Endotracheal Intubation and Mechanical Ventilation by yXimv2On

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									Endotracheal Intubation and
  Mechanical Ventilation
        Endotracheal Intubation
•   Components of the endotracheal tube
•   Preparation for intubation
•   Verifying tube placement
•   Stabilizing the tube
•   Nursing care
          Mechanical Ventilation
• Types of ventilators:
  – Negative-pressure ventilators
  – Positive-pressure ventilators
     •   Pressure-cycled ventilators
     •   Time-cycled ventilators
     •   Volume cycled
     •   Microprocessor ventilators
         Modes of Ventilation
• The ways in which the client receives breath
  from the ventilator include:
  – Assist-control ventilation (AC)
  – Synchronized intermittent mandatory ventilation
    (SIMV)
  – Bi-level positive airway pressure (BiPAP) and
    others
    Ventilator Controls and Settings
•   Tidal volume
•   Rate: breaths per minute
•   Fraction of inspired oxygen
•   Sighs
•   Peak airway (inspiratory) pressure
•   Continuous positive airway pressure
•   Positive end-expiratory pressure
    Mechanical Ventilation with PEEP
•   Sedation
•   Neuromuscular blocking agents
•   Reassure patient that paralysis is temporary
•   Closely monitor
         Nursing Management
• First concern is for the client; second for the
  ventilator.
• Monitor and evaluate response to the
  ventilator.
• Manage the ventilator system safely.
• Prevent complications.
               Complications
• Complications can include:
  – Lung
  – Cardiac
  – Gastrointestinal and nutritional
• Infection
• Muscular complications
• Ventilator dependence
                   Weaning
• Methods:
  – Conventional
  – Intermittent Mandatory Ventilation (IMV)


  How will you know that weaning is successful
   and the ETT can be removed?

								
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