Doctor insights on:
Patient Mechanical Ventilation
Indefinitely: Until a ventilator is available or the person is breathing on their own. ...Read more
Indefinitely: If you are able to continue bagging with reasonable volumes you could continue for an indefinite amount of time. ...Read more
Bagging: If performed properly, there is no time limit. ...Read more
What are the benefits of a sigh breath during mechanical ventilation(v-simv). What is the normal calculated sight breath for a vented patient?
Sigh breath: The purpose of the sigh breath is to increase gas gas exchange and improve lung compliance. There are several studies looking at the addition of a sigh breath. One sigh breath every 60 to 90 seconds is what i customarily order. ...Read more
When is it required to switch from endotrach tube to tracheostomy for an IPF patient who is on long term mechanical ventilation?
Trach and Vent mgt: It depends on the ICU and medical history and settings of the ventilator. One to two weeks on the ventilator is the usual time period before discussing tracheostomy. The tracheostomy has its own benefits and complications. Optimally, trying to wean off the vent and using BiPAP or CPAP may be considered. ...Read moreSee 1 more doctor answer
Check: http://www.rncentral.com/nursing-library/careplans/100_really_useful_web_sites_for_nursesGet a more detailed answer ›
Many possible: Not just peep-peak and mean pressures also must be considered. High pressure can indicate inappropriately high volumes, leading to volutrauma/ventilator associated lung injury. Increased intrathoracic pressures can impair heart function (decrease preload), impair kidney function (decrease renal blood flow), and contribute to higher intracranial & intra-abdominal pressures. ...Read more
Simply : Intubation is placement of a tube in the trachea (wind pipe), mechanical ventilation is the process by which a patient receives oxygen using artificial means (a ventilator). Almost always, intubation is followed by mechanical ventilation and mechanical ventilation is performed most times after intubation. ...Read more
Why consider a tracheostomy if anticipated prolonged ventilatory support >2 wks? Why not continue mechanical ventilation? how is nutrition addressed?
Comfort: Tracheostomy is more comfortable for patient and may allow better pulmonary clearing, and should be considered if prolonged vent necessary . Feeding may be via IV of via soft tube through nasal passage down into stomach or small bowel or can also place feeding tube percutaneously into stomach or small bowel through abdominal wall. Nutrition key to weaning off vent. ...Read more
Artificial respiratn: Simply put 'ventilating' or breathing for the patient 'mechanically' . These machines are getting more and more sophisticated and have a lot of settable and measurable data points. ...Read more
It happens: Pneumonia, heart failure, stroke, & serious injury are some of the more common reasons; it's important to consider the goals of care & realistic expectations. Patients/family/power of attorney should make it clear what level of support they feel is acceptable. It's ok to make comfort a priority & say "no" to the ventilator. It's also ok to say "yes". Best to discuss this before the crisis. ...Read more
Baclofen overdose: Although 80 mg per day is a commonly accepted maximum, dosing up to 200 mg per day has been used safely and effectively. Baclofen is a great drug, but is also extremely deadly. The highest dose of baclofen ever recorded, 2 grams in a suicide attempt, btw patient has recovered. For Baclofen intoxication supportive care including mechanical ventilation is required. See your PCP ASAP. ...Read more
Mechanical ventilation - if you're old and don't want to be on a machine, what papers do carry on you?
Advance Directive: Advance directives & living wills are legal documents for you to instruct healthcare providers about what life-support measures you do or don't want. Your regular doctor can help you fill one out, or you can also get the forms from any hospital admitting office (you don't have to be a patient at the hospital, just ask for the form). Also talk with friends/family so they know what you want. ...Read more
Do pts on long term mechanical ventilation (at a vent home) have to be sedated during ventilation hrs? If not, why sedated in hospital setting?
Depends on Pt., etc.: Sedation for the ventilated patient is dependent upon the patient (level of cognitive/ physical function and level of anxiety), the pt's comorbidities/active medical problems, and vent mode regardless of the setting. No two patients and their hospital courses are alike. Therefore, sedation and comfort plans should be pt.-specific with frequent assessment for appropriate modification if needed. ...Read more
Yes: Mechanical ventilation is dangerous for a large variety of reasons, but the alternative is not pretty. Long term mechanical ventilation is associated with a well defined risk for ventilator associated pneumonia and close adherence to established protocols has been shown to dramatically lower that risk. ...Read more
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