Question

Determine initial ventilator settings for the following patient. Describe not only what settings you will put her on but also the indication for ventilation and how the intubation and mechanical ventilation will be carried out.

• You are in the ER. Your patient is a 68year-old emphysema patient with bilateral lower lobe pneumonia. She is breathing 34 per minute and has very diminished breath sounds. She complained of exhaustion and asked for mechanical support to help her out. Her ABGs pH 7.23, PaCO2 102, PaO2 47 on 30% venti mask. She is 5 feet 6 inches and weighs 99 pounds. She is lethargic but cooperative. Describe the indication for ventilation and explain how you will ventilate her.

Answer 1

Determine initial ventilator settings for the following patient. Describe not only what settings you will put her on but also the indication for ventilation and how the intubation and mechanical ventilation will be carried out.

• You are in the ER. Your patient is a 68year-old emphysema patient with bilateral lower lobe pneumonia. She is breathing 34 per minute and has very diminished breath sounds. She complained of exhaustion and asked for mechanical support to help her out. Her ABGs pH 7.23, PaCO2 102, PaO2 47 on 30% venti mask. She is 5 feet 6 inches and weighs 99 pounds. She is lethargic but cooperative. Describe the indication for ventilation and explain how you will ventilate her.

ANS-  patient is a 68year-old emphysema patient with bilateral lower lobe pneumonia. She is breathing 34 per minute and has very diminished breath sounds. She complained of exhaustion and asked for mechanical support to help her out .in that case pateint cant not take normal breath due do infection and inflamtion of their lung theirs lungs can not exchnage proper air and as per abg(ABGs pH 7.23, PaCO2 102, PaO2 47 on 30% venti mask.)this patient is on sever respiratory acidosis and she is lethargic so they need immidate ventilating intervention otherwise she may be death.first priorty is proper ventilation through a mechanical ventilation becuse she is not mentained by face mask.

as per ibw we have to ventilate a patient.

so their ibw is =45.5+2.3kg for each inch over 5 feet

=45.5+2.36

=45.5+13.8

=59.3kg

so their ventilator setting hvae to initial stage as per ibw tidal volume 350 ml,rr rate is 22 ,peep 6,fio2 100 and ventilator mode is pressure related volume contole mode.then we can change their ventilater setting as per requied .

so immidiate intubate to the patient by a duty doctor with appropriate tube size and ventilate her.