Question 1

What is the function of the structure labeled "A" in the following figure of a Bunnell Life Pulse High-Frequency Jet Ventilator?

Accepted Answer

"A" is the monitoring lumen of the hi-lo tube and is used to monitor pressures at the distal end of the hi-lo jet tube.

Question 2

Which of the following statements concerning the volume guarantee mode on the Dräger Babylog 8000 ventilator is true?

Accepted Answer

When the volume guarantee mode is activated,the ventilator continuously measures and compares inspired and expired tidal volume.Each following breath uses the comparisons from the previous breath to make adjustments to the peak inspiratory pressure so that a volume as close as possible to the preset value can be delivered.If there is a positional leak and it is active,the expired tidal volume will be lower than the inspired tidal volume,and the ventilator will increase the pressure to attempt to match the two monitored volumes.This increase in pressure continues if the leak continues.However,if the patient's position changes and the leak is not occurring,the breath delivered will be significantly larger than intended.The limit to the amount of volume is 130% of the targeted volume.At this point,the exhalation valve will open,and no additional ventilator-driven gas will be delivered to the patient.Close monitoring of patient-ventilator interaction is needed during use of this mode.

Question 3

The bias flow for the CareFusion V.I.P.Gold Ventilator when the Pediatric "Smart" Flow Sensor is in use is _____ L/min.

Accepted Answer

When the Pediatric "Smart" Flow Sensor is in use,bias flow operates at a fixed 5 L/min flow when it is turned on.

Question 4

Which of the following CareFusion V.I.P.Bird Gold Infant Ventilator controls can adjust pressure delivery at the beginning of inspiration in the pressure control,volume-assured pressure support,or pressure support mode?

Accepted Answer

The rise time control adjusts the inspiratory pressure rise time.A setting of 1 is the fastest rise time,and a setting of 7 is the slowest rise time.The bias flow control is always present when the Infant "Smart" Sensor is used and can be turned on or off when the Pediatric "Smart" Sensor is used.The assist sensitivity controls how sensitive the ventilator is to the patient's efforts,and the flow display comp is used to display real-time inspiratory and expiratory flows.

Question 5

The Bunnell Life Pulse High Frequency Jet Ventilator creates high-frequency jet ventilation by using which of the following mechanisms?

Accepted Answer

An electromagnetic solenoid activates the pinch valve,which breaks the flow of pressurized gas into small bursts with the pinch-and-release action of the silicone tube of the patient breathing circuit.

Question 6

On the Dräger Babylog 8000,which of the following is an operator-adjustable alarm?

Accepted Answer

Adjustable alarm limits include apnea (5 to 20 seconds),high and low minute ventilation,and minute ventilation delay.

Question 7

When volume-assured pressure support is selected in the synchronized intermittent mandatory ventilation/continuous positive airway pressure/pressure support setting on the CareFusion V.I.P.Bird Gold Infant Ventilator,mandatory breaths are classified as which of the following?

Accepted Answer

When volume-assured pressure support is selected from the synchronized intermittent mandatory ventilation/continuous positive airway pressure/pressure support column,mandatory pressure-controlled breaths are delivered at a guaranteed volume.

Question 8

The oxygen concentration alarm limits on the Dräger Babylog 8000 are set _____ at _____ of the setting.

Accepted Answer

The Dräger Babylog 8000 microprocessor automatically sets the oxygen concentration limits at ± 4%.

Question 9

On a Dräger Babylog 8000,which of the following variables can trigger mandatory breaths in the synchronized intermittent mandatory ventilation mode?

Accepted Answer

The mandatory breaths in the synchronized intermittent mandatory ventilation mode on the Dräger Babylog 8000 are either time-triggered or patient-triggered.Patient-triggering is accomplished by volume,when a patient's spontaneous inspiratory volume is equal to or greater than the set trigger volume.

Question 10

Which operating mode on the Dräger Babylog 8000 allows the clinician to adjust the flow during the expiratory phase to match the patient's needs during mandatory and spontaneous breaths?

Accepted Answer

The variable inspiratory,variable expiratory operating mode allows the clinician to adjust the flow during the expiratory phase to match the patient's needs during mandatory and spontaneous breaths.

Question 11

When the Dräger Babylog 8000+ is used in the pressure support mode,the patient's peak inspiratory flow is 30 L/min.At what flow rate will the ventilator cycle to expiration?

Accepted Answer

Pressure support breaths are flow-cycled on the Dräger Babylog 8000+ at 15% of peak flow.

