NBME Step 2 CK Form 6 Wean from the ventilator (NBME Answers)

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Retired NBME Step 2 CK Form 6 Answers

step2ck_form6/Block 4/Question#27 (reveal difficulty score)
A 67-year-old woman has been intubated for 1 ...
Wean from the ventilator 🔍 / 📺 / 🌳 / 📖
tags: Pulm inc

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submitted by ∗medicalmike(82)

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Criteria for weaning from ventilator:

O2 sat >= 90% with FiO2<=40% and PEEP<=8
pH>7.25
Initiating breaths (SIMV allows patient to initiate breaths)

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tinylilron Where can I find this information? I have not had my ICU rotation yet. I see in First Aid Step 2CK there is some information in the Pulmonary chapter but it is a long list and what is the high yield to remember? +

charcot_bouchard Initial criteria for extubation readiness include - pH >7.25 Adequate oxygenation on minimal support (i.e FiO2 <40% and PEEP <5cm H2O) Intact inspiratory effort and sufficient mental alertness to protect the airway. Those who meet the criteria should undergo spontaneous breathing trial (Turn off ventilatory function while intubated). +

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submitted by ∗step_prep7(71)

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3 major criteria for extubation of patient includes (1) pH > 7.25 (not retaining CO2) (2) Adequte oxygenation on minimal support (FiO2 40% or less and PEEP 5 mm Hg or less) (3) Intact inspiratory effort and sufficient mental alertness to protect the airway
Key idea: As with all other interventions/tubes (Foley, central line, etc.), we only want to use them as long as necessary because they are not harmless interventions
Key idea: FiO2 and PEEP are responsible for controlling oxygenation while on ventilator, whereas tidal volume and respiratory rate (which when multiplied equals minute ventilation) are responsible for ventilation (CO2 levels)

https://step-prep.org/tutoring/

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submitted by ∗tinylilron(57)

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Where can I find this information? I have not had my ICU rotation yet. I see in First Aid Step 2CK there is some information in the Pulmonary chapter but it is a long list and what is the high yield to remember? What is a good, fast, easy to understand source that I can use?

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nayyyy UWorld QID 16112 +4

rkd BNB video on mechanical ventilation is too good. +

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