Lung Protective Ventilation

Another important intervention was to maintain the head of the bed at 30-45 degrees and position L.M.’s left lung into a dependent position to improve ventilation and perfusion. L.M.’s O2 was decreased to 63 and her CO2 was increased to 50. According to the IHI, it is recommended to elevate the bed to 30- 45 degrees to improve ventilation. Patients that lay in the supine position have lower spontaneous tidal volumes on pressure support ventilation compared to those laying at more of an angle (Institute for Healthcare Improvement, 2012). In regards to positioning, when the least damaged portion of the lung is placed in a dependent position it receives preferential blood flow. This redistribution of blood flow helps match ventilation and perfusion, therefore, improving gas exchange (Lough, Stacy & Urden, 2010). Implementing these interventions combined with respiratory therapy, significantly improved the blood gas values for oxygen and carbon dioxide levels.

In recent years respiratory therapy has gained a vast amount of recognition. According to "The Bureau of Labor Statistics", the employment of respiratory therapists is projected to grow nineteen percent over the next seven years. Along with increasing advancements in technology and medical research, there is also an ever increasing demand for respiratory therapists worldwide. Breathing is something that every individual must do, however, there are sometimes altercations in doing so, and this is where respiratory therapy comes into effect. In order to learn more about this topic, I enrolled into a Writing and Research course at my college. Upon taking this course, I had the pleasure of shadowing a couple of respiratory therapists at

Forty-nine states require licensing.In order to take the entry-level examination for certification, which is required by the National Board for Respiratory Care, respiratory students must get at least an associate's degree and a certificate of completion. Respiratory therapists are licensed in all states except Alaska; requirements vary in different states. Many colleges and universities, vocational–technical institutes, and the Armed Forces offer education and training programs. Most programs will award RT’s with an associate’s or bachelor’s degree.All programs have clinical classes that allow therapists to earn credit and gain supervised experience treating patients. According to the American Association for Respiratory Care, there are 381 associate programs throughout the country, 57 bachelor’s degree programs and three master’s programs(home) (business) (explore).

Stretch-induced lung injury may not occur if lung compliance is not greatly reduced. However, the benefit of ventilation with a lower tidal volume was independent of the static compliance of the respiratory system at base line, suggesting that the lower tidal volume was advantageous regardless of lung compliance. Variations in chest-wall compliance, which contributes to compliance of the respiratory system and is reduced in many patients with acute lung injury and the acute respiratory distress syndrome,39 may have obscured a true interaction between tidal volume and base-line lung compliance.

Hypoxemia is defined as low levels of oxygen in the body. Based on the Rush university medical center respiratory protocol, Refractory hypoxemia is defined as Sp02 < 300 mm Hg; ARDS = PaO 2 /FIO 2 ratio <200 mm Hg”2. According to Chest article, patients with ARDS who are placed on mechanical ventilation showed an improvement in oxygen and disease severity with 24 hours, plus their mortality was increased from 13% to 28% . So lung protective maneuvers should be continued. The literature review showed that the use of high levels of positive end expiratory pressure (PEEP), recruitment maneuvers,

It is a useful way to identify those patients who are at high risk for pressure injuries.23Based on the risk assessment score, a plan is then established to suit the patients’ individual care needs. For example, patients who score a mild risk, may require frequent turning schedules, maximal remobilization, a pressure reduction support surface, management of moisture, nutrition, and friction/shear, etc. For those at very high risk, a static air overlay or a low air loss bed may be needed.24 These recommendations as identified by Braden and Bergstrom24 allows for clinicians to limit interventions to those patients who are at risk, to reserve intensive and costly interventions to those who are in most need, as well as address specific problems that contribute to that level of risk. Following the admission assessment, reassessments should be done 48 hours later and at periodic intervals thereafter depending on the rapidity of changes in the patient’s health condition and depending on the health care setting. 23 In a long term care facility for example, 80% of residence who develop pressure injuries do so within 2 weeks of admission, and 96% do so within 3 weeks of admission. Therefore, in this type of setting, an appropriate schedule for a reassessment may be different, i.e every 4 weeks followed by quarterly assessments. 23 In an intensive care unit, reassessments may be

