Mechanical ventilation provides breathing support for patients unable to breathe on their own. The nurse cares for patients on ventilators by monitoring vital signs, ensuring proper endotracheal tube placement and securing, adjusting ventilator settings per orders, preventing infections and complications, meeting nutritional needs, and coordinating with respiratory therapists. Potential complications include pneumothorax, decreased cardiac output, ventilator-associated pneumonia, and airway injury.

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.

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

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

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

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