Terms
Positive pressure at the end of every breath to improve oxygenation and keep the alveoli open
PEEP
This can cause high pressure alarms
Secretions, coughing, bronchospam, asynchrony with ventilator
What is the safe suction pressure to use when suctioning a patient?
80 - 120 mmhg
Who can reinsert a tracheostomy?
trained inserters. CCHS RNs are NOT trained inserters
Degree of Head of bed
30-45
Volume delivered to patient with each breath
Tidal volume
This can cause low pressure alarms
Disconnection, self decannulation, cuff leak
Prior to suctioning a patient, what should one do with the Fi02?
Hyper oxygenate patient at 100%
When a patient self decannulates, what are the next steps?
Call respiratory; cover stoma with sterile gauze, apply oxygen and/or bag via mouth as necessary
Frequency of mouth care
every 2 hours
Fraction of inspired oxygen
Fi02
If vent failure occurs, what should one do next?
disconnect from ventilator and provide oxygen via Ambu bag
When withdrawing the suction catheter, what type of of suction should be used?
intermittent
If total laryngectomy and patient has a decannulation, how does one ventilate the patient?
All ventilation must occur at the stoma site as their upper and lower airways do NOT communicate
12 hours
Assist Control
Ventilator alarms for apnea, what could be a cause?
over sedation
Select what button the ventilator to move oxygen to 100%?
"O2 suction" - ensure you select the confirmation button and see the "O2 button" turn green. This will silence audible alarms for 2 minutes
What is the frequency of trach care?
Every 24 hours and/or as needed due to secretions and drainage
What reduced ventilator days, decreased length of stay and supports return to independent fuctionins?
Early mobilization ... AMP!
Has the following settings: PEEP, Fi02; Does not have a set respiratory rate
Pressure support
What could cause high respiratory alarms?
pain; change in patient condition
How long will oxygen be increased to 100% when using the "O2 suction" button
3 minutes
What is the frequency of skin and stoma assessment?
What is included in the assessment?
Every 8 hours; redness/swelling/skin integrity/drainage/pain at site/secretions
What is paired together to reassess the need for ventilation to reduce ventilator days?
SAT / SBT