Respiratory Emergencies and Mechanical Ventilation Flashcards

During air transport, a mechanically ventilated patient has decreasing SpO2 and increasing peak airway pressures. What is the first assessment the flight nurse should perform?

Answer: Use DOPE mnemonic to troubleshoot (Displacement, Obstruction, Pneumothorax, Equipment)

The DOPE mnemonic (Displacement, Obstruction, Pneumothorax, Equipment failure) guides systematic troubleshooting of acute ventilator deterioration.

What is the recommended tidal volume for lung-protective ventilation in a patient with ARDS during transport?

Answer: 6–8 mL/kg IBW

Lung-protective ventilation uses 6–8 mL/kg ideal body weight to minimize volutrauma and barotrauma in ARDS patients.

A flight nurse suspects tension pneumothorax in an intubated patient. What is the immediate intervention?

Answer: Needle decompression at the second intercostal space, midclavicular line

Tension pneumothorax is a clinical diagnosis requiring immediate needle decompression without waiting for imaging due to rapidly fatal hemodynamic collapse.

Which ventilator mode allows the patient to initiate breaths while the ventilator provides a set backup rate if the patient becomes apneic?

Answer: Synchronized Intermittent Mandatory Ventilation (SIMV)

SIMV delivers mandatory breaths synchronized to the patient's effort while allowing spontaneous breaths between, with a guaranteed backup rate if the patient is apneic.

In altitude physiology, what happens to air trapped in a pulmonary bulla as the aircraft ascends?

Answer: It expands due to decreased atmospheric pressure, risking rupture

According to Boyle's Law, gas expands as pressure decreases with altitude, making pulmonary bullae at risk for rupture and pneumothorax during ascent.

What is the correct management for a patient with status asthmaticus who is not responding to bronchodilators during transport?

Answer: Consider IV magnesium sulfate and early preparation for intubation if needed

IV magnesium sulfate causes bronchial smooth muscle relaxation and is a key adjunct in refractory asthma; intubation preparation is critical if ventilatory failure is imminent.