Evaluating the patient – the ventilator

today-icu-bed

VENTILATOR :   10 seconds – give the pulmonary stance of a patient by looking at the ventilator and / or everything around the room that is pulmonary related >> performing an evaluation and having a conclusion within 10 seconds.

Glance at the following quickly :

Type & Mode of Ventilation :   VCV  vs.  PCV  ;  AC  vs.  SIMV  vs. PSV

PEEP :    hi  /  lo  / normal

FiO2 :    hi  /  lo  / normal

P/F ratio :  hi  /  lo  / normal

Lung compliance :   hi  /  lo  / normal

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VCV – likely that the patient is  normal.

PCV – likely that the patient is  sick.

PEEP  > 14 – likely that the patient is  sick.

P/F ratio < 300 – likely that the patient is  sick.

Lung compliance :  round off delivered Vt >> round off dP (change in press).

dV / dP – change in volume / change in pressure = compliance.

compliance < 40  : likely that the patient is  sick.

Ex :  PS=10 yields a spontaneous Vt=500 >> Complinace = 500 / 10 = 50

PCV=30 yields a Vt=1200 >> Compliance = 1200 / 30 = 40

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