I'm a former RT. I think that the most important concept that you should remember is to maintain the airway. Learning the variouse modes of delivery is important to your patients comfort, but not as much as seeing that the Tube is secure as your first line of defense.
Observe the RT tape a tube. You'll want to see what a perfectly taped tube is SUPPOSED to look like. That way when it's in bad shape you'll be able to tell. Patients sometimes fiddle with them(it's shoved down their throat, after all) and that can work a tube loose enough to auto-extubate. Be aware of the tube when you turn a patient, Bathe them, When they are "out of it"............and when you first come on shift take note of the tubes position(what mark on the tube is at the bottom lip) and the condition of the tape.
All the modes of breath cycling are intimidating to understand but remember that the key to the mode that a patient is set on is based on their ability to create acceptable negative pressure with their diaphragm, and the compliance(stretching ability) of their lungs. Your RT can explain why each patient is on the mode they are on. You'll learn the variouse stages of weaning as you see more and more cases.
The most important skill to learn is when to be concerned....................ALWAYS LOOK AT THE PATIENT. It's easy to get involved looking at the vent with all the lights and alarms, but the only parameter that I can imagine you will need is the inspiratory pressures. 9.99 times out of ten it will be alarming momentarily a couple of times a minuet because the patient is coughing, or turning, sitting up, having a BM. Mostly the vent alarm is a good thing. Frequent short alarms usualy indicate either a need for suction, sedation, or weaning. Any duration longer than 10 seconds or so should draw your attention. LOOK AT THE PATIENT! I wish I had a dime for every time a scurried into a room with people looking intently at the vent to fix the problem when the tube was disconnected.
Learn to suction your patients and how to do it right. You'll save your patients alot of discomfort and yourself a few grey hairs waiting for the RT with the three beepers and 40 patients to run up three flights of stairs!
You'll also get more advice and personal service from an RT staff that feels valued for their expertise and troubleshooting abilities if you just call them when you can't handle it yourself.
After you have a baseline of what normal pressures should be at the start of your shift just remember to look at the pressure of the airway when you are doing other things...................When your patients in distress and you haven't got a clue...........BAG them and get help. There's no shame in that if your patient feels better until you learn the ropes. If you are trying to learn how to handle alarms on your own, that's what counts. As you see more cases and build your understanding of ventillator settings and how that relates to your patients disease process, the more you will be comfortable with that.
If you call respiratory every time a patient coughs, you'll get a reputation and after awhile it will be harder to take you seriousely, but if you take the time to learn and ask RT questions that will give your RT staff an irreplaceable sense of value and they will come help you even when you didn't ask. Try it and see.
I hope some of what I said gives you some level of comfort. I remember what it was like to hear all those alarms and see all those settings and just be sure that my ignorance must be killing them. For the most part vent settings will only be where they are because those are all the parameters that your patient is comfortable at, so why screw with that?
You can post your questions about anything Respiratory to me on the messaging system here or to firstname.lastname@example.org
Happy oyster digging!