27-11-2012, 03:43 PM
Mechanical Ventilation
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Mechanical Ventilation
Non Invasive: Ventilatory support that is given without establishing endo- tracheal intubation or tracheostomy is called Non invasive mechanical ventilation
Invasive: Ventilatory support that is given through endo-tracheal intubation or tracheostomy is called as Invasive mechanical ventilation
Continuous Positive Airway Pressure (CPAP)
Given through air tight mask/ ET/ Tracheostomy tube
Applies continuous positive pressure to the air way.
Tidal volume and Resp. Rate are patient dependent.
FiO2 & PEEP are to be set in the equipment.
Assist Controlled Ventilation (ACV):
Delivers a preset tidal volume for every breath initiated by the machine
Or triggered through the patient’s effort
Intermittent Mandatory Ventilation (IMV):
Delivers a preset tidal volume at a preset rate while allowing the patient to breathe at his own rate and tidal volume in between.
Can cause breath stacking – because preset frequency of the machine may not occur in the same phase as the patient’s own efforts.
Nebulisation
It is advisable to put all the patients on bronchodilators on regular basis.
Nebulise as per the doctor’s order
Monitoring for infection
Colour, consistency, and amount of the sputum / secretions with each suctioning should be observed.
Fever and other parameters have to closely observed for any other infection. (central line, etc)
Sterilisation and decontamination
After use, the patient circuit should be detached from the ventilator and disassembled to expose all surfaces prior to cleaning.
Thoroughly clean to remove all blood, secretions, thick mucus and other residue.
You may use multi enzyme cleaner.
Medical detergent solution can also be used to thoroughly to flush the tubings.