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Advanced Life Support Final Exam
Questions With Verified Answers
What is the difference between a closed and open loop ventilation system. - answer✔closed loop
has an inhalation and exhalation. open loop has only an inspiratory limb with an exhalation valve
what term refers to how much effert the patient has to exert to trigger an inspiration -
answer✔trigger mechanism
flow triggering is used in which ventilation modes? - answer✔complete control
which type of triggering has a decreased risk of trauma to patient - answer✔flow triggering
list and define the indications for MAV - answer✔respiratory insufficiency, acute respiratory
failure, apnea, refractory hypoxemia W.O.B, head trauma, severe cases of COPD
a patient who is successful in achieving ventilation and oxygenation, but at such a physical cost
that their ability to maintain their status is short term and will eventually lead to respiratory
failure - answer✔respiratory insufficiency
any conditon in which respiratory activity is completely absent or is inadequate to maintain
oxygen reuptake and CO2 clearance - answer✔respiratory failure
what are the goals of MAV - answer✔to maintain adequate alveolar ventilation, reduce W.O.B
until cause can be determined, restore acid/bases balance, increase oxygen
what are the common conditions which can cause respiratory failure - answer✔myasthenia
gravis, guillain-barre, ALS, drugs, pleura occupation, chest wall deformities, conditions with
increased RAW, interstitial fibrosis, aspiration
what are the respiratory causes of respiratory failure - answer✔tachypnea, dyspnea,
paleness/cyanosis
what are the cardiovascular causes of respiratory failure - answer✔tachycardia/bradycardia,
hypertension/hypotension, vasoconstriction, and arrhythmias
what are the neurological causes of respiratory failure - answer✔restlessess, disorientation,
headache, lassitude, somnolence, confusion, delirium, blurred/tunnel vision
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what are the ventalitory values association with the need for MAV? - answer✔<8 and >35bpm,
Vt <5ml/kg, VC <15mmHg, NIF/MIP -20 - 0, MEP <40, PEFR 75-100, CO2 >55mmHg, pH
<7.25, Vd,Vt >0.6
what are the oxygenation values indicative of the need for MAV? - answer✔PaO2 <70 on O2 >
0.6, A-a gradient >450 on O2, PaO2/PAO2 < 0.15, PaO2/FiO2 <200
what ventilator mode would you put a patient with restrictive lung disease or inconsistent
breathing patterns on - answer✔volume control or PRVC depending on patients ability to
maintain consistency in their breathing
what mode woud you put patients with obstructive lung disease on - answer✔pressure ventilation
what setting allows the ventilator to compensate for loss of volume along the length of the circuit
- answer✔automatic tube compliance (ATC)
what is the purpose of Sigh - answer✔lung recruitment
what is the purpose of an inspiratory hold on a ventilator and what are the restriction -
answer✔measures plateau pressure and should not be used in pressure modes
what are the physiological consequences of a Sigh? - answer✔overdestention, hyperventilation,
and volutrauma
what are the goals of PEEP - answer✔to improve lung compliance, advance tissue oxygenation,
maintain a PaO2 of >60mmHg, or SaO2 of 90% (88% for COPD) while attempting to reduce
FiO2, minimise the effects of the cardiovascular system
what are the values for minimum, moderate, and high PEEp - answer✔min (1-5), mod (5-15),
high >15
maxmum oxygen deliver without compromising cardiac output accomplished at a safe FiO2
refers to what - answer✔optimal PEEP
list the indications of CPAP - answer✔presence of an airway, maintenance of collapsing alveoli,
hyoxemia with FiO2 > 50% (refractory), stabilize chest wall injury, decrease lung compliance
disease, counteract autoPEEP for COPD
what are the absolute contraindications of PEEP - answer✔tension or untreated pneumothorax
what are the relative contraindications of PEEP - answer✔hypovolemia, increased ICP,
barotrauma, recent lung injury, BP fistula
the failure of lung volume to return to passive FRC caused by a decrease in elastic recoil -
answer✔auto-PEEP
