Mechanical Ventilation

Overview

Mechanical ventilation improves gas exchange and decreases the work of breathing until respiratory failure cause is identified and corrected.

Low-Pressure Alarms
- Causes: Leaks such as disconnection, cuff leak, tube displacement.
- Mnemonic: Starts with "L" for low-pressure and leaks.
High-Pressure Alarms
- Causes: Increased pressure.
- Mnemonic: "Two PB sandwiches can make you sick."
  - Two P's: Pulmonary edema, Pneumothorax
  - Two B's: Bronchospasm, Biting
  - S-C-K: Secretions, Cough, Kink

Respiratory Rate: Number of breaths per minute delivered.
Tidal Volume (VT): Volume of gas delivered with each breath.
FiO2: Fraction of inspired oxygen, varies between 21% to 100%.
IE Ratio: Duration of inspiration to expiration, typical ratio 1:2 or 1:1.5.
PEEP: Positive end expiratory pressure to prevent alveoli collapse.

Keep a manual resuscitation bag and reintubation equipment (two tube sizes) at bedside.
Regularly assess:
- Patient's level of consciousness
- Vital signs
- Breath sounds
- Pulse oximetry
- ABGs (arterial blood gases)
Suction oral and tracheal secretions as needed.
Reposition ET tube every 24 hours or more to prevent mucosal damage and pressure injury.
Provide frequent oral care.
Monitor for complications like ventilator-associated pneumonia.
After extubation, encourage deep breaths, coughing, and use of incentive spirometer.

Excess secretions cause what type of alarm?
- Answer: High-pressure alarm
What should be kept at the bedside for a patient on a mechanical ventilator?
- Answer: Manual resuscitation bag and reintubation equipment
A cuff leak causes what type of alarm?
- Answer: Low-pressure alarm