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A Mechanical Ventilator is a machine that generates a controlled flow of gas into a patient's airways. Oxygen and air are received from cylinders or wall outlets, the gas is pressure reduced and blended according to the prescribed inspired oxygen tension. The gas is accumulated in a receptacle within the machine, and delivered to the patient using one of many available modes of ventilation.
A Mechanical Ventilator is a machine that generates a controlled flow of gas into a patient's airways. Oxygen and air are received from cylinders or wall outlets, the gas is pressure reduced and blended according to the prescribed inspired oxygen tension. The gas is accumulated in a receptacle within the machine, and delivered to the patient using one of many available modes of ventilation.
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A Mechanical Ventilator is a machine that generates a controlled flow of gas into a patient's airways. Oxygen and air are received from cylinders or wall outlets, the gas is pressure reduced and blended according to the prescribed inspired oxygen tension. The gas is accumulated in a receptacle within the machine, and delivered to the patient using one of many available modes of ventilation.
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Attribution Non-Commercial (BY-NC)
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Скачайте в формате DOC, PDF, TXT или читайте онлайн в Scribd
Mechanical Ventilator soon as the client initiates a breath, the ventilator is
triggered to produce inhalation. The sensitivity of
the system is set to reduce the workload of breathing. Pressure fluctuations (e.g. hiccoughs, A mechanical ventilator is a machine that generates leaks) can cause premature triggering. a controlled flow of gas into a patient’s airways. Oxygen and air are received from cylinders or wall Flow-triggered inhalation occurs when the client outlets, the gas is pressure reduced and blended can initiate a breath. The ventilator completed the according to the prescribed inspired oxygen tension breath by sensing the flow of air into the chest. This (FiO2), accumulated in a receptacle within the system works well in combination with positive end- machine, and delivered to the patient using one of pressure (PEEP). many available modes of ventilation. Volume-triggered ventilation occurs when the Indications : ventilator completes the breath to maximize inhaled gas volumes. Maintain oxygenation e.g patients with respiratory arrest, CVA patients
Contraindications: Alarms Ventilators have several alarms to assist
with their safe use. DNR request
Nursing Management: Types of Ventilators:
Neuromuscular Blocking agents
o Pressure-cycled Ventilators - delivers a volume of gas to the airways using positive sedation is often necessary to maintain ventilation pressure during inspiration. The positive by creating a synchronus respiratory pattern and pressure is delivered until the preselected reduce O2 demand. pressure has been reached. When the preset pressure has been reached, the machine Most common agents: Vecuronium (Norcuron) and cycles into exhalation. pancuronium (pavulon). Do not inhibit pain or awareness o Volume-Cycled Ventilators – delivers a present tidal volume or inspired gas. The tidal volume that has been preselected is Suctioning delivered to the client regardless of the pressure required to deliver this volume. A because the client loses ability to cough while on pressure limit can be set to prevent the mechanical ventilation and secretions tend to pool occurrence of dangerously high airway and obstruct the airways, suctioning is often pressures. required. o Time-cycled Ventilators – terminate when a preset inspiratory time has elapsed. In most of these devices, a pressure limit is Weaning also incorporated gradual removal of te mechanical ventilator; the o Flow-cycled Ventilators – are triggered to physician decides when to wean the patient from the stop when a preset flow rate has been ventilator. It is usually based on ABG readings and achieved assessment made by nurses and respiratory therapists. The length of time required for successful weaning generally relates to the underlying disease process and to the client’s state of health before the Triggering Mechanisms ventilator was used.
Time-triggered inhlation is used to manage 2 Types of weaning:
clients who cannot breathe on their own. The ventilator will trigger a breath after a preset time, serving as a back-up in case a client’s own breathing rate falls below a preset value. Rapid weaning – The rapid (t-piece) weaning techniques is used when mechanical ventilation has Negative pressure inhalation is triggered by the been instituted briefly. Place the client in a semi- initial negative pressure that begins inspiration. As high fowlers position. Reduce the ventilator’s respiratory rate to no more thatn half the original rate. Obtain ABG values in 30 minutes. If these values are at or near beaseline level, place the client on a T piece at the same FiO2. Obtain ABG value in 30 minutes. If the ABGs are again at or near the baseline level and the respiratory rate is below 25- 30 bpm, the client may be extubated. Apply a face tent to deliver oxygen and humidity
Gradual weaning – this technique is used after
prolonged mechanical ventilation or if a neuromuscular disorder is present. The first step is to ascertain whether spontaneous breathing is present. Once spontaneous breathing has been established, slowly reduce the amount of ventilator support. Continue to reduce ventilator support until the client can accept full responsibility for his or her own ventilator requirements. Thei process may ba accomplished through increasingly longer periods on a T piece (followed by periods of CMV support) or by decreasing the rate of intermittent mandatory ventilations (IMV) or synchronized IMV (SIMV) breaths. This technique may tke weeks or even months. Patience is crucial