Professional Documents
Culture Documents
ventilator
MECHANICAL
VENTILATOR
Mechanical ventilation is a life
saving intervention in the
emergency department. It
functions as a supportive
measure for patients during
acute illness.
INDICATIONS
Failure of ventilation
1.
2.
3.
4.
5.
Neuromuscular disease
Central nervous system disease
CNS depression
Musculoskeletal disease
Thoracic malformation/ trauma
1.
2.
3.
4.
An endotracheal
(ET)/tracheostomy tube is
needed for mechanical
ventilation.
Intubation procedure
Head positioning
The laryngoscope
Endotracheal tube advancement
Cuff inflation
Conforming position
Securing the tube
NG tube insertion
Connect to ventilator
Position
Hygiene
Feeding
Management of stressors
Pain and sedation management
Possible Cause
Remedy
HIGH
CONTINOU
S
PRESSURE
Disconnected pressure
transducer block pressure
transducer Water in
expiratory limb. Wet bacterial
filter clogged bacterial filter.
Kinked/blocked tubing.
Mucus or secretion plug in
ETT or airways client
coughing or fighting.
CHECK
TUBING
AIRWAYS
PRESSURE
TOO HIGH
Display
message
Possible Cause
Remedy
LIMITED
PRESSURE
Kinked/blocked Mucus in
tubing coughing / fighting
patient.
EXPRIED
MINUTE
VOLUME TOO
HIGH
EXPRIED
MINUTE
VOLUME TOO
LOW
Display
message
Possible Cause
Remedy
EXPRIED MINUTE
VOLUME DISPLAY
READS
APNEA ALARM
PEEP/CPAP & OR
PLATEAV
PRESSURE FAILS
TO BE MAINTAIN
Airway
Stability/Patency of ETT
Length of fixing
CXR
Breathing
Chest expansion, breath sounds, synchrony
Circulation
Colour, warmth of extremities, pedal pulses
Systems assessment
CVS
CNS
Renal function
Gastro intestinal
Metabolic
Skin
Color,pulse,HR,BP
Sedation ,paralysis
Urine output
Abdominal distension,
gastric
aspirates,bowel
sounds
Temperature,blood
sugar levels
Integrity,pressure
sores
Position
Humidification
Inspired gas
temperature 35-37 0 C
Maintain waterlevel
Circuit
condensate/empty
water trap
Patient comfort
HOB elevation 30-450
Repositioning /Passive
limb exercises
Pain control and sedation
Prevent pressure sores
Wound care
Hygiene-Eye care/Mouth
care, Body care
Feeding
Enteral feeding always!!
Check position of NGT
Continuous /Bolus
feeds
Assessing feed
intolerance?
Interruption of feeds
Feeding in prolonged
ventilation
Endotracheal suctioning
Two nurses/ Physician in sick patients
Top up sedation
Hand hygiene/Sterile gloves
Nursing diagnosis
Impaired gas exchange related to
underlying illness, or ventilator setting
adjustment during stabilization or weaning.
Ineffective airway clearance related to
increased mucus production associated
with continuous positive-pressure
mechanical ventilation
WEANING
Physician orders
Reverse paralysis
Decrease sedation
Stop feeds/4 hrs/start MF
Decrease in RR/spontaneous modes
Preventing airway edema
Is the patient comfortable?
Weaning parameters
Awake& alert
PEEP 5cmH2O
PaO2>60 mmHg on Fio2 50%
Pao2 acceptable with PH of 7.35-7.45
Spontaneous inspiratory force of at least
20 cm of H2O
Stable vital signs
Adequate nutrition
Hyperglycemias
Infection
Renal failure
Protein loss
Shock
Sleep deprivation
COMPLICATIONS
Perintubation : laryngeal trauma,
Pharyngeal trauma,
Tracheal or bronchial
rupture,
Epistaxis,
Tooth trauma,
Arrhythmias
Bronchospasm
Ventilator induced
lung injury----- barotraumas
volutrauma
biotrauma
CONCLUSION
Patients on ventilator need constant
observation and skilled care to protect,
restore and maintain their health. Nursing
care challenging, compassionate care is
the corner stone of nursing management
of ventilator patient .
Thank you