PERFORMANCE OBJECTIVES:

1. Define the terminology used in ventilator care.

2. Recognize the ventilator used by reading pressure curves.

3. Discuss the different cycling mechanisms of mechanical ventilators and the variability of ventilator parameters while using these.

4. List the ventilator parameters which are used and monitored in ventilator care. 5. When given blood gas parameters for a patient, discuss changes which should be

made in the ventilator parameters.

Course Competencies:

1. List the indications for mechanical ventilation.

2. List and explain the causes and effects of respiratory failure. 3. Define the terminology of mechanical ventilation.

4. Provide a rationale for ventilator commitment.

5. Describe the hemodynamic effects of mechanical ventilation. 6. List the factors which must be optimized prior to weaning.

7. Discuss the psychological impact of mechanical ventilator on the patient and the family.

8. Knows various techniques, indications, contraindications of weaning. 9. List the parameters which must be monitored in mechanical ventilation. 10. Describe the various methods of mechanical ventilation, and give criteria. 11. Recognize the ventilator mode by reading pressure and flow patterns. 12. Discuss the different cycling mechanisms of mechanical ventilators, and the

TOPICAL OUTLINE:

RSP 202 - MECHANICAL VENTILATION TECHNOLOGY & MANAGEMENT

I. Indications

A. Respiratory Failure B. Ventilatory Failure

C. Cardiopulmonary Reserve D. Parameters/Measurements II. Goals of Mechanical Ventilation

A. Desired Parameters B. Effects IV. Complications IV. Methods A. Modes B. Parameters 1. Volume 2. Flow 3. Rate 4. Pressures C. Special Methods 1. PEEP 2. CPAP D. Modification V. Monitoring A. Volume B. Pressures C. Compliance D. Resistance E. FiO2 F. Alarm Systems

G. Recording and Reporting VI. Weaning

A. Methods B. Monitoring

C. Special Considerations

INSTRUCTIONAL OBJECTIVES

RSP 202 - MECHANICAL VENTILATION TECHNOLOGY & MANAGEMENT

Upon completion of appropriate units of instruction, the student will demonstrate on examination the ability to:

1. Define ―critically ill‖.

2. Differentiate between respiratory and ventilatory failure. 3. List common causes of respiratory and ventilatory failure.

4. Recognize the signs and symptoms and respiratory and ventilatory failure. 5. Outline methods of assessing cardiopulmonary reserve.

6. List the indications for mechanical ventilation. 7. List the goals of mechanical ventilation.

8. Explain the importance of early ventilator commitment.

9. Identify the moral and ethical problems associated with life support systems. 10. Delineate the sequence of steps in ventilator commitment.

11. Outline the use of and special considerations of the various modes of mechanical ventilation including: control, assist, assist-control, IMV, SIMV, IDV, EMMV, pressure support.

12. Describe the physiologic effects and hazards of mechanical ventilation. 13. Describe the psychological impact of mechanical ventilation.

14. Summarize the use of PEEP including indications, contraindications, effects, and hazards.

15. Select the optimal PEEP level for a patient based on physiologic response. 16. List the indications, contraindications, and hazards of CPAP.

17. Describe the application of CPAP and its monitoring.

18. Given simulated or common clinical situations, determine changes to be made in mechanical ventilation modes or parameters to restore blood gas values or other physiologic responses to appropriate levels.

19. List parameters that should be monitored during the course of mechanical ventilation and describe the significance of those measurements.

20. Calculate static compliance and dynamic characteristics of a mechanical ventilation patient.

21. Calculate and correct for lost volume due to compression in the ventilator circuitry.

22. Determine safe limits for alarms used during mechanical ventilation.

23. Identify the parameters to be measured in monitoring the patient‘s physiologic response to mechanical ventilation.

24. List the indications for weaning from mechanical ventilation.

25. List the physiologic factors which must be optimized prior to successful weaning from mechanical ventilation.

26. Describe the procedure and special considerations for conventional weaning techniques.

27. Summarize the use of IMV and associated techniques for weaning and describe the procedures used.

28. Explain special considerations for weaning from PEEP and high oxygen concentrations.

TOPICAL OUTLINE:

RSP 202 - MECHANICAL VENTILATION TECHNOLOGY & MANAGEMENT

I. Assessment of Cardiopulmonary Reserve II. Respiratory Failure

A. Causes

B. Effects

III. Mechanical Ventilation Terminology IV. Pressure Patterns

V. Flow Patterns

VI. Ventilation Commitment

VII. Effects of Mechanical Ventilation

VIII. Weaning from the Mechanical Ventilator

PERFORMANCE OBJECTIVES:

1. Define ―critically ill‖.

2. Describe how and why to assess mechanical pulmonary reserve. 3. List normal and abnormal levels of:

a. tidal volume b. respiratory rate c. I:E ratio d. Vital capacity

e. Negative inspiratory force f. Dead space and VD/VT

4. Describe the methods of assessing the cardiovascular reserve.

5. List and describe normal and abnormal limits of:

a. EKG

b. blood pressure

c. pre-load and after-load d. central venous pressure e. pulmonary artery pressure

f. pulmonary capillary wedge pressure g.

6. Differentiate between primary and secondary (relative) hypovolemia. 7. List the clinical signs used to assess perfusion.

8. Discuss the importance of blood constituents, and micro-circulation in relation to perfusion.

9. Assess the levels of gas exchange and reserve when given blood gas parameters. 10. List the normal and critical levels of blood gas parameters.

11. When given a clinical description of a patient‘s status in relation to parameters of cardiopulmonary reserve, make a decision as to need for cardiovascular or mechanical pulmonary support.

RSP 202 - MECHANICAL VENTILATION TECHNOLOGY & MANAGEMENT

Ventilator Commitment

PERFORMANCE OBJECTIVES:

Upon completion of this unit, the student will demonstrate on examination, the ability to: 1. Discuss the importance of early ventilator commitment.

2. List the goals of mechanical ventilation. 3. List the indications for mechanical ventilation.

4. Describe moral and ethical problems associated with mechanical ventilators and life-support systems.

INSTRUCTIONAL OBJECTIVES

RSP 204 – CARDIOPULMONARY DIAGNOSTICS