Help! I don't "get" vents!!! - page 2
Hey everyone! Very recently I left MedSurg after 7 years for critical care. Thank goodness I have years of experience and knowledge of what "normal" assessments are. So far things are going very well. Titrating pressors,... Read More
- 0Jul 23, '13 by mlbluvrAnybody- please offer your opinions as to why, really, so many thousands of people in this country are being kept alive by ventilators. And please, by all means - cut my head OFF before you ever contemplate giving ME a tracheotomy. IMO it's a fate far worse than death. It makes me squeam to think about. It's just too gross for normal conversation. And I've had more than one trach disgorge an unholy amount of secretions onto me, my uniform, my hands, and etc. Eegads.
- 3Jul 23, '13 by JeanettePNPQuote from woohI keep seeing this on the side under "Liked Nursing Topics" and can't understand why someone doesn't understand vents. It's just ranting for goodness sake! What is there to understand??
What? You mean nurses VENT? Don't they even care about their patients? If you need to vent why did you ever go into nursing in the first place? Don't you know there are a million new grads who'd kill for your job???
- 0Jul 23, '13 by LadyFree28at the last 2 posts!
vanilla bean, Esme and NRS and PPs gave some great advice and links...helped me out a TON as a refresher when learning about vents in a critical care.
When I started out, part of my orientation was shadowing a RT...it REALLY help put it all together. Hope you get a chance to grab one!
- 0Jul 24, '13 by KenHHere are the Basics
Ventilation is just like understanding I&O's, to much or not enough will cause problems
Normally we breath by negitive pressure, when a person is intubated the cuff/balloon on the tube seals the airway so you can ventilate them with positive pressure.
When a patient is on a vent you are managing there breathing, sedation your friend
Vt= how big a breath, both to little and to much will cause problems, how big a breath depends on the disease process.
Rate, to fast and to slow hyper & hypo ventilation
AC = all the time, every breath the patients gets is what the vent is setup for
too slow= hypo ventilation increased Co2, to fast = hyper ventilation
Simv= sometimes, part of the breaths are AC (see above)and part of them are
spontaneous, how big of a breath depends on Pressure support = helping taking a
breath, to small, not enough support = hypo ventilation, to much help/ support =
Peep = 5 of peep changes your base line end pressure from 0 to +5, peep is use for
oxygenation, recruitment of alveoli , to much peep can cause decreased cardiac
Cpap/Peep + PS pressure support, every breath is spontaneous, totally patient driven.
To high of a Respiratory Rate and or to much Pressure Support = hyper ventilation
To Low of a Respiratory Rate and or not enough Pressure Support = hypo
Lung compliance, low lung compliance = stiff lungs, hard to ventilate, higher peak
pressures. High lung compliance = soft lungs, easy to ventilate, lower peak
pressures. High Peak Pressure = lung injury
ABGs on the ventilation side PH and Co2 have an inverse action to each other
High Co2 = Low PH, hypo ventilation, Low Co2 = High PH, hyper ventilation
On the metabolic side you have Bicarb = buffering system, you can tell a lot about
respiratory status base on the bicarb, acute, partly compensated, not
- 0Jul 24, '13 by KenHQuote from mlbluvrRule # 1 NEVER stand at the foot of the bed, if you do you are just asking to be sprayedAnybody- please offer your opinions as to why, really, so many thousands of people in this country are being kept alive by ventilators. And please, by all means - cut my head OFF before you ever contemplate giving ME a tracheotomy. IMO it's a fate far worse than death. It makes me squeam to think about. It's just too gross for normal conversation. And I've had more than one trach disgorge an unholy amount of secretions onto me, my uniform, my hands, and etc. Eegads.
Rule # 2 Treat every trach as if they are Dirty, MRSA and mmmmmmm the smell of pseudomonas.
why, sometimes it a personal choice, ease of weaning off the ventilator, people can have normal lives and have a trach. Most of the time family cant let there love one go, some will call it selfish of them or loving, some time it just torture.