Mechanical Ventilation - Medical-Surgical - Respiratory System | @LevelUpRN

Summary

In this Level Up RN video, Cathy discusses mechanical ventilation, covering alarms, settings, and nursing care. She explains low and high pressure alarms, using the mnemonic 'Two PB sandwiches can make you sick' to remember causes. Key ventilator settings like respiratory rate, tidal volume, FiO2, I:E ratio, and PEEP are outlined. Nursing care best practices include having resuscitation bags, monitoring vitals, and preventing complications post-extubation. A quiz tests knowledge on alarms and bedside essentials.

Takeaways

• 🌟 Mechanical ventilation enhances gas exchange and reduces the work of breathing until the cause of respiratory failure is addressed.
• 🚨 Low pressure alarms are triggered by leaks, such as disconnection, cuff leaks, or tube displacement.
• 🚨 High pressure alarms are due to increased pressure and can be remembered using the phrase 'Two PB sandwiches can make you sick', which stands for Pulmonary edema, Pneumothorax, Bronchospasm, Biting, Secretions, Cough, and Kink.
• 🛠 Settings on a mechanical ventilator include respiratory rate, tidal volume (VT), FiO2 (oxygen concentration), I:E ratio (inspiration to expiration), and PEEP (positive end-expiratory pressure).
• 🏥 ICU nurses should be trained and comfortable with operating ventilators and understand the importance of having a manual resuscitation bag and reintubation equipment readily available.
• 👁 Regular assessments for patients on mechanical ventilation should include level of consciousness, vital signs, breath sounds, pulse oximetry, and ABGs (arterial blood gases).
• 🌀 Suctioning of oral and tracheal secretions is necessary for patients on mechanical ventilation.
• 🛌 Repositioning the ET tube every 24 hours or more frequently is crucial to prevent skin breakdown and hospital-acquired pressure injuries.
• 🦷 Providing frequent oral care is an essential part of nursing care for mechanically ventilated patients.
• 💊 Monitoring for complications such as ventilator-associated pneumonia is a key aspect of care for patients on mechanical ventilation.
• 🌈 After extubation, patients should be encouraged to take deep breaths, cough, and use an incentive spirometer to aid recovery.

Q & A

What is the primary purpose of mechanical ventilation?

Mechanical ventilation improves gas exchange and decreases the work of breathing until the cause of respiratory failure can be identified and corrected.

What are the two types of alarms mentioned in the video?

The two types of alarms mentioned are low pressure alarms and high pressure alarms.

What causes a low pressure alarm in a mechanical ventilator?

Low pressure alarms are due to leaks, which can be caused by disconnection, cuff leak, or tube displacement.

How can the phrase 'Two PB sandwiches can make you sick' help remember the causes of high pressure alarms?

The phrase helps remember the causes of high pressure alarms by associating them with the first letters: 'Two PB' stands for pulmonary edema and pneumothorax, 'B' for bronchospasm and biting, and 'Sick' for secretions, cough, and kink.

What is respiratory rate in the context of mechanical ventilation?

Respiratory rate is the number of breaths per minute that are delivered to the patient.

What does the abbreviation 'VT' stand for and what does it represent?

VT stands for tidal volume, which is the volume of gas that is delivered with each breath.

What is the FiO2 setting in mechanical ventilation and what range does it cover?

FiO2 is the fraction of inspired oxygen, which is the O2 concentration of the air being delivered to the patient and it can vary between 21% and 100%.

What is the I:E ratio in mechanical ventilation and what are typical values?

The I:E ratio is the duration of inspiration to expiration, and that ratio is typically 1:2 or 1:1.5.

What does PEEP stand for and what is its function?

PEEP stands for positive end-expiratory pressure, which is the pressure applied at the end of expiration to distend the alveoli and prevent collapse.

What equipment should be readily available at the bedside for a patient on mechanical ventilation?

A manual resuscitation bag and reintubation equipment, including two different tube sizes, should be readily available.

What are some nursing care best practices for a patient on mechanical ventilation?

Best practices include regularly assessing the patient's level of consciousness, vital signs, breath sounds, pulse oximetry, and ABGs, suctioning oral and tracheal secretions as needed, repositioning the ET tube every 24 hours or more frequently, providing frequent oral care, and monitoring for complications such as ventilator-associated pneumonia.

What should patients do after extubation to aid in their recovery?

After extubation, patients should take deep breaths, cough, and use their incentive spirometer.