Long term ventilation Flashcards
How long does a patient have to be on mechanical ventilation to be considered a long term ventilator assisted individual?
Require mechanical ventilation for at least 6 hours a day for more than 21 days
Which patient populations are likely to require long term mechanical ventilation
Those recovering from an acute illness and unable to maintain adequate ventilation for prolonged periods
Those with chronic progressive cardiopulmonary disorders
What are the goals of long term mechanical ventilation?
Enhance individuals living potential
Improve physical and physiologic levels of function
Reduce morbidity
Reduce hospitalization
Extend life
Provide cost effective care
What characteristics are shared by ventilator assisted individuals in specialized units of the hospital
Longer hospital stays
Lower mortality rates
Higher weaning rates
Higher likelihood of discharge to home
Longer life expectancy after discharge
Great independence in daily activities
Describe intermediate care sites for patients who are ventilator dependent
Designed to provide care for long term VAIs whose length of stat usually exceeds 25 days
Patients generally require high peep or FiO2
What is true regarding long term care sites for VAI?
They are not ideal for weaning
They do not have resources to treat acutely ill patients
Least expensive
What is required in order to discharge a VAI?
Geographic and home assessment
Family education
What considerations should be take into account regarding ventilator selection for VAIs?
Reliability
Safety
Versatility
User friendly
Easy patient cycling
What equipment is required for VAIs to be discharged to home?
Mechanical ventilator and related equipment
Airway management equipment
Oxygen administration equipment
Disinfectant stuff
Describe home care and transport ventilators
Microprocessor controlled
Piston driven
Patient or time triggered
Pressure or volume targeted
Pressure, volume, flow or time cycled
What are complications to the airway that can arise in long term ventilation?
Nasopharyngeal injury
Laryngeal injury
Tracheal injury
GI disorders
Psychological disorders
What are the advantages of tracheostomy tubes?
Increased potential to speak
Reduction of VAP
Improved weaning times
Improved patient comfort
Potential to eat
Effective airway suctioning
Decreased airway resistance
What are speaking device options with a trach tube?
Electrically activated speaking devices
Speaking trach tubes
Speaking valves
What is normal speaking pressure?
5-10 cm H2O
What is the minimum tracheal pressure required to vibrate the vocal cords?
2 cm H2O
