1. DEFINITION
It is the care rendered to patient on mechanical
ventilator. A medical ventilator is an artificial
mechanical ventilator or breathing device, a machine
designed to move breathable air into and out of the lungs,
to provide breathing for a patient who is physically
unable to breathe, or breathing insufficiently.
2. PURPOSES
To maintain arterial oxygenation for adequate oxygen
delivery to the tissues.
To maintain alveolar ventilation for adequate
elimination of carbon dioxide.
To promote safety and prevent complications among
mechanically ventilated patients.
5. STEPS ON CARE OF PATIENT ON
MECHANICAL VENTILATOR
Monitor vital signs every 2 hourly
Verify endotracheal tube (ETT) placement at prescribed
level
Ensure that ETT is properly secured at all times.
6. Contd..
Change ET plaster aseptically on daily basis and as
necessary
Ensure cuff inflation using minimal occlusive volume
(MOV). Cuff pressure should be recorded on the nurse’s
progress notes and flow sheets
7. Contd..
Evaluate respiratory status (ventilation and
oxygenation) by inspection, palpation and
auscultation as well as laboratory data and
oxygen saturation
Maintain head of bed elevation at 30 – 45o angle
8. Contd..
Ensure the following alarms are activated (the
respiratory therapist will set these alarms
High pressure
Low pressure
Temperature
Oxygen
Apnea
Low – exhaled volume
High respiratory rate
9. Contd..
Ensure ventilator settings are adjusted according to
doctors order
Suction secretion as needed
Carries out hygienic necessities
Oral care every 4 hourly
10. Contd..
Check prescribed ventilatory set up as to:
Mode
FiO2
Tidal volume (if applicable)
Respiration rate
Adjunction therapy (e.g., PEEP/CPAP)
11. Contd..
Assess pain and sedation needs
Prevent infection
Prevent hemodynamic instability
Maintain head of bed elevation at 30 – 45o angle
ensure patent airway through proper suctioning
technique
12. Contd..
Meet the patient’s nutritional needs
Wean the patient from the ventilator
appropriately
Educate the patient and family
13. Contd..
Monitor for complications (e.g., Pneumothorax,
decreased cardiac output, dysrhythmias,
ventilator associated pneumonia, fear, anxiety
and acid base imbalances)
Coordinate with the Respiratory Therapist on
issues related to mechanical ventilation
14. Contd..
Document the following:
Assessment findings
Patient’s physical and psychological response
Type and size of ETT, position at lips, amount of
air in cuff
Type of ventilator and its settings