Help Please!

Jenny P · Jan 12, 2002

Nancy, start with the basics: purpose of vents; how they work (pressure vs. volumes, etc.); and of course terminology and abbreviations. I have some books at work that I'll check and see if any have really good and basic info and get back to you either tomorrow or Mon AM (depends on how functional I am after tonight and tomorrow-- both 12 hr night shifts) with sources.

You probably can do a large part of the terms and abbreviations from memory; and maybe once you do the easy stuff, the whole outline will fall into place (at least that has been my experience in the past).:)

Remember, YOU are the expert; and you can do it! GOOD LUCK!

Jenny P · Jan 12, 2002

BTW, did you try

http://www.ventworld.com/

for info and help?

kids · Jan 13, 2002

Just got back from there...lots of good info, think I will end up plagerizing half the net doing this.

Think part of my problem is I have never done any teaching of this magnitude...usually have a starting point. Got handed this on Friday, have to work this eve and days tomorrow and CAN NOT pospone this training...we are admitting the babe these nurses are going to staff on Thursday...

hoolahan, ASN, RN · Jan 13, 2002

I could send you a copy of the vent self-learning packet I made several years ago. Only problem is, it was designed for more volume-controled vents, not pressure controlled, which I believe is the way most portable vents work. (I don't know, I've never worked with portable vents.)

I think all you need to do is make a good outline to follow, then just talk about what you know.

Most people who are new to vents need to know, what to do when the alarm goes off, what does that mean, what must they do immediately? Teach them to trouble-shoot that after the initial vent review. I also set-up a fake neck with a trach, to practice bagging and suctioning as well as trach care. I had out RT set-up a vent and gave each person there a six inch length of corrugated tubing so the could feel the difference between SIMV and pressure support. They loved that.

I had the ominous job of cross-training our floor staff to work in the MICU with stable vent pt's. So, they all attended the two-part workshop. In one year, I cross trained 23 nurses to the MICU, and that was only nights. My colleagues did way more on days.

Have lots of props, different types of trachs (if you're doing kids, I guess you may not (?) have as many as adults.

I think I would start out by recognizing why a kid would need a vent, and how it is that the vent corrects that situation. Or start out with a case study. Then go over the vent, define the terms volume minute volume, peep, etc... then the modes.

Then on to the trouble shooting. I used a Stop Look Listen theme for responding to vent alarms. When you hear an alarm STOP what you are doing and respond. LOOK at the pt, don't worry about the machine. Is the chest rising and falling, how is their color, look at the pulse ox, is anything disconnected. LISTEN for tube placement and breath sounds. Emphasize if the pt is OK, there is no need to panic. Or if there IS a problem with the pt, "Bag and Blab" Bag the pt, and ask for help.

In the second part I did more discussion about weaning, interpreting abg's, etc....

I am sure you wouldn't have been asked to do this if you weren't respected for your abilities and knowledge. Let us know how it went.

Home Health Columnist / Guide · Jan 13, 2002

Check out these resources:

Adult care

http://www.icufaqs.org/VentFAQ.doc

Pediatric Tracheostomy and Ventilator Care Joan McNichol Dougherty, RN, BSN, CPN

Georgette Kandrak, RN, BSN Zoe Kinney, RN, BSN Martha Parra, RN, BSN. ...

nsweb.nursingspectrum.com/ce/ce131.htm

Good luck, we know you can do it!

nur20 · Jan 13, 2002

OUTLINE....purpose...types....power sources.....testing batteries....controls and what they mean......operating modes....pressure limits......safety checks....alarms and monitoring.....trouble shooting.....trach and other related items......disinfecting, cleaning and maintenence

Jenny P · Jan 15, 2002

Sorry, Nancy that I didn't get back to you-- I had the proverbial weekend-from-he!! experience, and am just waking up mentally from it. The kicker was having a Sundowner syndrome PLUS a pt. with a blood ETOH level of 0.365 and multiple fractures last night! I did have a sitter, but it really wasn't fun with the puke and all. :eek:

So, how did it go? Lots of good suggestions here; Hoolihan, your packet sounds really good!

kids · Jan 15, 2002

I survived it. Turned out to be 9 people...

We use several different models of 2 different vents. I decided that if you know the nomenclature you can apply it to just about any vent so that was where I started...

We do next to no blood gas monitoring so I didn't spend any time explaining how vent setting are established-other than the bare basics. Then worked from the manufacturers operators manuals.

I realised it was making sense to everybody when they were asking intellegent questions.

The post test was on index cards...different vent settings(programing them on the vents) and senarios...everyone passed with a minimum of 8 out of 10.

Unfortunately my boss was there for it and also liked it so the performance will likely be repeated...

Big thank you to everyone, I had such a mind block on the whle thing I was totally blank

-nancy

Jenny P · Jan 15, 2002

Glad to hear it went so well. I TOLD you that you were the expert!

Home Health Columnist / Guide · Jan 15, 2002

Knew you could do it! Nine more homecare nurses WOW!

hoolahan, ASN, RN · Jan 15, 2002

Sounds like the beginnings of a new career in nursing education. It gets addictive. Way to go!!