5_Troubleshooting the Ventilator

Description

Troubleshooting the ventilator
Roery Nara
Mind Map by Roery Nara, updated more than 1 year ago More Less
Kesh K
Created by Kesh K over 8 years ago
Roery Nara
Copied by Roery Nara over 8 years ago
11
0

Resource summary

5_Troubleshooting the Ventilator
  1. Is the Patient haemodynamically unstable?
    1. Yes - Disconnect and use BVM - can you BMV?
      1. Yes - Circulation/ventilator problem
        1. Causes of hypotension
          1. Hypovolaemia
            1. Drug Induced (e.g.Sedatives)
              1. Raised intrathoracic pressure from dynamic hyperinflation
                1. Tension Pneumothorax
              2. No -
                1. ETT problem
                  1. Manual Obstruction
                    1. Sputum plugging, kinking of ETT, Positioning of ETT, Patient biting
                      1. Suction ETT and reposition
                    2. Bronchospasm
                    3. Bronchospasm/Dynamic Hyperinflation
                      1. Pneumothorax
                  2. Is there sudden desaturation?
                    1. Assess the patient
                      1. Check rise and fall of chest
                        1. Auscultate for equal air entry
                          1. Check O2 sats
                            1. Check CXR/perform USS
                              1. Check connections
                                1. ETT Cuff & pressure
                                  1. ETT Placement
                                    1. Circuit to ETT
                                      1. Circuit to ventilator
                                      2. Causes of desaturation
                                        1. Endobronchial intubation - check ETT position
                                          1. Accidental extubation - check ETT position
                                            1. Pneumothorax - decompress
                                              1. Pulmonary Embolus
                                                1. Shunting - e.g. ARDS, collapse, cardiac failure/APO
                                                  1. Ventilator malfunction
                                                    1. Circuit connection, O2 supply,
                                                      1. Ventilator flow connections
                                                        1. Kinking of circuit
                                                          1. Fluid in circuit
                                                            1. Fluid in filter
                                                      2. Is there high PIP alarms?
                                                        1. Check Pplat - Inspiratory hold gives estimate of Palveolar
                                                          1. Paw High, Pplat High
                                                            1. Reduced Lung Complicance
                                                              1. Endobronchial Intubation - check position
                                                                1. Sputum plugging - suction tube
                                                                  1. Chest wall stiffness - paralyse
                                                                    1. Abdominal distension - NGT
                                                                      1. Pneumothorax - CXR/USS & decompress
                                                                        1. Collapse/Consolidation/Oedema -> Increase PEEP, small Vt
                                                                        2. Patient/Ventilator dysynchonry

                                                                          Annotations:

                                                                          • Assess, treat these and paralyse
                                                                          1. Mode - SIMV if not paralysed
                                                                            1. Gas Trapping - dynamic hyperinflation
                                                                              1. Pain
                                                                                1. Under sedation/Pt coughing
                                                                                  1. Other causes
                                                                                    1. Cardiac ischaemia
                                                                                      1. Abdominal distension
                                                                                        1. Neurological deterioration (chest wall/diaphram)
                                                                                    2. Paw High, Pplat Low/Normal
                                                                                      1. Anaphylaxis
                                                                                        1. Kinked ETT
                                                                                          1. Mucous plugging
                                                                                            1. Bronchospasm/Dynamic Hyperinflation
                                                                                              1. Reduce RR
                                                                                                1. Reduce I:E time
                                                                                                  1. Increase Inspiratory flow
                                                                                                    1. Sedate adequately
                                                                                                      1. Treat bronchospasm
                                                                                                        1. Disconnect the ventilator
                                                                                                  Show full summary Hide full summary

                                                                                                  Similar

                                                                                                  4_Troubleshooting the Ventilator
                                                                                                  Roery Nara
                                                                                                  Troubleshooting the Ventilator
                                                                                                  Roery Nara
                                                                                                  1_Troubleshooting the Ventilator
                                                                                                  Roery Nara
                                                                                                  2_Troubleshooting the Ventilator
                                                                                                  Roery Nara
                                                                                                  3_Troubleshooting the Ventilator
                                                                                                  Roery Nara
                                                                                                  Pulmonary Pretest (Paramedic care and Principles: 5th Edition chapter Pretest)
                                                                                                  Jake Anderson
                                                                                                  Pulmonary (Paramedic care and Principles: 5th Edition chapter Post Test)
                                                                                                  Jake Anderson
                                                                                                  Ventilator Alarms
                                                                                                  Cassandra Bucey
                                                                                                  Untitled_1
                                                                                                  afterthought
                                                                                                  RSI Drugs
                                                                                                  apemartin
                                                                                                  Airway Management
                                                                                                  Zikri