Equipment used in the reception and emergency department

Policy:

Mechanical Ventilation: It is a method of breathing or assisting the breathing process using a mechanical device. It is used when a patient is unable to breathe sufficiently for adequate gas exchange to meet the body's and tissues' needs, or when the patient is completely unable to breathe. This can occur due to several reasons, such as respiratory failure or other conditions that require respiratory support to maintain oxygen levels in the blood and remove carbon dioxide.

Indications for placing a patient on a mechanical ventilator:

With the presence of some indicators (cyanosis, excessive sweating, confusion, shallow and rapid breathing), it should be evaluated by a doctor.

Different methods of using a ventilator:

1- Continuous Mandatory Ventilation (CMV):

Through this method, the ventilator delivers a set number of breaths and a specific volume of air as determined by the doctor. In this case, the patient does not take any breaths on their own and relies entirely on the ventilator.

Uses of this method:

➡️ It is used for patients with head injuries, as involuntary breathing may lead to increased intracranial pressure.

➡️ During surgical procedures, to administer anesthetic drugs that relax the muscles.

➡️ In cases where anesthetic drugs or muscle relaxants are used, especially when the patient is placed on a ventilator.

2- Synchronized Intermittent Mandatory Ventilation (SIMV):

This method provides the patient with a set number of breaths and a specified volume of air, but the ventilator also allows the patient the opportunity to take breaths on their own.

Uses of this method:

• It is used as a method to begin weaning the patient off the ventilator.
• It is used in cases where the patient is able to start breathing on their own.

3- Continuous Positive Airway Pressure (CPAP):

This method involves supplying the patient with air at a specific pressure during the breathing process, allowing some air to remain in the alveoli of the lungs. This helps with gas exchange and improves lung efficiency.

Uses of this method:

• It is used as a method to wean the patient off the ventilator.
• It is used for patients who are able to breathe voluntarily but need assistance by being supplied with compressed air.

steps:

The nursing team must observe the following:

• Monitor the patient's vital signs and observe the monitor for any changes in heart rate.
• Observe the patient's color for any cyanosis or color changes, and check the amount of air entering the patient's chest using a stethoscope.
• The respiratory rate should be 10–12 breaths per minute.
• Any increase in airway pressure indicates a problem, such as the accumulation of secretions in the patient's chest.
• The patient's alertness on the ventilator or the presence of ventilator tube pressure.
• Ensure that the movement of the patient's chest is even on both sides to guarantee fair distribution of air in both lungs, as the endotracheal tube might enter one lung more than the other.
• The patient should be at a temperature of 34°C.
• Suctioning the endotracheal tube.
• Care for the tracheostomy tube.
• Regular exercises and maintaining the patient's cleanliness.
• Ongoing care and maintaining the patient's hygiene.

In the case of weaning the patient off the ventilator:

• Explain the steps to the patient to reduce fear and anxiety.
• Wear latex gloves.
• Position the patient in a sitting position (according to their health condition).
• Suction the endotracheal tube.
• Deflate the tracheostomy balloon.
• Encourage the patient to take some breaths.
• Remove the tube.
• Place the patient on an oxygen mask (O2) or according to the doctor's instructions using a T-Tube or Ventorey mask depending on the required concentration.
• Monitor changes in the patient's breathing.
• Encourage the patient to cough and clear phlegm.
• Perform a blood gas analysis for monitoring.
• Prepare a ventilator near the patient, ready for use, along with an endotracheal tube in case the patient needs to be reconnected to the ventilator.