Ventilator Settings for a Drug Overdose Patient (TMC Practice Question)

This video breaks down a TMC Practice Question about making the proper adjustments to a patient's Ventilator Settings. ✅
💥Full Guide on Ventilator Settings ➜ ➜ ➜ https://bit.ly/2KMrNle
💥Full Guide on Arterial Blood Gases ➜ ➜ ➜ http://bit.ly/2YYavvh

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➡️ Question
A 43-year-old male patient was admitted to the emergency department with a suspected drug overdose. The patient is receiving oxygen via nonrebreather but is unconscious and isn’t making any respiratory efforts to breathe. The patient’s body weight is 57 kg and his ABG results are as follows:
pH 7.28
PaCO2 64 torr
HCO3 22 mEq/L
PaO2 315 torr
Which of the following would you recommend?
A. Apply BiPAP with: IPAP 20 cmH2O, EPAP 5 cmH2O, FiO2 30%
B. Intubate and apply: SIMV, tidal volume 600 mL, rate 6/min, FiO2 40%
C. Intubate and apply: A/C ventilation, tidal volume 450 mL, rate 12/min, FiO2 40%
D. Apply CPAP at 10 cmH2O and an FiO2 of 100%

Let's break it down and see if we can come up with the correct answer. First we must interpret the ABG results. With a decreased pH, normal BiCarb, and an increased PaCO2, this tells us that the patient is in:

➡️ Acute Respiratory Acidosis

This, along with the other information that we gathered in the question, let's us know that the patient is in need of full invasive ventilatory support. So that means we can rule out A and D automatically because BiPAP and CPAP are forms of noninvasive ventilation. Now we just need to figure out which remaining option is the best for this patient. SIMV mode at a rate of 6/min, which is very low, is only going to provide partial ventilatory support. So we can rule that one out as well.

The best option for this patient is Assist/Control ventilation at a normal rate with an initial tidal volume of about 8 mL/kg.

The question gives us the patient's body weight which is 57 kg. And just a quick note about the FiO2: The patient has a PaO2 of 315 torr due to being on a nonrebreather. That number is way too high which means that the patient has been getting too much oxygen. So now we know that we need to decrease that amount. An FiO2 of 40% is a good starting point and we can continue to monitor the patient and reassess at a later time.

💥Full Guide on Ventilator Settings ➜ ➜ ➜ https://bit.ly/2KMrNle
💥Full Guide on Arterial Blood Gases ➜ ➜ ➜ http://bit.ly/2YYavvh

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🚑MEDICAL DISCLAIMER
Medicine and Respiratory Therapy are continuously changing practices. The information in this video is for educational and entertainment purposes only. For medical advice, please consult with a physician or qualified medical professional.

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⏰TIMESTAMPS
0:00 - Intro
0:27 - Practice Question
1:46 - Explanation
2:42 - Correct Answer

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