Mechanical Ventilation

  1. Indications and goals for mechanical ventilation
    Indications: failure to generate spontaneous ventilations (trauma, drug overdose, etc), hypoxia & hypercarbia (ARDs, COPD)

    Goals: Maintain alveolar ventilation appropriate for the pt, correct hypoxemia and max oxygen transport
  2. Intubation Equipment
    Ambu bag, larynogoscope & ET tubes, suction equipment, ventilator, tape to secure ET tube
  3. Oral ET Tube
    easier insertion, larger diameter tubes can be used, less chance of sinus infections and VAP
  4. Nasal ET Tube
    better tolerated, better access for oral care, can increase work of breathing (farther distance to lungs)
  5. Tracheostomy
    Most comfortable, more permanent and stable, less dead space
  6. Balloons in ET Tubes are used for:
    preventing aspiration and to keep air from escaping, pressure in the balloon is checked once a shift
  7. Nursing Considerations
    Impaired communication, ineffective airway clearance, ineffective breathing pattern, anxiety, risk for infection
  8. What do long-term trach pts use to speak?
    Passy Muir Speaking Valve
  9. VAP prevention
    HOB: 30-45 degrees, provide routine oral care, use ETT w/ dorsal lumen above ETT cuff to allow drainage by continuous suctioning of subglottic collections of secretions, do NOT routinely change ventilator circuit
  10. Post Extubation Care
    Assess for airway trauma, assess resp rate, resp rhythm, quality, breath sounds, pulse ox, assess vital signs, pulmonary hygiene q2 hrs, keep oxygen device in place

    if trauma (strider/difficulty breathing) immediate replacement of tube
Card Set
Mechanical Ventilation
Schell Med Surg