Care of patient on ventilator

2. 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.

3. 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.

4. ARTICLES
 Mechanical ventilator
 Manual resuscitation device
 Cardiac monitor
 Pulse oximeter
 Suction equipment and supplies

5. Contd..
 Disposable cup
 Oral care kit
 Stethoscope
 Oxygen humidifier
 Intubation kit (standby)

6. 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.

7. 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

8. 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

9. 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

10. Contd..
 Ensure ventilator settings are adjusted according to
doctors order
 Suction secretion as needed
 Carries out hygienic necessities
 Oral care every 4 hourly

11. Contd..
 Check prescribed ventilatory set up as to:
 Mode
 FiO2
 Tidal volume (if applicable)
 Respiration rate
 Adjunction therapy (e.g., PEEP/CPAP)

12. 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

13. Contd..
 Meet the patient’s nutritional needs
 Wean the patient from the ventilator
appropriately
Educate the patient and family

14. 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

15. 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

16. COMPLICATIONS:
1. Pneumothorax
2. Decreased cardiac output
3. Ventilator associated pneumonia
4. Airway injury
5. Oxygen toxicity