Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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Severe Asthma Exacerbation
Signs of a Severe Asthma Exacerbation:
 • Vitals: ↑HR ↑RR ↓SpO2
 • High work
↓SpO2 • High work ... with increased work ... • Initial ventilator ... #Exacerbation #CriticalCare ... #pulmonary #ventilation
Work Shifting - Mechanical Ventilation
Why the new term:
Synchrony issues, by definition, have to do with timing.
Mechanical Ventilation ... is done by the ventilator ... CPAP, with no ventilator ... by the ventilator ... Troubleshooting #diagnosis #criticalcare
Non-Invasive Ventilation (BiPAP) Algorithm - Indications and Contraindications
Indications for NIV:
 • COPD - pH <7.35, pCO2
Non-Invasive Ventilation ... (BiPAP) Algorithm ... #Noninvasive #Ventilation ... #BiPAP #Algorithm ... #criticalcare #
APRV - Overview 

Airway pressure release ventilation (APRV) uses prolonged periods of high continuous positive airway
pressure release ventilation ... volutrauma, increased work ... MDaniyalHashmi1 #APRV #CriticalCare ... #Ventilation #Management
Weaning from the Ventilator - Algorithm
Setting up for extubation success
 • Decrease demand — correct metabolic
Weaning from the Ventilator ... - Algorithm Setting ... nickmmark #Weaning #Ventilator ... #Algorithm #Extubation ... #CriticalCare #
Mechanical ventilation in obese patients according to the i-STAR Algorithm
Intubate
 • Anticipate difficult airway management and
Mechanical ventilation ... to the i-STAR Algorithm ... difficult mask ventilation ... patients #iSTAR #Algorithm ... obese #Management #CriticalCare
Approach to Selecting Respiratory Support:
-The role of noninvasive respiratory support is generally to reduce the patient's
the patient's work ... #Management #CriticalCare ... #Noninvasive #Ventilation ... RespiratorySupport #Selection #Algorithm
General schema for respiratory support in patients with COVID-19
Low flow nasal cannula
 • Typically set at
Invasive Mechanical Ventilation ... lung-protective ventilation ... indication for prone ventilation ... management #schema #criticalcare ... hypoxia #failure #algorithm
Proposed Respiratory Support Algorithm in COVID19

The ‘intubate early’ paradigm, where patients who “fail” low flow oxygen
Respiratory Support Algorithm ... the mechanical ventilation ... management #schema #criticalcare ... hypoxia #failure #algorithm
Volume Assist/Control Mechanical Ventilation
How does this mode work?
 • Delivers a set volume of air with
Control Mechanical Ventilation ... does this mode work ... Lung Protective Ventilation ... initial minute ventilation ... #AC #criticalcare