Question 1

A pressure-support breath on a CareFusion V.I.P.Bird delivers 230 mL,and the peak inspiratory flow is 18 L/min.This breath will flow-cycle at _____ L/min.

Accepted Answer

For delivered volumes greater than 200 mL,the flow cycle value is 25% of peak flow.Therefore,25% * 18 L/min = 4.5 L/min.

Question 2

The volume delivered by a time-triggered,pressure-limited,time-cycled infant ventilator depends directly on which of the following ventilator parameters?
1)Flow rate
2)Pressure limit
3)Respiratory rate
4)Inspiratory time

Accepted Answer

The volume delivered by a pressure-limited,time-triggered,time-cycled ventilator depends on the pressure setting,the flow rate,and the inspiratory time.The respiratory rate is not directly related to volume.It determines the total cycle time and expiratory time because inspiratory time is set.In the case of a set ratio of inspiratory time to expiratory time,the respiratory rate determines the inspiratory time,which is directly related to the volume delivered.

Question 3

The stable jet flow from the ARABELLA System causes which of the following?

Accepted Answer

A more stable jet flow seems to require a more substantial patient expiratory flow to cause the device to switch into expiration.The additional flow that is required for the ARABELLA suggests that a patient must work harder to breathe when this system is used.

Question 4

What is the maximum tidal volume available for a time-triggered,pressure-limited,time-cycled infant ventilator with the flow rate set at 6 L/min and the inspiratory time at 0.6 second?

Accepted Answer

Tidal volume (liters)= [Inspiratory time (seconds)* Flow (L/min)] ÷ 60 = [0.6 * 6] ÷ 60 = 0.6 L,or 60 mL.

Question 5

The volume delivered by a time-triggered,pressure-limited,time-cycled infant ventilator is dependent on which of the following factors?
1)Positive end-expiratory pressure level
2)Airway resistance
3)Lung compliance
4)Chest wall compliance

Accepted Answer

Changes in the patient's airway resistance,lung compliance,and chest wall compliance can alter the volume delivered to the patient.Lower volumes are delivered when airway resistance is high or lung and chest wall compliance are low.

Question 6

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

Accepted Answer

When the infant sensor is in use,the bias flow is automatically turned on at 3 L/min.

Question 7

What is the amount of pressure drop required to initiate the leak-compensation feature on the CareFusion V.I.P.Bird Infant-Pediatric Ventilator during the volume-cycled mode?

Accepted Answer

When pressure decreases 0.25 cm H₂O below baseline pressure,the leak-compensation feature introduces small amounts of flow into the circuit in an attempt to reestablish baseline pressure.

Question 8

The CareFusion Bird Partner IIi infant sensor should be cleaned every _____ hours.

Accepted Answer

The infant flow sensor should be cleaned every 24 hours to maintain accurate tidal volume measurements and flow-triggering capabilities.

Question 9

Circuit positive end-expiratory pressure may be avoided by using:

Accepted Answer

Demand flow is believed by some clinicians to be advantageous to operator-selected,continuous-flow systems because continuous-flow systems tend to produce resistance to expiration at the airway,commonly known as circuit positive end-expiratory pressure.For patients whose ventilatory needs include high inspiratory flows but low end-expiratory pressure,the demand system eliminates the need to set a high continuous flow.

Question 10

The termination sensitivity control on the Care Fusion V.I.P.Bird Infant-Pediatric Ventilator does which of the following?

Accepted Answer

The termination sensitivity control adjusts the flow-termination point of the breath,preventing air-trapping and an inverse inspiratory-to-expiratory ratio,providing expiratory synchrony.It is used only in the assist/control time-cycled mode and has a range of 5% to 25%.

Question 11

What is the breath termination for a CareFusion V.I.P.Bird Infant-Pediatric Ventilator set to deliver pressure support at tidal volume = 250 mL and peak expiratory flow 15 L/min?

Accepted Answer

Breaths in the volume-cycled mode on the CareFusion V.I.P.Bird Infant-Pediatric Ventilator are terminated using flow-cycling.For delivered tidal volume greater than 200 mL,the flow-cycle value is 25% of peak flow.

Question 12

A pediatric patient is being ventilated with a CareFusion V.I.P.Bird Gold Infant/Pediatric Ventilator in the assist/control volume mode with appropriately set trigger sensitivity.Physical assessment of the patient reveals the use of accessory muscles during patient triggering.What is the most appropriate action?

