A ventilator is a machine that provides mechanical ventilation by moving breathable air into and out of the lungs, to deliver breaths to a patient who is physically unable to breathe, or breathing insufficiently. 

1. MEDICAL SURGICAL NURSING
SUBMITTED TO-
Mr. SUDHEER CHAUHAN
ASST. PROFESSOR OF
MEDICAL SUGICAL NURSING
RASTOGI COLLEGE OF NURSING BHILAI
SUBMITTED BY-
Mr. DHANESHWAR
BSC. NURSING 3rd YEAR
RASTOGI COLLEGE OF NURSING
BHILAI

2. INTRODUCTION:-
• A mechanical ventilator is a positive or negative
pressure breathing device that can maintain
ventilator & oxygen delivery for a prolonged
period.
• Caring for a patient for mechanical ventilation
has become an integral part of nursing care in
critical care or general medical surgical units
extended care facility and the home. Nurse
physicians, & respiratory therapists must
understand each patient specific pulmonary
needs and work together to set realistic goals.

3. DEFINITION:-
• A ventilator is a medical device or machine
that help to mechanically assist or replace
spontaneous breathing use of posiive
pressure:-
- To physically transport gases into and out of
lungs( Earlier ventilators used negative
pressure).
- Usually performed via ETT but not
always.(Noninvasive ventilation).

4. PRINCIPLES OF MECHANICAL VENTILATOR
• A mechanical ventilator is an automatic machine
designed to provide all of part of the work the
body must do to move gas into and out of the
lungs.
• The act of moving air into and out of the lungs is
called breathing or, more formally ventilation.

5. CLASSIFICATION OF VENTILATORS:-
Mechanical ventilators are classified acc. To
method by which they support ventilation. The
two general categories are negative- pressure
ventilators.
1. Negative pressure ventilators
- Exert a negative pressure on the external chest.
- Decreasing the intrathoracic pressure during
inspiration allows air to flow into the lung, filling
its volume.
- Physiologically this type of assisted
ventilation is similar to spontaneous
ventilation.

6. CONT.
- It is used mainly in chronic respiratory failure
associated with neuromuscular condition such as
poliomyelitis muscular dystrophy.
2. Positive pressure ventilator
- Today the most common ventilators use positive
pressure.
- Positive pressure ventilators inflate the lungs by
exerting positive pressure on the airway, pushing air
in similar to a bellows mechanism forcing the alveoli
to expand during inspiration.
- These ventilators are widely used in the hospital
setting for primary lung disease.

7. MODES OF VENTILATORS:-
Ventilator mode refers to how breaths are delivered to
the patient.
The most commonly used modes are:-
1. Assist-control (A/C) ventilation- provides full
ventilator support by delivering a preset tidal
volume and respiratory rate
2. Intermittent mandatory ventilation (IMV):-
provides acombination of mechanically assisted
breaths and spontaneous breaths mechanical
breaths are delivered at present intervals and a
preselected tidal volume, regardless of the patient’s
efforts.

8. 3. Synchronized intermittent mandatory ventilation(SIMV):-
also deliver a preset tidal volume and number of breaths per
minute between the patient cab be breath spontaneously
with no assistance from the ventilator on those extra
breaths.
4. Pressure support ventilation(PSV):- applies pressure
plateau to the airway throughout the patient triggered
inspiration to decrease. Resistance within the tracheal tube
and ventilator tubing. Pressure support is reduced gradually
as the patient strength increase.
Cont.

9. INDICATION
 Decrease oxygen(PaO2) in patient blood.
 Increase arterial (PaCO2) level’s.
 A persistent acidosis ( decrease PH).
 Thoracic or abdominal surgery.
 Drug overdose.
 Neuromuscular disorder.
 Inhalation injury.
 COPD.
 Multiple trauma.
 Shock.
 Multisystem failure and coma.
All lead to respiratory failure.

10. PROBLEM WITH MECHENICAL VENTILATOR:-
Increase in peak airway pressure due to cause:-
• Coughing or plugged airway tube.
• Patient bucking ventilator decreasing lung compliance.
• Tubing kinged.
• Pneumothorax.
• Bronchospasm.
Decrease in pressure or loss of volume:-
• Leak in ventilator or tubing cuff on tube/humidifier not
tight.
• Increase in compliance.

11. COMPLICATION OF VENTILATOR PATIENT:-
 Pulmonary infection due to impaired cough reflex.
 Barotrauma/pneumothorax.
 Cardiovascular compromise.
 COPD.

12. NURSING CARE OF VENTILATOR PATIENT:-
 Suction airway for secretions empty condensation
fluid from circuit.
 Assess for hypoxia or bronchospasm.
 Check arterial blood gas values.
 Check tubing position , insert oral airway.
 Check ventilator circuit for correct leak.
 Check and monitor vital sign.
 Central venous pressure measure.
 Provide frequent mouth care.
 Optimize nutritional status.
 Use aseptic techniques.
 Alternate change patient position or use
mattress.