Assessment for Ventilator Training – Doctors

assessment

“You are requested to attend all the Questionnaires in the three tabs”

Assessment Questionnaire 1
Assessment Questionnaire 2 - Case Study I
Assessment Questionnaire 3 - Case Study II

Created on February 02, 2022

Post Assessment Questionnaire of Doctors

Multiple choice questions.
Every question carries one marks.
No negative marking is there.

The number of attempts remaining is 2

1 / 20

Patient having ARDS on VAC mode with TV- 8ml/kg,RR-18/min,Peep 10 cm,Fio2 90% goes into sudden tachycardia,hypoxia and hypotension.What will be the next best step?

1. Change to Pressure A/C mode

2. ECG and Defibrillation

3. Increase sedation paralytic drip and start inotropic support

4. Auscultate patient see for chest rise and Do emergency Xray

2 / 20

____ is defined as an absence of ventilatory support 48 hours following an extubation.

1. Spontaneous breathing trial

2. Weaning success

3. Weaning failure

4. Weaning in progress

3 / 20

Which of the following is not a component of weaning criteria?

1. I:E ratio

2. Minute volume

3. Negative inspiratory force

4. Vital capacity

4 / 20

You have a patient who was found unconscious and you do not have any other information about the patient. What would the initial ventilator setting need to be ?

1. Mode :PressureControl,Pressure support 5 cm ,RR-20-30/min,peep-8 cm

2. Mode : Volume control ,tidal volume : 6-10ml/kg.Respiratory rate : 10-20 bpm,I-time:1sec,PEEP:5cm H2o,& FIO2 :100%

3. Mode: Non invasive ventilation BiPAP IPAP-16cm,EPAP-10 cm RR-20/min

4. Mode: Non invasive ventilation CPAP Pressure support 12cm ,peep-8 cm,Fio2 100%

5 / 20

What should the initial setting for tidal volume be for a new mechanical ventilation patient

1. 3-4 ml/kg

2. 6-8 ml/kg

3. 10-12ml/kg

4. 4-6 ml/kg

6 / 20

Minute ventilation is equal to...

1. Tidal Volume/Respiratory Rate

2. FiO2 X PEEP

3. Tidal Volume X Respiratory Rate

4. FiO2/PEEP

7 / 20

What is tidal volume?

1. The amount of oxygen delivered with each breath

2. The number of breaths per minute

3. The volume of gas delivered in a single breath

4. The amount of pressure used to deliver a breath

8 / 20

A 58 year old patient (weight 60 kg)known case of COPD admitted in ICU with severe respiratory acidosis.

Arterial Blood Gas –ph 7.275, pco2 94,po2 61,HCO3 – 35.6, Sao2 89%.

Patient intubated on VAC MODE

What two setting on the ventilator allow you to manage the patient’s Co2?

1. Fio2 and inspiratory pause

2. Flow trigger and peep

3. Fio2 and peep

4. Respiratory rate and tidal volume

9 / 20

Your patient has a PaO2 of 48 mmHg on 40%. The doctor wants a PaO2 of 80 mmHg. WHat FiO2 do you need?

1. 60%

2. 48%

3. 67%

4. 82%

10 / 20

The degree of ventilation may be increased by increasing all of the following ventilator parameters except:

1. Rate

2. PS

3. VT

4. PEEP

11 / 20

Airway resistance may be increased in all of the following clinical conditions except:

1. airway obstruction

2. Tachycardia

3. ETT with small internal diameter

4. Condensation in ventilator circuit

12 / 20

Which artificial airway isused for long-term airway management?

1. Laryngeal mask airway

2. Endotracheal tube

3. Nasopharyngeal airway

4. Tracheostomy tube

13 / 20

What should the initial setting for respiratory rate be for a new mechanical ventilation patient?

1. 5-10 breaths per min

2. 10-20 Min breaths per min

3. >30 breaths per min

4. depends on ideal body weight of the patient

14 / 20

What ventilator changes could be made to correct respiratory alkalosis?

1. Increase peak flow and Peep

2. Completely sedate paralyse the patient

3. Increase the tidal volume or respiratory rate

4. Decrease the tidal volume or respiratory rate

15 / 20

What is an absolute contraindication for initiating mechanical ventilation?

