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. You have been giving a continuous nebulizer to a patient and status asthmaticus. She becomes lethargic in her respiratory rate drops from 21 to 11. Breath sounds are very quiet, with the end-expiratory wheezing. Blood pressure is good. ABG is pH 7.30, PaCO2 52, PaO2 67, on the continuous nebulizer. She is 5 feet 6 inches, 259 pounds. 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.

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. You have been giving a continuous nebulizer to a patient and status asthmaticus. She becomes lethargic in her respiratory rate drops from 21 to 11. Breath sounds are very quiet, with the end-expiratory wheezing. Blood pressure is good. ABG is pH 7.30, PaCO2 52, PaO2 67, on the continuous nebulizer. She is 5 feet 6 inches, 259 pounds. 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.

ANS-in that case patient having astamaticus so they have the problem in bronchos that is sever bronchospasm so they required bronchodileter thats why we give a continue nebulization after that she becomes lethargic and drop their respiratory rate she has not getting effective result through nebulize.so in that abg(pH 7.30, PaCO2 52, PaO2 67)patient going towads respiratory acidosis whis is harmfull to body so they need other intervention like mechanical ventilation support with endotracheal tube to creat a possative pressure in their air pathway.so we put ventilation support as per IBW of the patient.

she is female and hight is 5 feet 6 inch so  patient ibw is =45.5+2.5number of inches over 5 feet

=45.5+2.56

=45.5+15

=60.5 kg

for this patient pressure related volume controle mode is required initially and as per ibw tidal volume is 360 ml,peep 5,fio2 100,rr rate 14.

note;tidal volume is body weight 6ml

as per improvement of patient respiratory pattern and their chest sound and abg value we shoud plan for weaning the ventilater mode .as per patient effortness we have to plan for remove their tube.