physician ordered patient driven ventilator protocol

Specialties Pulmonary

Published

Does anyone out there have a ventilator or BiPap protocol that they use that is therapist driven? I am to create one for our facility but if there are some out there then I don't want to recreate one. Thanks

We use PDP's for both bipaps and vents at my hospital. What type of info are you looking for?

With bipaps, at my place we do not need a dr's orders to get an ABG. If the ABG is bad, we are allowed to slap the pt on bipap and titrate the settings to fit the pt's needs. Then we get a follow up gas. At some point in time we will call the dr to let them know what is going on with the patient - and we HAVE to call them if the second gas is worse and the bipap isn't working, obvs.

For the vent protocols...basically we need an order to intubate (unless it's a code blue situation). Once we get that, we intubate, slap the pt on the vent - us RT's choose the vent mode and settings. We get a follow up gas about an hour or so after intubation and tweak the settings. From there, we're basically on a weaning protocol where as RT's we're focused on getting the pt off the vent as soon as possible, depending on what's going on with other things. We get gases at least once a day, or an hour or so after any major changes. We generally have to report any bad gases to the md's, but they pretty much let us change the settings the way we want. Pt's coming out of heart surgery have their own set of protocols. Long term vent patients have another protocol. I don't know. They're pretty much all kind of the same. Pt the pt on bipap/vent if needed, get them off ASAP. It's not rocket science. :)

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