Question 12

A trigger sensitivity setting of 1 on a Dräger Babylog 8000 Infant Ventilator indicates ____ trigger.

Accepted Answer

The trigger sensitivity range is 1 to 10,with 1 (minimum)representing increased trigger sensitivity and 10 (maximum)representing the least-sensitive trigger.A setting of 1 indicates that when the Dräger Babylog measures a flow change of 0.25 L/min (straight flow-trigger),the mandatory breath is synchronized with the patient's effort.

Question 13

The "cannot meet PIP" alarm is active on a Bunnell Life Pulse High-Frequency Jet Ventilator.The respiratory therapist should do which of the following?
1)Check the humidifier cartridge for a leak.
2)Check the jet tube connection to the circuit.
3)Look for kinks in the jet tube connections.
4)Check the dump valve for proper function.

Accepted Answer

The "cannot meet PIP" alarm can be a result of a leak in the humidifier cartridge/patient circuit; an incomplete connection of the circuit to the jet tube; a defective or damaged jet tube (e.g.,a kinked tube,improper positioning,occlusion,leak); the present settings being insufficient to ventilate larger patients; a patient fighting the Life Pulse; or an ineffective pinch valve opening action resulting in higher servo pressures being necessary to meet current settings.

Question 14

The Bunnell Life Pulse High-Frequency Jet Ventilator is being set up to ventilate an infant who has already been intubated with a regular endotracheal tube.A 2.5-mm internal diameter Life Port adapter is being used. The conventional peak inspiratory pressure is set at 26 cm H₂O.The high-frequency jet ventilation peak inspiratory pressure should be set at a pressure of _____ cm H₂O.

Accepted Answer

When using a Life Port adapter with a 2.5-mm internal diameter,the clinician should set up the initial high-frequency jet ventilation peak inspiratory pressure equal to the conventional peak inspiratory pressure.Therefore,26 cm H₂O should be the setting.

Question 15

Which of the following ventilatory modes is available only on the CareFusion V.I.P.Bird Gold Infant Ventilator and not on the other V.I.P.Infant ventilators?

Accepted Answer

The volume-assured pressure support mode is available only on the CareFusion V.I.P.Bird Gold model.

Question 16

At what point in the Bunnell Life Pulse High-Frequency Jet Ventilator,shown in the following figure,should a bacterial filter be placed?

Accepted Answer

The bacterial filter should be placed downstream from the pinch valve to provide particle filtration.

Question 17

On the CareFusion V.I.P.Bird Gold Infant Ventilator,the control that ends a pressure support breath in case of a leak also does which of the following to the breath?

Accepted Answer

The pressure support/volume-assured pressure support time limit control will time-cycle the normally flow-cycled pressure support breath when there is a leak.

Question 18

The Bunnell Life Pulse High-Frequency Jet Ventilator is being set up to ventilate an infant who has a regular endotracheal tube with a 3.5-mm internal diameter Life Port adapter.Conventional peak inspiratory pressure is set at 30 cm H₂O.The high-frequency jet ventilation peak inspiratory pressure should be set at a pressure of _____ cm H₂O.

Accepted Answer

When a LifePort adapter larger than 2.5-mm internal diameter is used,the clinician should set up the initial high-frequency jet ventilation peak inspiratory pressure at 90% of the conventional peak inspiratory pressure.Therefore,90% of 30 cm H₂O is 27 cm H₂O.

Question 19

The respiratory therapist has determined that a 4.0-mm internal diameter standard endotracheal tube is necessary for the patient.What is the equivalent hi-lo jet tube to be used with a Bunnell Life Pulse High-Frequency Jet Ventilator?

Accepted Answer

The external diameter of a hi-lo jet tube is approximately equal to the external diameter of a standard endotracheal tube that is a half-size larger.Therefore,hi-lo tube size = standard endotracheal tube size - 0.5 mm; 4.0 mm is standard endotracheal tube size,so 4.0 mm - 0.5 = 3.5-mm hi-lo tube size.

Question 20

Mean airway pressure can be increased when ventilating with the Bunnell Life Pulse High-Frequency Jet Ventilator by doing which of the following?

Accepted Answer

The function of the purge valve is to provide a moisture-free environment in the monitoring line of the hi-lo jet tube.Decreasing the rate decreases the mean airway pressure because less time is spent at the inspiratory pressure.Decreasing the positive end-expiratory pressure level decreases the mean airway pressure.Increasing the rate and volume of the sigh breaths increases the mean airway pressure.

Quiz 14: Infant and Pediatric Devices