Summary
Highlights
Mechanical ventilation improves gas exchange and decreases the work of breathing until the cause of respiratory failure can be identified and corrected. This video will cover alarms, settings, and nursing care related to mechanical ventilation.
There are low and high-pressure alarms. Low-pressure alarms are due to leaks (disconnection, cuff leak, tube displacement). High-pressure alarms are due to increased pressure, and common causes can be remembered with the phrase 'Two PB sandwiches can make you sick': Pulmonary edema, Pneumothorax, Bronchospasm, Biting, Secretions, Cough, and Kink.
Key ventilator settings include: Respiratory rate (breaths per minute), Tidal volume (volume of gas per breath), FiO2 (fraction of inspired oxygen, 21-100%), I:E ratio (inspiration to expiration duration, typically 1:2 or 1:1.5), and PEEP (positive end-expiratory pressure to prevent alveolar collapse).
Best practices include having a manual resuscitation bag and reintubation equipment (two tube sizes) at the bedside. Regularly assess consciousness, vital signs, breath sounds, pulse oximetry, and ABGs. Suction oral and tracheal secretions as needed, and reposition the ET tube every 24 hours to prevent skin breakdown. Provide frequent oral care and monitor for complications like ventilator-associated pneumonia. After extubation, encourage deep breaths, coughing, and incentive spirometer use.
A quiz covers common scenarios: excess secretions cause a high-pressure alarm, a manual resuscitation bag and reintubation equipment should be kept at the bedside, and a cuff leak causes a low-pressure alarm.