Help Please!

  1. I have been working with 'portable'vents for 10 years...just about every brand that was or is.

    On Monday I have to teach 5 Nurses about vents, 3 of who have never worked around one. I have to instruct on the basics... like modes, volume -vs- pressure ventilation, what MAP & I:E ratio are (and what they mean), PIP, PEEP get the picture.

    Heres my problem...
    I have been doing this stuff for so long that I just know it, I don't have any idea where to begin on it. I don't even have an (old) outline as a starting point. I don't know how to communicate what I know onto paper.

    Any suggestions? Has anyone across (something maybe like) a patient teaching tool?


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  3. by   Jenny P
    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!
  4. by   Jenny P
    BTW, did you try
    for info and help?
  5. by   kids
    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...
  6. by   hoolahan
    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.
  7. by   NRSKarenRN
    Check out these resources:
    Adult care

    Pediatric Tracheostomy and Ventilator Care Joan McNichol Dougherty, RN, BSN, CPN
    Georgette Kandrak, RN, BSN Zoe Kinney, RN, BSN Martha Parra, RN, BSN. ...

    Good luck, we know you can do it!
  8. by   nur20
    OUTLINE....purpose...types....power sources.....testing batteries....controls and what they mean......operating modes....pressure checks....alarms and monitoring.....trouble shooting.....trach and other related items......disinfecting, cleaning and maintenence
  9. by   Jenny P
    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.

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

  11. by   Jenny P
    Glad to hear it went so well. I TOLD you that you were the expert!
  12. by   NRSKarenRN
    Knew you could do it! Nine more homecare nurses WOW!
  13. by   hoolahan
    Sounds like the beginnings of a new career in nursing education. It gets addictive. Way to go!!