The respiratory therapist is using a bag-valve-mask resuscitator ...

[faduma]

The respiratory therapist is using a bag-valve-mask resuscitator to ventilate an adult patient. The tidal volume and inspiratory time produce an inspiratory flow of 60 L/minute. What should the therapist do at this time?
 
  A. Continue providing this level of ventilation.
  B. The therapist needs to increase either the Vt or the Ti to deliver a flow greater than 60 L/minute.
  C. The inspiratory flow needs to be reduced to 40 L/minute or less.
  D. The therapist needs to alternate squeezing the bag gently and vigorously to fluctuate the flow.

Question 2

While performing CPR on a cardiac arrest victim, the therapist is ventilating the patient with a bag-valve-mask manual resuscitator, and is delivering pressures between 30 and 35 cm H2O to the patient's airway. What should be this therapist's concern?
 
  A. overdistention of the patient's lungs
  B. gastric insufflation
  C. under inflation of the patient's lungs
  D. No is necessary because these pressures are harmless.

[sultana.d]

Answer to Question 1

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: For adults, ventilation standards include a frequency of 8 to 10 breaths/minute with a tidal volume of 0.5 to 0.6 liter (6 to 7 ml/kg), and an inspiratory time of 1.0 to 2.0 seconds. This combination corresponds with and inspiratory flow of 30 to 40 L/minute. The use of longer inspiratory times and slower flows is recommended to prevent gastric insufflation.
D. Incorrect response: See explanation C

Answer to Question 2

ANS: B
A. Incorrect response: See explanation B.
B. Correct response: A factor affecting delivered Vt during CPR is esophageal opening pressure. Because airway pressure is increased to deliver volume in the face of increased pulmonary impedance, gastric insufflation results. Based on work by Rueben and associates, esophageal opening pressure is approximately 20 cm H2O. Airway pressures of 30 to 35 cm H2O will likely produce gastric insufflation. The use of longer inspiratory times and slower flows is recommended to prevent gastric insufflation.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B

[faduma]

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TYSM