Term
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Definition
- Explain procedure to pt
- Equipment - intubation kit & suction equipment
- Hyperoxygenate - prior to intubation
- Limit length of insertion attempt - stop and reoxygenate between attempts
- Verify ET tube placement
- Secure ET tube - to upper lip & nose to prevent mvmt; if taped to lip, remove daily and reposition
- Document - placement (confirmation of), how pt tolerated, resp status
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Term
| Complications of intubation |
|
Definition
- Tube displacement
- Obstruction - if unable to clear, replace tube
- Air leak - cuff not fully inflated
- Infection
- Tracheal necrosis
- Oral or nasal necrosis
- Sinusitis
- Aspiration
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Term
|
Definition
- Have oxygen device ready
- Suction pt immediately prior (mouth and ET tube)
- Remove tube at MAXIMAL INSPIRATION - deflate and pull out to prevent aspiration
- NPO except ice chips (in case of reintubation)
- Cough and deep breathe frequently
- Monitor resp status
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Term
| Types of Mechanical Ventilators |
|
Definition
Negative pressure - uncommon
Positive pressure - pressure limited (infants, children, adults with chronic illness, fragile lung tissue) & volume limited |
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Term
| Modes of positive pressure ventilation |
|
Definition
The way the pt receives the breath:
- CMV (controlled mandatory vol)
- AC (assist controlled)
- IMV/SIMV (intermittent vol)
- CPAP
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Term
|
Definition
Most controlled mode
Controls rate and vol pt gets per min |
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Term
|
Definition
| Will be set vol and rate but pt may breathe over that rate (but they always receive the same volume of air) |
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Term
|
Definition
- Ventilator gurantees min rate and volume
- ANY BREATHS TAKEN OVER WILL BE AT PATIENT'S OWN VOLUME (unlike AC)
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Term
|
Definition
- No set rate or vol
- Keeps alveoli inflated
- Helps determine pt ability to be extubated
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Term
|
Definition
- PEEP (positive end expiratory pressure)- prevents alveolar collapse so that it's easier to take the next breath)
- PS (pressure support) - used most commonly with CPAP
- FiO2 (fraction of inspired O2)
- TV - amt of each breath in mL
Rate |
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Term
|
Definition
Silence the alarm to prevent anxiety, give 100% O2 for 3 min (button, allows to hyperoxygenate b4 suctioning); If you can't figure it out, manually ventilate and call RT.
- High rate- pt breathing over
- High pressure- resistance; kink, pt biting, ET tube, secretions in a/w, pneumothorax
- Low pressure - if cuff deflated, d/c'ed tubing, pt pops off ventilator (same for low vol)
- Low vol
- Apnea
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Term
|
Definition
- Weaning parameters - awake, alert, cooperative
- Limit or withhold sedation
- LT ventilator facilities
- ET tube (7-10 days) vs. trach (pt comfort, hygiene, no sedation, restraints)
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