Ch. 21 Pilbeams Flashcards
Most patients receiving mechanical ventilation require ventilatory support for less than ______ days.
7
Approximately ____ % of those patients requiring more than ____ days cannot be successfully weaned from ventilatory support and require ______.
5, 7, LTMV
Patients receiving LTMV are divided into 2 groups:
- Those recovering from an acute illness and unable to maintain adequate ventilation for prolonged periods.
- Chronic progressive cardiopulmonary disorders.
Key point 21.1
Long term ventilator-assisted patients are defined by the American College of Chest Physicians (ACCP) as individuals requiring mechanical ventilation for at least 6 hours per day for 21 days or more.
What are the goals of LTMV?
- Enhancing an individual’s living potential
- Improving physical and psychological level of function
- Reducing morbidity
- Lessening hospitalizations
- Extending life
- Providing cost effective care
What are some sites for ventilator dependent patients?
• Acute care sites
• Intermediate care sites
• Long term care sites
Acute care sites include:
- ICU
- Specialize respiratory care units.
- Long-term acute care hospitals
Intermediate care sites include:
• subacute care units
• long-term care hospitals
• rehabilitation hospitals
These patients may still require high levels of PEEP or FIO2
Patient selection (3 groups):
- Disease process and clinical stability
- Psychological evaluation of patient and family
- Financial considerations
Long term care sites include:
SNF
Long term care sites are not the ideal site for weaning a patient from ventilation
Least expensive and provide a better quality of life and more independence for the patient
Preparation for discharge to home:
Respiratory therapists who are assigned to prepare a ventilator-assisted patient for transfer to another facility or home must ensure that the receiving site can accommodate the patient’s and family’s.
What are some questions to ask the patient?
• are you feeling anxious?
• are you getting a deep enough breath?
• does the breath last long enough?
• is it too long?
• do you have enough time to get all your air out?
• do you need more breaths? Do you need fewer breaths?
What is a piece of equipment that can be used for home care ventilation?
Tracheostomy tube
What are some important factors in choosing a ventilator?
• Reliability
• Safety
• Versatility
• User friendly
• Easy pt cycling
What is the most common complication with long term ventilation?
Vocal cord injury or paralysis
