Vent settings and documentation

  1. Hi.
    Im a newish grad who is now working in the ED. I had a vent patient the other day and the RT told me the settings very quickly for me to document. I am just wondering what settings should I be expecting to document? what are the norms for these settings? I just want to have a heads up for next time in case something is missing..
    Thanks!!!
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  2. 9 Comments

  3. by   pickledpepperRN
    This is a good thread on the subject. Look at the link to ICU FAQs.http://allnurses.com/forums/f15/vent...gs-122919.html

    Document the
    Mode: The way a breath is delivered.
    Assist Control: A/C
    Intermittent Mandatory Ventilation: IMV
    Synchronized Intermittent Ventilation: SIMV
    Pressure Support Ventilation: PSV

    Rate = breaths per minute
    Tidal Volume
    Fi02: Fraction of Inspired Oxygen.
    PEEP if used

    Look at the actual settings on the vent. Don't just chart what is ordered or what you are told.
  4. by   Lizziefive
    Thanks!!!! im going to check it out!
  5. by   pickledpepperRN
    Here is the site. Really good!

    http://www.icufaqs.org/
  6. by   cardiacRN2006
    Quote from spacenurse
    This is a good thread on the subject. Look at the link to ICU FAQs.http://allnurses.com/forums/f15/vent...gs-122919.html

    Document the
    Mode: The way a breath is delivered.
    Assist Control: A/C
    Intermittent Mandatory Ventilation: IMV
    Synchronized Intermittent Ventilation: SIMV
    Pressure Support Ventilation: PSV
    Rate = breaths per minute
    Tidal Volume
    Fi02: Fraction of Inspired Oxygen.
    PEEP if used

    Look at the actual settings on the vent. Don't just chart what is ordered or what you are told.
    If they aren't on AC we chart the pressure support.
    Also, we chart the PIP (peak inspiratory pressures and the pt's tidal volume, which is slightly different from what the machine is set at.
  7. by   Indy
    -What they said. I always add the patient's rate in addition to the set rate if they are on IMV, and the minute volume in addition to the set tidal volume. I try to do this each hour on the flowsheet along with the vital signs, or if RT makes a change I document what changed. This has helped me greatly in remembering how the patients respond to what changes have taken place.
  8. by   poppy07
    We chart mode, Fi02, PS (if any), PEEP (if any), set TV, pt's TV, set rate, pt's rate, MAP & PIP ---- these pressures can tell you if there is resistance in the lungs, such as from increased secretions, consolidation, narrowed airways, etc. Based off of high airway pressures, I called RT and MD and initated getting the vent mode changed for the pt, which went well for the pt.
  9. by   patrick1rn
    Quote from Lizziefive
    Hi.
    Im a newish grad who is now working in the ED. I had a vent patient the other day and the RT told me the settings very quickly for me to document. I am just wondering what settings should I be expecting to document? what are the norms for these settings? I just want to have a heads up for next time in case something is missing..
    Thanks!!!
    If that RT established the intial settings, that RT should document those intial settings and not dump that off on the RN. Rts have a role in the ER and ICU setting and it involves that vent ! The RT is their to support you when it comes to that vent, I feel by the way you describe this situation that the RT is pulling a fast one on you . That RT knows you are a new grad and I feel is dumping something off on you . If you are not familiar with vent settings, then get familiar with them as others have posted in here. Dont let other departments abuse you as a new grad... they will try to pull a fast one because of laziness.
  10. by   meandragonbrett
    Quote from patrick1rn
    If that RT established the intial settings, that RT should document those intial settings and not dump that off on the RN. Rts have a role in the ER and ICU setting and it involves that vent ! The RT is their to support you when it comes to that vent, I feel by the way you describe this situation that the RT is pulling a fast one on you . That RT knows you are a new grad and I feel is dumping something off on you . If you are not familiar with vent settings, then get familiar with them as others have posted in here. Dont let other departments abuse you as a new grad... they will try to pull a fast one because of laziness.

    I don't think the OP was asking the RT about the initial settings? Even so, the RT's chart their vent checks, but the RN needs to also be charting the vent settings regardless if they are initial or ongoing settings.
  11. by   cardiacRN2006
    Quote from patrick1rn
    If that RT established the intial settings, that RT should document those intial settings and not dump that off on the RN. Rts have a role in the ER and ICU setting and it involves that vent ! The RT is their to support you when it comes to that vent, I feel by the way you describe this situation that the RT is pulling a fast one on you . That RT knows you are a new grad and I feel is dumping something off on you . If you are not familiar with vent settings, then get familiar with them as others have posted in here. Dont let other departments abuse you as a new grad... they will try to pull a fast one because of laziness.

    The RT does not document on my flow-sheet. I am just as responsible for knowing the vent settings as the RT is. The RT documents on his/her RT sheet at the bedside, and I document it Q1 (and with each change) on my graphics flow-sheet.

    You can't rely on the RT being there. In fact, they miss half of the vent setting changes because they are made by the pulmonologist with me at the bedside.

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