![]() Mechanical ventilation ppt including airway, ventilator, tubings and connections, nursing management, trouble shooting common problems and issues, suctioning e. Mechanical Ventilation in the Neonate. Pulmonary baro/volutrauma Mechanical failure Usually human failure! MAP PowerPoint Presentation Target Values. ![]() Slide 12: Origins of mechanical ventilation Negative-pressure ventilators (“iron lungs”)Non-invasive ventilation first used in Boston Children’s Hospital in 1928Used extensively during polio outbreaks in 1940s – 1950sPositive-pressure ventilatorsInvasive ventilation first used at Massachusetts General Hospital in 1955Now the modern standard of mechanical ventilation The iron lung created negative pressure in abdomen as well as the chest, decreasing cardiac output. Iron lung polio ward at Rancho Los Amigos Hospital in 1953. Pressure/Volume Loops: Pressure/Volume Loops Volume is plotted on the y-axis, Pressure on the x-axis.Inspiratory curve is upward, Expiratory curve is downward.Spontaneous breaths go clockwise and positive pressure breaths go counterclockwise.The bottom of the loop will be at the set PEEP level. Epson tm-l60ii driver windows. Support Information: Device Type: Printer / Plotter / Multi-Office Manufacturer: Epson Model: epson TM-L60II plural Interface: USB Operating System: Windows 7 x64 Age of Device. It will be at 0 if there’s no PEEP set.If an imaginary line is drawn down the middle of the loop, the area to the right represents inspiratory resistance and the area to the left represents expiratory resistance. Flow/Volume Loops: Flow/Volume Loops Flow is plotted on the y axis and volume on the x axisFlow volume loops used for ventilator graphics are the same as ones used for Pulmonary Function Testing, (usually upside down).Inspiration is above the horizontal line and expiration is below.The shape of the inspiratory curve will match what’s set on the ventilator.The shape of the exp flow curve represents passive exhalationit’s long and more drawn out in patients with less recoil.Can be used to determine the PIF, PEF, and VtLooks circular with spontaneous breaths. Air Trapping (auto-PEEP): Air Trapping (auto-PEEP) Causes: Insufficient expiratory timeEarly collapse of unstable alveoli/airways during exhalationHow to Identify it on the graphicsPressure wave: while performing an expiratory hold, the waveform rises above baseline.Flow wave: the expiratory flow doesn’t return to baseline before the next breath begins.Volume wave: the expiratory portion doesn’t return to baseline.Flow/Volume Loop: the loop doesn’t meet at the baselinePressure/Volume Loop: the loop doesn’t meet at the baselineHow to Fix:Give a treatment, adjust I-time, increase flow, add PEEP. Airway Resistance Changes: Airway Resistance Changes Causes: BronchospasmETT problems (too small, kinked, obstructed, patient biting)High flow rateSecretion build-upDamp or blocked expiratory valve/filterWater in the HMEHow to Identify it on the graphicsPressure wave: PIP increases, but the plateau stays the sameFlow wave: it takes longer for the exp side to reach baseline/exp flow rate is reducedVolume wave: it takes longer for the exp curve to reach the baselinePressure/Volume loop: the loop will be wider. Increase Insp. Resistance will cause it to bulge to the right. Exp resistance, bulges to the left.Flow/Volume loop: decreased exp flow with a scoop in the exp curveHow to fixGive a treatment, suction patient, drain water, change HME, change ETT, add a bite block, reduce PF rate, change exp filter.
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