How does one proceed with CPR on a vented patient? Do you let the ventilator do the work still? Does it depend on what mode and settings? Do you crank up the Fi02? Just do compressions?need some help here...thanks!
Christie RN2006 572 Posts Specializes in SICU, EMS, Home Health, School Nursing. Nov 5, 2007 When we have a patient that is on the vent that is coding, we take them off the vent and bag them with 100% O2, but thats just us... I really don't know if there are actual guidelines for that.
RN1980 666 Posts Specializes in icu/er. Nov 5, 2007 for the most part we take the patient off the vent and bag them, this offers the airway guy alittle control over how many breaths the pt gets, cause the patient very well just might have been on a very low rate and tv without anyother vent support. plus the dang vent will be screaming every few seconds cause of low numbers. we have before just turned the vent on cmv on 100% but you still have to break the circut for sxn and the vent gets in the way. best just to disconnect place the machine on standby, roll it out of the way and bag the patient.
jmgrn65, RN 1,344 Posts Specializes in cardiac/critical care/ informatics. Has 16 years experience. Nov 5, 2007 ACLS Guidelines say to take them off the vert and bag with 100% 02.
ICUColtRN 5 Posts Specializes in ICU. Nov 7, 2007 How does one proceed with CPR on a vented patient? Do you let the ventilator do the work still? Does it depend on what mode and settings? Do you crank up the Fi02? Just do compressions?need some help here...thanks!Disconnect the vent, and bag them on 100% O2.
cardiacRN2006, ADN, RN 4,105 Posts Specializes in Cardiac. Nov 7, 2007 Same here, start bagging at 100% and start compressions...
elizabells, BSN, RN 2,094 Posts Specializes in NICU. Nov 9, 2007 Same with the babies. There is some research out there about bagging with whatever FiO2 the pt was vented at, but it's early days, and not recommended yet.
Azee 19 Posts Has 3 years experience. Nov 12, 2007 Agree with bagging pt with 100% O2 and ACLS states 6-8/min.
gwlillith 164 Posts Specializes in Trauma, ER, ICU~CCRN,CNRN. Nov 19, 2007 Just don't forget to let go and step back when you hear the word, "CLEAR!"...:Reindeer:
smileyRn96 161 Posts Specializes in ER/ICU, CCRN, SRNA (class of 2010). Has 11 years experience. Nov 20, 2007 Definately bag with o2, if the vent gives a breath during your compressions they will be ineffective. A big asynchronis mess hence the ACLS guidelines.-Smiley
sjt9721, BSN, RN 706 Posts Specializes in Emergency/Trauma/Education. Nov 20, 2007 Definately bag with o2, if the vent gives a breath during your compressions they will be ineffective. A big asynchronis mess hence the ACLS guidelines.-SmileyI'm not sure of the point you're trying to make.Ventilations via BVM are ineffective if given asynchronously during compressions. But the ACLS guidelines recommend asynchronous compressions/ventilations when the patient is intubated.
smileyRn96 161 Posts Specializes in ER/ICU, CCRN, SRNA (class of 2010). Has 11 years experience. Nov 20, 2007 I'm not sure of the point you're trying to make.Ventilations via BVM are ineffective if given asynchronously during compressions. But the ACLS guidelines recommend asynchronous compressions/ventilations when the patient is intubated. Asynchrony in the timing need for proper CPR to maximize blood flow and oxygenation of the body. This is dependent upon both the depth of compression and the pressures in the chest to allow blood to move out of the heart to the body. I hear what your saying, I am not saying that you have to stop compressions to give breaths but giving a breath while a compression is being delivered will not go in or the compression will be altered. There still needs to be synchrony (proper timing) to maximize the effect of CPR. -Smiley
