Which of the following can be adversely affected by poor patient-ventilator interaction? 1. Gas exchange 2. Ventilatory patterns 3. Hemodynamics 4. Length of mechanical ventilation
a. 1 and 3 only
b. 1, 2, and 3 only
c. 2 and 4 only
d. 1, 2, 3, and 4
ANS: D
At minimum hemodynamics, ventilatory pattern and gas exchange are adversely affected. Recent data indicates that asynchrony occurs in ALL patients receiving assisted patient-triggered venti-lation, is most significant during the morning when clinician patient interaction is greatest, is pre-sent even during period of sedation, and varies from mild to very severe asynchrony7. What is most important to remember is that asynchrony has been associated with increased length of me-chanical ventilation, ICU and hospital length of stay, the need for tracheostomy, and ICU and hospital mortality.
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You have been called for a patient who had a large bag of lime powder tear as he was unloading it from a truck. On arrival you notice that the patient is wearing shorts and has lime dust covering both lower legs. He is complaining of leg pain from the chemical powder. Which one of the following should be the AEMT's next immediate action?
A) Move him to the stretcher for transport. B) Wash his legs off with plenty of water. C) Brush as much of the lime off his legs as possible. D) Cut his clothes off to better assess the extent of the burns.
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