initial choice of mechanical ventilation?

Answer 1

simv with pressure support using 8ml per kg of actual ideal body weight of your patient for the tidal volume using a rate of 14-16 bpm, fio2 at 50 titrate to keep sats at least 90 percent keeping in mind the longer a patients lungs are exposed to high levels of fio2 then the likelyhood of deveolping ARDS is more common. I always start with a peep of 5 (remember if the patient is having a copd exacerbation or severe bronchoconstricion they will be autopeeping so watchout for that, and give no peep in that case) also titrate the peep if the patient needs it up, don't let your plat pressures climb above 30cmh2o though, I always watch plats instead of peaks. Pressure support of 10 is perfect to start with, so when the patient starts spont breathing they have a little help,


low tidal volume high rates are great ways to ventilate a patient, I have worked with ardsnet and seen a mortatlity rate go down to 30 percent, remember ards mortatlity rates are almost 80 percent with normal methods of ventilation

any questions?

I would be glad to make suggestions for pressure control if needed or starting ardsnet

Answer 2

Controlled Mandatory Ventilation (CMV) if the patient can't breathe at all; or Synchronised Intermittent Mandatory Ventilation (SIMV) if the patient is making respiratory efforts but the tidal volume generated is not adequate.

Answer 3

AC if the patient has no resp drive, PA if they need the Ti for comfortable breathing, and PS if they are able to be totally spontaneous. I like using pressure over volume, much better control and I find it easier to trend.

Do you need more info than this?

Answer 4

PRVC (Pressure Regulated Volume Control). This will give the patient a set volume at the lowest possible pressure.

Answer 5

contact cutie RRT she has hekped me alot