A patient is being ventilated by a transport ventilator en route ...

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A patient is being ventilated by a transport ventilator en route to a hospital. During ventilation, the high-pressure alarm, which is set at 40 cm H2O, sounds periodically. What should the therapist do at this time?
 
  A. Increase the pressure limit.
  B. Change the Fio2.
  C. Increase the inspiratory flow.
  D. Continue ventilating the patient with the current settings.

Question 2

The therapist is using an O2-powered breathing device that is being manually triggered. Each time the therapist depresses the actuator, he continues to depress the actuator. What effect will maintaining pressure on the actuator have on the inspiratory time?
 
  A. It will have no influence on the inspiratory time.
  B. It will prolong the inspiratory time because inspiration will be maintained as long as the actuator is depressed.
  C. Inspiration will automatically be terminated after 3 seconds despite depressing the actuator continuously.
  D. Maintaining pressure on the actuator will cause multiple inspirations to be triggered.

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Answer to Question 1

ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: See explanation D.
C. Incorrect response: See explanation D.
D. Correct response: Transport ventilators contain a high-pressure relief valve, which vents gas to the atmosphere at a preselected peak inspiratory pressure. The pressure limit typically is 60 to 80 cm H2O for adults and 30 to 40 cm H2O for children. Activation of the high-pressure limit is usually signaled by a visual or audible alarm to alert the operator. Since the patient in this problem is periodically reaching the high pressure limit set at only 40 cm H2O, ventilation should continue as selected.

Answer to Question 2

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: O2-powered breathing devices (OPD) are frequently called demand valves. A typical OPD consists of a demand valve that can be manually triggered or patient triggered. Newer OPDs limit the available airway pressure via a pressure-limiting valve, and limit the length of the inspiratory time. In terms of the inspiratory time, inspiration is terminated after 3 seconds elapse, even if the operator continues to depress the actuator. Therefore maintaining pressure on the actuator for a prolonged period will have no influence on the inspiratory time.
D. Incorrect response: See explanation C

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Excellent

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