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Discussion

Case studies on shock

I am currently in a critcal care mini session course. One of the case studies is talking about patient who had a diving accident and has damaged the cervical portion of his spinal cord and has become paralyzed. His vitals are labile. The nurse comes in due to his ventilator machine going off. Vitals: T:99.6, P 60 and bounding, BP 82/60/ RR 28 and bucking the ventilator. Skin is warm and dry. Anxious, and extremely restless.

We have to state the classification of the shock and what stage.

I said neurogenic and stage II. I really want to know why patient's "buck" the ventilator though? I have never heard that expression before. What causes this to happen?

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    "bucking the vent" is an expression used to denote a patient triggering the high pressure alarm on the vent due to not being in-synch with with the ventilator's breath triggers and delivered tidal volumes. This can manifest as coughing while the vent is delivering a breath, breath stacking or the patient breathing right before completion of a delivered vent tidal volume making the vent trigger another delivery of tidal volume. It can be caused by agitation, a mucus plug, or just the plain discomfort brought about by the artificial nature of volume cycled vent modes.

    http://rtboardreview.com/public/rc_procedures/dyssynchrony.htm

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