ventilators

Hi janleb,

PEEP stands for positive end expiratory pressure. Does help to keep alveoli open. The amount is patient dependant and is increased to improve oxygenation and ventilation. Complications of peep are: barotrauma (leading to pneumothorax), increased intrathoracic presuure can lead to dramatic falls in BP due to less blood returning to the heart (preload). Contraindications to peep are PFO or septal defects. Often they will try a peep study with serial abgs to dtermine the most effective level of PEEP for the patient. Go to the critical care websites (ACCN or CACCN) there are likely to be some good journal articles for you to have a look at. But don't spend your whole summer studying

I checked out the web site. They are great, thank you. Right now I am going back over normal respiratory physiology. And slowly but surely putting it all together. Again thanks

janleb,

If you have access and know anyone, I would recommend trying to follow an RT around for a couple of days over the summer. My start in pulmonary was transfer to a new unit pulmonary only, everyone was learning. I had gotten out of nursing school 4 months earlier. Where did I learn the most? From the RTs. They taught me most of what I know and understand about ventilators, ABGs, and treating pulmonary patients. A good RT can be your best friend if they are willing to teach. I worked with a great bunch that found a lot of joy in teaching "us nurses" about their area of specialty. After a couple of years, they were helping pull patients up in bed, give baths when they weren't busy, and we helped with the vents, O2 checks, etc when we weren't busy :). Nothing like true teamwork.

janleb, most institutions rely on the respiratory therapists to handle the ventilators. You need to rely on them also. They have had a 16 week session on ventilator therapy alone. As a nurse, we don't come near to that level of education. In their department they have excellant reference books. I'm sure they will let you borrow them.

What is PEEP : normal physiological PEEP created by the anatomy of the airway is about 3-5 cm. Consider the fact that an artificial airway/endotube creates a direct unobstructed (think: comparatively low turbulence) air flow. A normal un-intubated resistance to exhalation (think of all those twist/turns in the airway/nasal turbinates, etc) creates "normal PEEP". You can feel PEEP yourself by exhaling through a straw into a liquid beverage. That resistance to exhalation is PEEP. You (could) put a pressure manometer inline to the straw and measure the pressure. Applying a 5 cm of PEEP is just replacing what was bypassed by the endotube being in there. Its just a bit of positive airway pressure, without volume.

Hi, I have scoured the internet for info on vents. I am a first yr student nurse(end of my first yr :). My last clinical I was in ICU. They went over things briefly, but I don't like being near equipment if I don't have a good knowledge of at least what is normal, and what could go wrong. PEEP... is the pressure that is put in the alveoli after expiration....right? The RT said they set it at 5 usually 10-15 sometimes. At that time I didn't have time to question. What determines what it is set at. Possible complications? pros cons ect...and any good resources I could go over during the summer. Thank you I really appreciate any help given. Janice

Hi, I have scoured the internet for info on vents. I am a first yr student nurse(end of my first yr :). My last clinical I was in ICU. They went over things briefly, but I don't like being near equipment if I don't have a good knowledge of at least what is normal, and what could go wrong. PEEP... is the pressure that is put in the alveoli after expiration....right? The RT said they set it at 5 usually 10-15 sometimes. At that time I didn't have time to question. What determines what it is set at. Possible complications? pros cons ect...and any good resources I could go over during the summer. Thank you I really appreciate any help given. Janice

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Yes P.E.E.P @ 5 to 15 cm.H2O pressure.Now I don't know about books as mine are outdated BUT I have a lot of experience.One way of finding out what

settings are appropriate for a patient,look at the DRs orders frequently and you will see a pattern arise.There a 3 main elements to know 1)V.T=tidal volume, or how deep a breath,usually 500-600 cc 2)V=flow usually 15-20 L P M

3) R R=Respiratory Rate anywhere from 12to 20 Breaths P. M just as in doing Vitals. {This for Adults,much different for infants} I hope I havent confused you,if I have ask an R.T or DR. if I am correct O.K.? Nurse/R.T NRSDUG :)