[DaveUproar]

Hi there,

Got a new job doing pediatric home health, and the patient is on a vent only at night.

In my past jobs and in school I have had very little experience with vents. Do you have to program them and calculate volumes, etc? I'm a little confused and don't want to look like a complete idiot on my first day.

Info, please ;-)

[susieQ72]

I started working for a peds home agency and they sent me to a 3 hr class to feel comfortable with vents. Is there a home health agency in your area that supplies homes with medical equipment,they might have a class? There is also a post I saw in the peds forum that had some websites to go to dealing with vents and trachs. Good luck!

[bas812]

In adult health the ventilator volumes are calculated by the respiratory company servicing the client. Very rarely do the volumes change in the home, the patients are discharged from the hospital and all of the parameters on the vent should have been determined by the discharging MD--you should not be calculating anything.

[MeghanRN]

I've done pedi private duty before, and we oriented until the nurse was comfortable with the vent.

Most nurses who came to pedi private duty were not familiar with the vents and we oriented them until they were.

How long is your orientation to the patient? Were you allowed to attend a ventilator class? (Ours was taught by an RT that worked with the supply company). If not, ask them to attend one.

As for programming, all you do is turn it on and off Numbers are pre-set, and are just double checked against the order.


Also, remember there should be a supervisor on call 24/7 (been there!) And as much as they may not like being woken up, the patient comes first. Just make sure you are properly oriented to it, and they give you as much time as you need to learn the vent.

And last but not least, good luck on your new job!!

-Meghan

[dria]

Everyone who preceded me is pretty right on concerning orientation...but I wanted to add that these vents are designed for home use, so they are pretty user friendly and likely not as complex as those used for inpt care.

Some things you'll want to make sure to know: how to operate the vent-powering on/off, testing the vent, troubleshooting alarms, location of backup power supply and how to switch them, this client's plan in the event of vent failure, location of backup circuit and how to construct a new one, documentation of vent checks and payer's documentation requirements, any maintenance responsibilites related to the vent that fall on your shifts. I'm sure this is not all-inclusive since it's been a few years since I've worked with vents....

Good luck with your new job!

[lc177985]

I work home health with someone who is on a vent continuously and can't stress enough the importance of knowing what to do in the event of a power failure. Don't let the client lull you in to a false sense of security with "this never happens". It happened to me during my orientation with a nurse who had taken care of this client for 10 years and we were able to hook up to an outside power source. Know where the battery/generator is, make sure it is on a treatment order to be maintained/charged and checked for power. You don't want to be caught alone with no plan. As for the rest, I agree that the vent is set by the company and you simply have to make sure it is running according to their numbers. Good luck!

[caliotter3]

The ventilator settings are prescribed by the doctor and should be listed on the 485 plan of treatment. Your responsibility is to check the settings when you come on shift or when you place the person on the vent and to record them on the appropriate sheet. You do adjusting only if your check reveals that the settings do not match what the doctor has ordered. If the vent settings are not on the 485, then communicate with your supervisor/doctor and see that the latest order is added to the plan of care.

You can find info about operating different kinds of vents on the links listed on the sticky about vents at the top of this forum and by googling the subject. My agencies would send nurses to inservices provided by the vendors. Some were better at explaining things than others. One of my agencies had printed material about vents. You kind of have to do a little research on this subject. My original orientation was in the home of my new client. A nurse showed me how to check the vent and switch over to the spare in case of an emergency, how to clean and change the circuits, etc. Before that, I had no experience with vents other than looking at one in clinical in school. The more you work with them, the less intimidating they will become.