Accepted Answer

Leak compensation is used when an artificial airway leak prevents the ventilator from otherwise maintaining the positive end-expiratory pressure level.Small increments of flow are introduced into the circuit to provide back-pressure compensation for the leak.When leak compensation is in use,the patient's ability to trigger may be diminished.

Question 13

What are the two trigger mechanisms for the assist/control volume-cycled mode on the CareFusion V.I.P.Bird Infant-Pediatric Ventilator?
1)Flow
2)Time
3)Volume
4)Pressure

Accepted Answer

In the assist/control volume-cycled mode,inspiration is time-triggered or pressure-triggered as well as volume-targeted,flow-limited,and volume-cycled.

Question 14

Which of the following mechanisms is incorporated into the CareFusion V.I.P.Bird Infant-Pediatric Ventilator to prevent the risk of auto-PEEP during ventilation with the time-cycled modes?

Accepted Answer

Because of the possibility of inadvertent positive end-expiratory pressure developing from the continuous flow present in the expiratory limb of the patient circuit during time-cycled,pressure-limited ventilation,a jet Venturi is incorporated into the exhalation manifold.

Question 15

What is the maximum available tidal volume for a time-triggered,pressure-limited,time-cycled infant ventilator with the flow rate set at 8 L/min and the inspiratory time at 0.4 second?

Accepted Answer

Tidal volume (liters)= [Inspiratory time (seconds)* Flow (L/min)] ÷ 60 = [0.4 * 8] ÷ 60 = 0.053 L,or 53 mL.

Question 16

Which of the following statements concerning the CareFusion Bird Partner IIi monitor is true?
1)This device uses a vortex ultrasonic device to measure flow.
2)To prevent obstructions,12 mL/min of gas is passed through the pressure line.
3)This device can measure artificial airway leak only with the use of the infant sensor
4)Placement of the pediatric and infant sensors is the same in the ventilator tubing.

Accepted Answer

The gas inlet on the back of the ventilator connects to a 50-psig source and is used to inject 12 mL/min of gas through the pressure line to prevent obstructions within the line and to prevent water from entering the differential pressure transducer.By pressing and holding the "CONT V" button on the touch pad,the clinician enables real-time flow through the infant sensor to be displayed.The clinician can use the baseline leak or the flow displayed between breaths to determine the best trigger sensitivity setting and to prevent auto-triggering.This device uses a variable-orifice differential pressure transducer.

Question 17

With a CareFusion V.I.P.Bird Infant-Pediatric Ventilator,a flashing pressure-support display during spontaneous breathing can be caused by which of the following?

Accepted Answer

Leaks in the system,including around the artificial airway,may result in excessive inspiratory time.This would cause the ventilator to time-cycle instead of flow-cycle the pressure-support breaths.

Question 18

If a pressure-support breath on a CareFusion V.I.P.Bird Infant-Pediatric Ventilator is 25 mL and the peak inspiratory flow is 10 L/min,the breath will flow-cycle at _____ L/min.

Accepted Answer

Between tidal volumes of 0 mL and 50 mL,the flow-cycle value is 5% of peak flow.Therefore,5% * 10 L/min = 0.5 L/min.

Question 19

What is the maximum tidal volume available for a time-triggered,pressure-limited,time-cycled infant ventilator with a set inspiratory time of 0.5 second and a set flow rate of 12 L/min?

Accepted Answer

Tidal volume = [Inspiratory time (seconds)* Flow (L/min)] ÷ 60 = [0.5 * 12 L/min] ÷ 60 = 0.1 L,or 100 mL.

Question 20

When using the CareFusion V.I.P.Bird Gold Infant/Pediatric Ventilator with the infant flow sensor,the flow display comp button is pressed. The ventilator's monitor display window shows real-time inspiratory and expiratory flows of 9 L/min and 8.2 L/min.The most appropriate assist sensitivity control setting is ____ L/min.

Accepted Answer

The baseline leak is 9 - 8.2 = 0.8 L/min.The assist sensitivity control should be set at least 0.2 L/min above the detected leak,which is 0.8 L/min + 0.2 L/min = 1.0 L/min.

Quiz 14: Infant and Pediatric Devices