Low sat on vent fine off

Hello, I'm sorry you can't get an RT there to troubleshoot, it sounds like the home care company is slacking or simply short staffed. This question is open-ended, there can be many reasons why a patient may desat while back on the vent, including incorrect mode, or not enough oxygen bled in while on the vent. I presume the patient goes on the vent at night to sleep. Some pulmonary patients require supplemental oxygen only at night while asleep.

Commonly, vent settings need to be adjusted over time, because what may have worked when they were discharged simply doesn't cut it now, especially if the patient's confounding pulmonary disease gets worse over time. There are various settings on the vent that can improve oxygenation alone, aside from adding in oxygen- which frankly should be the last step as it is a drug. A review of current vent settings by the provider should be in order, coupled with a chest xray to see if the patient is underinflated or has atelectasis. If the patient has secretion issues, the patient may benefit from more PEEP, or a higher tidal volume, which should help with oxygenation. It could even mean that while asleep on the vent the patient may need to be suctioned, or given bronchodilators.

There's no sure fire answer here as there could be several answers. In short, really have an RT get out there, even if it means filing a complaint- because it is the patient that is suffering.

Thankyou! A meeting happened with the whole team with alot of issues addressed ; doing significantly better with a few med changes . Thankyou for taking the time to reply!