1. An underlying tension pneumothorax

2. Myocardial infarction

3. Acute Left ventricular failure

4. Subcutaneous Emphsema

16 / 20

A patient has been using PEEP at levels between 15 and 18 cm H20.The physician asks the therapist to monitor the potential adverse effects caused by PEEP.The therapist should monitor all of the following conditions except:

1. Barotrauma

2. Increased cardiac output and renal perfusion

3. Increased intracranial pressure

4. Decreased venous return

17 / 20

Which of the following will cause a high pressure alarm?

1. Hypoxia

2. Secretions

3. Disconnected ventilator tubing

4. A cuff leak

18 / 20

Plateau pressure (Pplateau) is measured during which phase of the ventilatory cycle?

1. Inspiration

2. End-expiration

3. End-inspiration

4. Expiration

19 / 20

What should the initial setting for PEEP before a new mechanical ventilation patient.

1. 4-6 cm H20

2. 0 cm should decide after obtaining ABG

3. 8-12cm H20

4. 2-4 cmH2o

20 / 20

Which of the following could you do for a high respiratory rate alarm?

1. Increase the respiratory rate alarm parameters

2. Assess the patient for pain and/or anxiety

3. Test Train-of-Four

4. Reduce sedation drip

Your score is

Created on February 02, 2022

Case Study 1- Doctors

A 45 year old male patient known case of COPD was admitted to ICU with breathing difficulty. His room air ABG showed: pH 7.32, PCO2 52, PO2 45, HCO3 - 26. He was started on ebulised medications and injectable antibiotics.

The number of attempts remaining is 2

1 / 5

Above patient on Volume assist control mode and is planned for weaning. Sedation drips of the patient has been stopped.A high PIP(Peak inspiratory pressure alarm is buzzing.

Which of the following cannot be a cause for the buzzing alarm?

1. Patient has excessive bronchial secretions and is trying to cough out

2. Patient has respiratory distress and bronchospasm

3. Patient out of sedation is biting the tube

4. ET cuff has got deflated and the ventilator tube is in oral cavity

2 / 5

the same patient if he fails the spontaneous breathing trial (SBT) may exhibit which of the following clinical signs and symptoms:

1. Cyanosis

2. All of the Above

3. Agitation

4. Diaphoresis

3 / 5

What would be the best mode of Oxygen therapy for this patient?

1. Invasive mechanical ventilation

2. Non invasive ventilation

3. Venturi face mask

4. Nasal prong

4 / 5

If the above patient worsens on non invasive ventilation and a plan for elective intubation is made.

What changes you would like to make in the predecided settings? VAC mode

1. Resp Rate 24/min

2. Tidal volume -280 ml

3. Peep 6 cm

4. Peak flow 35 L/min

5 / 5

What are the acceptable settings for the same patient on Non invasive ventilation?

1. CPAP with pressure support 8 cm,PEEP 12 cm

2. CPAP with pressure support 14 cm Peep 6 cm

3. IPAP 16 cm,EPAP 10 cm,PEEP 6cm,Fio2 70%

4. IPAP 10 cm,EPAP 16 cm,PEEP 6 cm,Fio2 70%

Your score is

Created on February 02, 2022

Case Study 2-Doctors

50 year old patient admitted with Organophosphorous poisoning is put on mechanical ventilation as he became suddenly unresponsive.Post intubation Chest Xray shows endotracheal tube in situ and no other parenchymal opacities.3 days later patient has development of fever and bilateral patches on radiograph with excessive secretions suctioned through ET tube and leucocytosis.

The number of attempts remaining is 2

1 / 5

What is the preferred method of suctioning to prevent such a condition?

1. Laryngoscopic suction

2. Bronchoscopic suction

3. Closed suction

4. Open suction

2 / 5

What is the likely cause?

1. Community acquired pneumonia

2. Ventilator associated Pneumonia

3. Ventilator iindued lung injury

4. Ventialtor associated tracheitis

3 / 5

What is the best measure to prevent above condition?

1. Chlorhexidine mouth wash

2. Changing position from supine to prone and back to supine

3. Bronchoscopic lavage on intubation

4. Keeping higher PEEP

4 / 5

Which one of the following is not a measure to prevent the above condition?

1. E T tube subglottic suction drainage

2. Cuff pressure between 20-30cm of H20

3. Chlorhexidine mouth wash

4. Continuous sedation and frequent re intubation

5 / 5

During mechanical ventilation,what primarily influences oxygenation?

1. PEEP and Fio2

2. Expired tidal volume

3. Respiratory rate

4. Both b and c

Your score is