Ventilator

A ventilator is a machine that provides mechanical ventilation by moving breathable air into and out of the lungs, to deliver breaths to a patient who is physically unable to breathe, or breathing insufficiently. 

1. RASTOGI COLLEGE OF NURSING BHILAI MEDICAL SURGICAL NURSING SEMINOR ON VENTILATOR SUBMITTED TO- Mr. SUDHEER CHAUHAN ASST. PROFESSOR OF MEDICAL SUGICAL NURSING RASTOGI COLLEGE OF NURSING BHILAI SUBMITTED BY- Mr . DHANESHWAR BSC. NURSING 3 rd YEAR RASTOGI COLLEGE OF NURSING BHILAI

2. INTRODUCTION :- A mechanical ventilator is a positive or negative pressure breathing device that can maintain ventilator & oxygen delivery for a prolonged period. Caring for a patient for mechanical ventilation has become an integral part of nursing care in critical care or general medical surgical units extended care facility and the home. Nurse physicians, & respiratory therapists must understand each patient specific pulmonary needs and work together to set realistic goals.

3. DEFINITION:- A ventilator is a medical device or machine that help to mechanically assist or replace spontaneous breathing use of posiive pressure:- To physically transport gases into and out of lungs( Earlier ventilators used negative pressure). Usually performed via ETT but not always.(Noninvasive ventilation).

4. PRINCIPLES OF MECHANICAL VENTILATOR A mechanical ventilator is an automatic machine designed to provide all of part of the work the body must do to move gas into and out of the lungs. The act of moving air into and out of the lungs is called breathing or, more formally ventilation.

5. CLASSIFICATION OF VENTILATORS:- Mechanical ventilators are classified acc. To method by which they support ventilation. The two general categories are negative- pressure ventilators. Negative pressure ventilators - Exert a negative pressure on the external chest. - Decreasing the intrathoracic pressure during inspiration allows air to flow into the lung, filling its volume. Physiologically this type of assisted ventilation is similar to spontaneous ventilation.

6. CONT. - It is used mainly in chronic respiratory failure associated with neuromuscular condition such as poliomyelitis muscular dystrophy. 2. Positive pressure ventilator Today the most common ventilators use positive pressure. Positive pressure ventilators inflate the lungs by exerting positive pressure on the airway, pushing air in similar to a bellows mechanism forcing the alveoli to expand during inspiration. These ventilators are widely used in the hospital setting for primary lung disease.

7. MODES OF VENTILATORS:- Ventilator mode refers to how breaths are delivered to the patient. The most commonly used modes are:- Assist-control (A/C) ventilation- provides full ventilator support by delivering a preset tidal volume and respiratory rate Intermittent mandatory ventilation (IMV):- provides acombination of mechanically assisted breaths and spontaneous breaths mechanical breaths are delivered at present intervals and a preselected tidal volume, regardless of the patient’s efforts.

8. 3. Synchronized intermittent mandatory ventilation(SIMV):- also deliver a preset tidal volume and number of breaths per minute between the patient cab be breath spontaneously with no assistance from the ventilator on those extra breaths. 4. Pressure support ventilation(PSV):- applies pressure plateau to the airway throughout the patient triggered inspiration to decrease. Resistance within the tracheal tube and ventilator tubing. Pressure support is reduced gradually as the patient strength increase. Cont.

9. INDICATION Decrease oxygen(PaO2) in patient blood. Increase arterial (PaCO2) level’s. A persistent acidosis ( decrease PH). Thoracic or abdominal surgery. Drug overdose. Neuromuscular disorder. Inhalation injury. COPD. Multiple trauma. Shock. Multisystem failure and coma. All lead to respiratory failure.

10. PROBLEM WITH MECHENICAL VENTILATOR:- Increase in peak airway pressure due to cause:- Coughing or plugged airway tube. Patient bucking ventilator decreasing lung compliance. Tubing kinged. Pneumothorax. Bronchospasm. Decrease in pressure or loss of volume:- Leak in ventilator or tubing cuff on tube/humidifier not tight. Increase in compliance.

11. COMPLICATION OF VENTILATOR PATIENT:- Pulmonary infection due to impaired cough reflex. Barotrauma/pneumothorax. Cardiovascular compromise. COPD.

12. NURSING CARE OF VENTILATOR PATIENT:- Suction airway for secretions empty condensation fluid from circuit. Assess for hypoxia or bronchospasm. Check arterial blood gas values. Check tubing position , insert oral airway. Check ventilator circuit for correct leak. Check and monitor vital sign. Central venous pressure measure. Provide frequent mouth care. Optimize nutritional status. Use aseptic techniques. Alternate change patient position or use mattress.

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