The initial step in the management of patient-ventilator ...

[ENagel]

The initial step in the management of patient-ventilator asynchrony is which of the following?
 
  a. Lower the high pressure alarm setting.
  b. Check the endotracheal tube cuff pressure.
  c. Ventilate the patient with a manual resus-citator bag.
  d. Check the low and high pressure alarm settings.

Question 2

Removing a patient from a ventilator to ventilate manually can lead to which of the following? 1. Barotrauma 2. Lung derecruitment 3. Increased airway resistance 4. Ventilator-acquired pneumonia
 
  a. 1, 2, and 3
  b. 1, 2, and 4
  c. 2, 3, and 4
  d. 3 and 4

[shewald78]

Answer to Question 1

ANS: C
If the patient is in severe distress, the first step is to disconnect the patient from the ventilator and carefully ventilate the patient using a manual resuscitation bag.

Answer to Question 2

ANS: B
Removing a patient from the ventilator for manual ventilation can inadvertently cause barotrauma by using excessive pressure during ventilation (>40 cm H2O). Disconnecting a patient who is be-ing ventilated with a high level of PEEP (15-25 cm H2O) can cause derecruitment of the lung. Disconnection of the ventilator can cause contamination of the patient's airway, increasing the patient's risk of developing ventilator-associated pneumonia.