This simulation will cover the management of a patient requiring respiratory support with a ventilator. The challenges to achieving adequate gas exchange are varying degrees of increased airway resistance, decreased lung compliance and cardiac shunts.
Your patient has been paralyzed and intubated and is being hand ventilated on 100% O2. Your task is to adjust the ventilator settings to maintain PO2, CO2, oxygen saturation and pH within normal limits for an hour of simulated patient time. The ventilator settings are adjusted using the controls on the simulated front panel the ventilator. In this simulation, time is speeded up by a factor of 60: one minute of real time is equivalent to an hour of time for the simulated patient. However, time stops while you are selecting your treatment options, so you have a chance to think about the intervention without further deterioration of the patient.
You may treat the patient with the following interventions:
- Adjust the FIO2 from 0.2 to 1
- Adjust all of the settings and ventilation modes of the ventilator.
- Suction the patient’s endotracheal tube
- Insert a chest tube to treat a pneumothorax
- Reconnect ventilator if there is an accidental disconnect
You will be provided with the following diagnostic information:
- Vital signs from the patient monitor
- Visual indication of adequacy of ventilation
- Arterial blood gas analysis
- Chest X-ray to check for pneumothorax.