STANDARD COMPETENCIES:

 

 I.      The Nature of Respiratory Failure

         A.      Clearly define respiratory failure.

         B.      Discuss hypoxemic versus hypercapnic respiratory failure

 II.     The Indications For Mechanical Ventilation

         A.      Discuss when mechanical ventilatory support should be instituted.

         B.      Explain how hypoxemic respiratory failure is characterized.

         C.      Identify five causes of hypoxemic respiratory failure.

         D.      Define eight specific causes of inadequate ventilatory muscle function.

         E.      Identify the factors associated with compromised pump function.

         F.      Explain from a physiologic perspective the four indications for    mechanical ventilation.

 III.    Mechanical Ventilator Systems, Classifications, humidification, and circuitry

         A.      Explain the ventilator pneumatic system

         B.      Explain the ventilator electronic system

         C.      Discuss the following classifications of ventilators:

         D.      Discuss the following breath types during ventilation

         E.      Discuss the techniques used in humidification of inspired gas.

         F.      Explain the following characteristics and problems associated with a ventilator circuit?

         G.      Discuss the variety and use of alarms found on a ventilator.

         H.      Discuss the indications for artificial airways.

         I.      Discuss the complications of an airway.

         J.      Define how to evaluate a patient for extubation.

         K.      Understand the complications of extubation.

         L.      Discuss the need for a tracheostomy.

         M.      Discuss the need and techniques used in secretion clearance.

         N.      Explain the need for positioning of a ventilated patient.

         O.      Discuss the need for the following pharmacological therapy:

         P.      Physiological Effects of Mechanical Ventilation

         Q.      Define mean airway pressure.

         R.      Discuss the factors that affect mean airway pressure.

         S.      List the seven effects that mechanical ventilation can have on the pulmonary system.

         T.      Discuss the causes of a patient ¿fighting the ventilator¿.

 IV.     Specific Ventilators and Modes:

         A.      Draw and explain the function of the IMV circuit of an MA ¿1.

         B.      Explain the demand valve system.

         C.      Discuss the difference between full support verses partial support.

 V.      Pressure and Volume Ventilators:

         A.      Discuss the difference between volume and pressure ventilation.

         B.      List the modes of ventilation available for volume and pressure ventilation.

         C.      Discuss the changes seen with different inspiratory times.

         D.      Discuss the complications of auto peep.

 VI.     Fractional Inspired Oxygen, Positive End Expiratory Pressure, and Management of Oxygenation on a Ventilated Patient.

         A.      Discuss the parameters for a desired FiO2.

         B.      Discuss the indications for PEEP.

         C.      Discuss the physiological effects of PEEP

         D.      Explain the means for management of oxygenation.

 VII.    Determining Appropriate Physiological Goals of Mechanical Ventilation and the Initial Settings for Mechanical Ventilation.

         A.      Discuss the cause of Ventilator Induced Lung Injury.

         B.      Discuss the use of Permissive Hypercapnia

         C.      Discuss the Cause of oxygen toxicity

         D.      Explain the wave forms for PSV.

         E.      Discuss changes seen with waveforms as ventilation changes.

 TOPICAL OUTLINE:

 

 I.      The Nature of Respiratory Failure

 II.     The Indications For Mechanical Ventilation

 III.    Mechanical Ventilator Systems, Classifications, Humidification, and Circuitry

 IV.     Airway Management and Bronchial Hygiene and Pharmacological Therapy.

 V.      Physiological Effects of Mechanical Ventilation

 VI.     Specific Ventilators and Modes

 VII.    Pressure and Volume Ventilators

 VIII.   Fractional Inspired Oxygen, Positive End Expiratory Pressure, and Management of

 IX.     Oxygenation on a Ventilated Patient.

 X       Determining Appropriate Physiological Goals of Mechanical Ventilation and the Initial

 XI.     Settings for Mechanical Ventilation.

 XII.    Flows, Waveforms and I:E ratios