iabp - radiogr

IABP inserted percutaneously via femoral artery and residing in the descending Aorta.