Vent help............!!

the following is an excellent resource for all things icu related in nursing.

i'm sure they have some vent info on there:

http://www.icufaqs.org/

i can try to help if you have any specific questions. usually, though, in a code we take the patient off the vent and bag them. i've read that this isn't such a good idea, esp if the patient is on a bunch of peep, but that is what we tend to do (i think it makes us feel like we are more in control :) )

hi! try this website: http://www.icufaqs.org

i remember feeling very intimidated by vents, but believe it or not the concept is very simple. think of it is a fancy air compressor pushing air into a person's lungs.

now a lot of different settings can be programmed into them.

the rate at which the machine breaths.

how much air the vent pushes into the lungs. (tidal volume)

the setting of oxygenation (fio2) in percentage. (30%-100%) in a code situation this may be one of the important things to know. how much oxygen were they on.

then the vent can be set to not fully allow the lungs to deflate at the end of expiration. this is called peep. positive end expiratory pressure. it is almost always set at 5.

those are the 4 most basic settings on a vent that a nurse should know. i am an icu nurse and that is really the only numbers i keep track of and report on to the next nurse.

hope this helps.

you can do it!!

:yeah:

another superior link.

this site has interactive pt simulators, variety of situations.

this link, however, is for respiratory.

http://www.geocities.com/nyerrn/simulators.htm#air

leslie

Not the original poster but thanks for the great link. I am a med-surg nurse and really find some of this information interesting as well as extremely helpful for orienting new nurses ( as general information)

Thanks again.

Glad to see this as well. I want to do vent care at home and these sites would be very helpful!

Very complicated subject. Are you able to take a critical care course? Here are a few things to study that will help with vent understanding.

Mode: (SIMV vs PS vs CMV etc...)

Tpe of ventilation: essentially two types. 1) Pressure 2) Volume

FIO2: % of inspired oxygen

Vt: amound of air delivered in a normal breath

PEEP: pressure at the end of exhalation

Peak Pressure: pressure of air in the upper airways and vent tubing

Plateau Pressure: complicated to explain, but an indicator of alveolar pressure and type of air flow. Becoming very important with ARDS and lung injury patients.

Flow: amount of air flow in LPM

I:E time: amount of time spent inhaling versus exhaling

Rate: resp rate in breaths per minute

Some of this was already covered by prior posts. Vent management is very complex and I suggest a critical care course. If you can spend some one on one time with a RT, you may find that to be very helpful.

Talk to your Resp Therapist that worls with your vents. I always ask them questions and usually they readily explain them. At my hosp we work as a team to take care of our pts. I depend on them to run the vent (to a certain degree...my fellow OCD friends) and they respect my knowledge of other nursing areas. Or ask your pulmonalogist. They will usually answer all of your questions. Good Luck.

I found icufaqs.org not long after I joined allnurses. I found it to be fantastic information. The Vent information was awesome. I had just moved from adults to NICU and even with some differences in how things are done the website had invaluable information that transcended the infant to adult worlds. I had worked with adults on vents before and even though I knew how to care for them I much more fully understood how things worked and rationales after reviewing all that great information. Check out his other topics, they are all great. I even read up on some that I will likely never see (like IABP) just to glean more great nuggets that are included.

Very complicated subject. Are you able to take a critical care course? Here are a few things to study that will help with vent understanding.

Mode: (SIMV vs PS vs CMV etc...)

Tpe of ventilation: essentially two types. 1) Pressure 2) Volume

FIO2: % of inspired oxygen

Vt: amound of air delivered in a normal breath

PEEP: pressure at the end of exhalation

Peak Pressure: pressure of air in the upper airways and vent tubing

Plateau Pressure: complicated to explain, but an indicator of alveolar pressure and type of air flow. Becoming very important with ARDS and lung injury patients.

Flow: amount of air flow in LPM

I:E time: amount of time spent inhaling versus exhaling

Rate: resp rate in breaths per minute

Some of this was already covered by prior posts. Vent management is very complex and I suggest a critical care course. If you can spend some one on one time with a RT, you may find that to be very helpful.

I think it is good for us to know that there IS a lot to think about in VENT management for a pulmonologist, but we do not have to manage all these vent settings you are speaking of. Like you say we always have RT to comanage the pt with us. But even they do not change vent settings without an MD order, except FIO2.

For someone in telemetry, (as the OP is) they have to know how to turn the patient, suction them and know the basic settings. I don't even know of any ICU nurses who do the complex vent management you are speaking of. My response to the OP was to allow her to see what the vent is doing at a basic level so that she can approach it with some confidence and not so much intimidation. If a vented pt is on tele, they are probably a stable long-term trached pt. They most likely don't even do ABG's on these pts if they have transferred off the ICU. They will need to learn to suction and do trach care.

So, again from my point of view, Vents are very simple. The basics can be mastered easily and safe pt care can be done by telemetry nurses. They do not need a critical care course.

In the case of a more stable or long term vented patient I agree; however, if you have a vented patient, you need to know about some of the dynamic processes at work. I agree, that in most cases we will not make or change settings on our own; however, we need to understand what is going on and how vent therapy will effect our patient. This is much like knowing in depth the pharmacology of the medications we administer to our patients. You could argue that we are simply following physicians orders when giving medications; however, we still need to know what these medications will do and how they act on a physiological level.

In addition, I still stand by my recommendation of taking a critial course. Sure, it may be over kill for a tele unit, but if you have the ability and time, additional knowledge will do nothing but help you in your career. I will agree, that perhaps a more basic level course or vent orientation will help with the fundamental aspects of understanding vent management.

In conclusion, I think we agree on many points; however, we may have to agree to disagree on the simplicity of vent management.

Hey, as a new grad I would also be super-scared workin' with vents my first job out of school. Granted, I don't feel completely retarded, but put in an autonomous position as a real nurse I probably would...Good luck, you'll learn a lot!!