Help! I don't "get" vents!!! - pg.2 | allnurses

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... Read More

  1. Visit  wooh profile page
    4
    I 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??
  2. Visit  JeanettePNP profile page
    3
    Quote from wooh
    I 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???
    DeLanaHarvickWannabe, Fiona59, and wooh like this.
  3. Visit  LadyFree28 profile page
    0
    at 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!
  4. Visit  MattNurse profile page
    0
  5. Visit  KenH profile page
    0
    Here 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 =
    hyperventilation.

    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
    output

    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
    ventilation

    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
    compensated
  6. Visit  KenH profile page
    0
    Quote from mlbluvr
    Anybody- 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 # 1 NEVER stand at the foot of the bed, if you do you are just asking to be sprayed
    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.
  7. Visit  Bortaz, RN profile page
    1
    I suggest you learn Bulgarian.
    DeLanaHarvickWannabe likes this.
  8. Visit  Dodongo profile page
    1
    Do you work in a teaching ICU with residents? At the beginning of every month the pulmonologist/intensivist will go over every aspect of the vent during rounds with the new interns. The experienced ICU nurses and residents gloss over during this time but the new nurses and interns love it and learn a ton. Once you get the basics down there is a lot you can do on the vent for your patients. Also, if you have RTs they can be a great resource for you.
    mcmgal likes this.
  9. Visit  DeLanaHarvickWannabe profile page
    1
    Quote from wooh
    I 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??
    You are wrong. Dead wrong!

    I don't understand that there are slits in the wall and floor that blow cold air out in the summer, then warm air in the winter! HOW DOES THAT WORK? How can they change their minds?
    wooh likes this.
  10. Visit  DeLanaHarvickWannabe profile page
    0
    You all have given me so many great resources and information. I am going to dig into this stuff very soon - for now I have to study for a final (I'm in grad school as well - my brain's fixin' to explode!).

    I did shadow respiratory for four hours and got a good explanation of everything but a few emergencies popped up and we kind of ended up running around! Thankfully respiratory and the residents are always on hand and willing to explain stuff.

    Thanks again everyone. Keep the resources coming!
  11. Visit  wooh profile page
    1
    Quote from DeLanaHarvickWannabe
    You are wrong. Dead wrong!

    I don't understand that there are slits in the wall and floor that blow cold air out in the summer, then warm air in the winter! HOW DOES THAT WORK? How can they change their minds?
    You must work in a magnet hospital. My hospital's slits seems to always have cold air blowing out in the winter and warm air in the summer....
    DeLanaHarvickWannabe likes this.
  12. Visit  mcmgal profile page
    1
    DeLanaHarvickWannabe
    I like your quote at the bottom of your post!
    DeLanaHarvickWannabe likes this.
  13. Visit  akinaRN profile page
    0
    Very basically, this is how I explain the 3 main settings we use in our ICU. With other modes, I have to ask our RRT to explain to me every time I come across it.

    AC--The vent gives set tidal volume on ALL the breaths, even the ones the pt initiates.
    SIMV--The vent gives set tidal volume on only the set breath rate.
    Spontaneous is, well, spontaneous--the pt does most of the work (I only say most, because generally they're on pressure support/PEEP as well.

    Correct me if I'm wrong. And obviously, this is just the most basic way to remember.

Must Read Topics



Visit Our Sponsors
Top
close
close