Control Comp #3 (Adult Mechanical Ventilation Initiation, Adult Mechanical Ventilation Rounds, Basic Waveform Graphic, Adult Mechanical Ventilation Change)

Question 1

Ventilatory Support - Ventilator Initiation - Adult (1)
Procedure Steps (14 Steps)

Answer 1

Procedure Steps
1. Verifies physician’s order or hospital protocols
2. Washes / gels hands and applies appropriate PPE*
3. Identifies patient, introduces self and department*
4. Assembles circuit, humidifier, and connects to the ventilator. 5. Attaches test lung to the circuit.
6. Plugs ventilator into correct electrical outlet and to 50 psi
7. Checks circuit for leaks and performs vent check
8. Programs correct or appropriate ventilator settings and correctly sets alarms
9. Attaches patient to ventilator and assures patient tolerates ventilator settings
10. Readjust ventilator alarms
11. Confirms that patient is being appropriately ventilated, and airway secured
12. Draws ABG according to hospital policy
13. Performs ventilator rounds
14. Thanks patient, assures patient’s safety, cleans up area and disposes of PPE*
15. Washes / gels hands and documents appropriately*

Question 2

Ventilatory Support - Ventilator Initiation - Adult
Procedure Steps (Steps 1-3)

Answer 2

Procedure Steps
1. Verifies physician’s order or hospital protocols
2. Washes / gels hands and applies appropriate PPE*
3. Identifies patient, introduces self and department*

Question 3

Ventilatory Support - Ventilator Initiation - Adult
Procedure Steps (Steps 4-13)

Answer 3

4. Assembles circuit, humidifier, and connects to the ventilator. 5. Attaches test lung to the circuit.
5. Plugs ventilator into correct electrical outlet and to 50 psi
6. Checks circuit for leaks and performs vent check
7. Programs correct or appropriate ventilator settings and correctly sets alarms
8. Attaches patient to ventilator and assures patient tolerates ventilator settings
9. Readjust ventilator alarms
10. Confirms that patient is being appropriately ventilated, and airway secured
11. Draws ABG according to hospital policy
12. Performs ventilator rounds

Question 4

Ventilatory Support - Ventilator Initiation - Adult
Procedure Steps (Steps 14-15)

Answer 4

14. Thanks patient, assures patient’s safety, cleans up area and disposes of PPE*
15. Washes / gels hands and documents appropriately*

Question 5

Ventilatory Support - Ventilator Rounds - Adult (2)
Procedure Steps (13 Steps)

Answer 5

Procedure Steps
1. Verifies physician’s order and scans chart for any other pertinent data*
2. Washes / gels hands and applies appropriate PPE*
3. Identifies patient, introduces self and department*
4. Explains purpose of the procedure and assesses patient
5. Assesses ventilator settings / alarms, makes changes if needed
6. Assesses waveform graphics and suctions if necessary
7. Empties condensation from circuit if necessary and changes any filters or HMEs that need to be changed
8. Assures BVM, syringe, and PEEP valve (if applicable) are at bedside
9. Reviews and IV drips patient may be on
10. Documents ventilator round
11. Thanks patient, assures patient’s safety, cleans up area
12. Disposes of PPE, washes / gels hand
13. Please list the name of ventilator

Question 6

Ventilatory Support - Ventilator Rounds - Adult
Procedure Steps (Steps 1-4)

Answer 6

Procedure Steps
1. Verifies physician’s order and scans chart for any other pertinent data*
2. Washes / gels hands and applies appropriate PPE*
3. Identifies patient, introduces self and department*
4. Explains purpose of the procedure and assesses patient

Question 7

Ventilatory Support - Ventilator Rounds - Adult
Procedure Steps (Steps 5-10)

Answer 7

6. Assesses waveform graphics and suctions if necessary
7. Empties condensation from circuit if necessary and changes any filters or HMEs that need to be changed
8. Assures BVM, syringe, and PEEP valve (if applicable) are at bedside
9. Reviews and IV drips patient may be on
10. Documents ventilator round

Question 8

Ventilatory Support - Ventilator Rounds - Adult
Procedure Steps (Steps 11-13)

Answer 8

11. Thanks patient, assures patient’s safety, cleans up area
12. Disposes of PPE, washes / gels hand
13. Please list the name of ventilator

Question 9

Ventilatory Support - Waveform Graphic Analysis (3)
Procedure Steps (6 Steps) (Steps 1-6)

Answer 9

Procedure Steps
1. Recognizes scalar graphic pressure vs. time
2. Recognizes scalar graphic flow vs. time
3. Recognizes the pressure-volume loop
4. Recognizes the flow-volume loop
5. Trouble shoots graphics such as: birds beak, overdistension, circuit leak, lack of ventilator response (ventilatory asynchrony), inadequate flow, increased airway resistance, and air trapping or autopeep
6. States how to correct abnormal graphics as listed in #5

Question 10

Ventilatory Support - Ventilator Circuit Change - Adult (4)
Procedure Steps (16 Steps)

Answer 10

Procedure Steps
1. Verifies physician’s order and scans chart for any other pertinent *
2. Gathers equipment, washes / gels hands and applies appropriate PPE*
3. Identifies patient, introduces self and department*
4. Explains purpose of the procedure and assesses patient before changing circuit*
5. Places patient in proper position and suctions if necessary
6. Assembles as much equipment as possible before removing patient from ventilator
7. Has helper manually ventilate patient during circuit change
8. Removes all dirty equipment before placing on clean equipment
9. Places new circuit on ventilator; assuring patient safety and comfort throughout procedure
10. Performs any tests required by hospital after the circuit is in place
11. Assures that ventilator passes tests and is ventilating
12. Places patient back on ventilator and monitors VT and VS
13. Performs ventilator round if appropriate
14. Correctly cares for the equipment following the circuit change and cleans up area
15. Thanks patient, assures patient’s safety and disposes of PPE*
16. Washes / gels hands and documents appropriately*

Question 11

Ventilatory Support - Ventilator Circuit Change - Adult
Procedure Steps (Steps 1-5)

Answer 11

Procedure Steps
1. Verifies physician’s order and scans chart for any other pertinent *
2. Gathers equipment, washes / gels hands and applies appropriate PPE*
3. Identifies patient, introduces self and department*
4. Explains purpose of the procedure and assesses patient before changing circuit*
5. Places patient in proper position and suctions if necessary

Question 12

Ventilatory Support - Ventilator Circuit Change - Adult
Procedure Steps (Steps 6-13)

Answer 12

6. Assembles as much equipment as possible before removing patient from ventilator
7. Has helper manually ventilate patient during circuit change
8. Removes all dirty equipment before placing on clean equipment
9. Places new circuit on ventilator; assuring patient safety and comfort throughout procedure
10. Performs any tests required by hospital after the circuit is in place
11. Assures that ventilator passes tests and is ventilating
12. Places patient back on ventilator and monitors VT and VS
13. Performs ventilator round if appropriate

Question 13

Ventilatory Support - Ventilator Circuit Change - Adult
Procedure Steps (Steps 14-16)

Answer 13

14. Correctly cares for the equipment following the circuit change and cleans up area
15. Thanks patient, assures patient’s safety and disposes of PPE*
16. Washes / gels hands and documents appropriately*