vent not working

[G'smommy]

Today a collegue of mine had a patient on the vent who started biting the tube and being restless in general. So the nurse gave him dilaudid. Well, the patient's mv started going down and he was not moving any air. They had just given blood so they gave him lasix iv and bagged him for a bit. He got better and the put him back on the vent. He quit moving air again so the bagged him. At this point he is tachy and bp is dropping. So we took a look at the vent and it wasn't blowing any air. It wasn't alarming either. The HME was clogged up somehow and the vent wasn't letting anyone know about it. We changed the HME and it started working fine. The patient may or may not be okay I am not sure. Have you ever seen anything like this?

[dfk, RN, CRNA]

dear 'take my breath away',

who's routinely checking THOSE vents? i would check with biomed, engineering, and especially those in charge of sending and receiving the vents to and from pts.. in my experience, check with the RT department head.. good luck!!!

[JiffyGriff]

I didn't read all of the responses so forgive me if I missed this, but what setting was the vent on? If it was CMV or SIMV then it shouldn't matter how much pain medication, sedative, whatever I gave the patient the ventilator will still control the breathing.....if it was just on CPAP, PSV, etc.... then the patient would be controlling their own breathing all the time, but it should still alarm low rate or something.... Sounds to me like the vent wasn't working at all... With that said I have experienced vent's that werent ventilating but didn't alarm, just the other night when we were hooking up a pt. that had just been intubated the vent wasn't ventilating and wasn't alarming, turned out to be a huge mucus plug in the patient.....but who know's the RT that was hooking it up could have had the alarms silenced, I didn't pay real close attn.

[sailornurse]

So we took a look at the vent and it wasn't blowing any air. It wasn't alarming either. The HME was clogged up somehow and the vent wasn't letting anyone know about it. We changed the HME and it started working fine. The patient may or may not be okay I am not sure. Have you ever seen anything like this?

This is one of those ?sentinel? events that are suppposed to be reported to: Risk management & or the manufacturer.

Equipment malfunctions might also be a JCAHO reporting issue.

[JiffyGriff]

It should most likely be filed as an incident report......something malfunctioned and it put a patient at risk....bottom line. However, where blame is filed could be various places.....it depends on whether or not the vent's inspection period had expired, and possibly whether or not the respiratory therapist that set up the vent did a vent check before they decided to use it.