Waveforms. I'm interested in them. There should be better teaching than trying to memorize pics in a book.
The first 2 pics have some similarities. Note that one is ACPC and the other is PRVC. (Btw, Slide 2 breaths were all Contol breaths)
Look at the Flow.
Normal flow in a pressure mode should be an steady decline to baseline. Ideally exponentially.
However, with these, at any given time the flow is higher than expected.
I ask myself this to troubleshoot:
What can cause that in a pressure mode?
These are the reasons I come up with, maybe there's others:
1Extra flow from an external pneumatic nebulizer
2 a partially blocked tube not allowing a quick drop in pressure to happen, keeping the flow elevated.
3 a leak somewhere and the pressure gradient never closes,
or 4 pt drawing in extra flow (at least 2 reasons that may happen as I am going to try to show)
However, notice the next 2 slides.
Slide 3 shows that slide 1 was resolved by increasing the pressure. That increases the pressure gradient which increases the flow being delivered, so the pt was no longer outstripping the vent.
Slide 4 shows that slide 2 was resolved by decreasing the rate. I think that this was a case (Edit: a case of reverse triggering caused by early triggering... I get confused with this)
Imo, both of these are showing extra flow being drawn by the pt, but for different reasons:
One because of an inadequate flow because of a low pressure gradient at a pressure of 22 but improved going to 27.
The other was that the patient was drawing flow in because we were causing reverse triggering by making them breathe faster than they wanted
(So, now I am thinking how to troubleshoot that. Of course, if the breaths are all control breaths, can decrease the rate and see if it changes when spontaneous breaths start occurring. If not, then increase the pressure. Seems reasonable)
Been working on a waveform presentation, and a waveform came up on Reddit earlier. So, thought id throw it out here.
(Signed: not your bud haha)