Also providing moisturizing measures, keep the patient’s head of bed elevated thirty to forty-five degrees to prevent the risk of aspiration unless the patient has another condition where this would be contraindicated. Finally, it is very important to wash hands thoroughly before and after touching ventilator tubing. It is also important to assess your patient’s breathing on a regular basis, if your patient is able to breath on their own, then they may be able to be taken off of mechanical ventilation. All of these are very simple nursing interventions that should be implemented consistently in order to provide the best possible care for these

Many patients with obstructive lung diseases such as Chronic Obstructive Pulmonary Disease (COPD), asthma, pneumonia, and Acute Respiratory Distress Syndrome (ARDS) need mechanical ventilation in order to support their breathing and restore respiratory function. However, mechanical ventilation can cause further lung injury. The mortality rate for patients requiring mechanical ventilation is about 35% and this rate increases to about 53% for the elderly [1]. Also, with increasing age, the severity of ventilator-induced lung injury (VILI) increases [2]. In general, with increasing age, the dynamic lung function and respiratory mechanics are compromised. In this study, several simulations are carried out to estimate these changes and understand

There has been a public health emergency! The air has been contaminaited by a chemical toxin and in order to survive, all citizens must wear a ventilator. At this time we have no further leads onto what cuased this outbreak to happen but first responders are trying to figure the problem as we speak. All we know is that this toxin is contagious and some of these affects can make you turn against people. Docters and scientists are saying that this outbreak must’ve came from out of the country we don’t know who had it first but we know that the ventilators are helping out with this toxin. Kids 10 and under will receive a ventilator first in order for your kid to get one you must bring birth certificate or SSN after that if your family needs more

Humidified oxygen may help facilitate easier expectoration versus standard oxygen. Chest physiotherapy should be taught and is often beneficial in helping patients breathe properly, control their breathing and optimize their posture to promote suitable lung expansion and expectoration. Nurses should assist patients cough and deep breathe at least every 2 hours. Alert patients can also use an incentive spirometer to assist with deep breathing and stimulate coughing. Encouraging patients to drink at least 2 liters of fluid daily to prevent dehydration unless contraindicated is important in helping thin secretions move from the airway. Intake and output, oral mucous membranes, and skin turgor should be monitored for adequate hydration, especially when fever and tachypnea are

Acute respiratory distress syndrome (ARDS) is a life-threatening condition which can be triggered by aspiration pneumonia. It is when the lungs become severely inflamed that causes increased permeability in the pulmonary vasculature and hypoxemia. The oedema and fibrin can cause stiffening of the lungs which decreases the lung compliance and also reduces the vital capacity of lungs. The inflammation of alveoli causes collapse which further reduces the concentration of the oxygen in the blood. Acute lung injury (ALI), on the other hand, is a subset of ARDS with less severe impairment in oxygenation (Ranieri, 2012). Protective ventilation strategy aims to prevent the aforementioned conditions by lowering the airway pressure and tidal volumes

The first ventilator the patient was placed on was the volume control and the second ventilator is the pressure control. Volume control ventilator is set up so the end of the inspiration meets the set tidal volume; this mode gurantees a specific amount of volume in the lungs. Some advantages are offering safety of having pre-set tidal volume. However, some disadvantages include causing the patient to have rapid breathing thus leading to hyperinflation and respiratory alkalosis eventually increasing the risk of barotrauma.

spontaneous patient who required maintain tidal volume, ready for wean, and patient who have asynchrony with ventilator. Every mode have advantages and disadvantages. Volume support guaranteed tidal volume with the less required pressure,

To prevent air leak syndrome, gentle ventilation with low pressure, low tidal volume, low inspiratory time, high rate, and

Millions of Americans work in buildings with mechanical heating, ventilation, and air-conditioning (HVAC) systems which have been designed to provide air at comfortable levels of temperature and humidity. Most never worry about harmful concentrations of air pollutants that may exist in the air they breathe. While heating and cooling are basic operations, the more complex processes involved in ventilation are paramount in ensuring high quality indoor air.