ventilator, child on ventilator, newborn

child on ventilator

1. CARING NEWBORN ON
VENTILATOR

2. Mechanical ventilation
Mechanicalventilationorassisted
ventilationisthemedicaltermforusinga
machinecalledaventilatortofullyor
partiallyprovideartificialventilation.
Mechanicalventilationhelpsmoveairinto
andoutofthelungs,withthemaingoalof
helpingthedeliveryofoxygenandremoval
ofcarbondioxide.

3. GOALS OF MECHANICAL VENTILATION
1.Minimizetheriskoflunginjury.
2.Reducepatientworkofbreathing.
3.Provideadequateoxygenationand
ventilationwiththemostminimal
interventionpossible.

4. Indications
1.Respiratory distress syndrome(RDS)
2.Persistent bradycardia.
3.Failure to establish spontaneous
respiration in spite of mask.
4.Extremely premature baby

5. GENERAL PRINCIPLES
1.Achieveandmaintainadequate
pulmonarygasexchange.
2.Reducenewbornworkofbreathing.
3.Minimizetheriskoflunginjury.
4.Optimizenewborncomfort.
5.Appropriateoxygenation

6. Positioning
Changeposition:Supine,rightorleft
lateralevery2–4hourly
Encouragesposturaldrainagewhen
indicated
Passivephysiotherapy.
Augmentwithnebulization

7. Promote Respiratory
Function
Auscultatelungsfrequentlytoassess
forabnormalsounds.
Suctionasneeded.
SecureETTproperly.
MonitorABGvalueandpulse
oximetry.

8. Prevention of Nosocomial
Infection
Surveillance of flora
Routine:Weeklyswabsfromvarioussitesof
NICU
Endotrachealtubetips
Strictasepticprocedures
Carbolysation/disinfectionofallequipments
/itemsenteringNICU

9. Provision of in-uterolike
environment
Gentlehandling
Reduceambientnoiselevels
ControlNICUenvironment-Optimum
Lighting
ThermalComfort:Thermoneutral
environment(22-26degreecelcius)

10. Minimizing Oxygen demand
Treatfeverandpainastheyincreaseoxygen
consumption
Preventinghypothermia
Excessivecryingandexcessivemovementsof
limbsincreaseBMRandhenceoxygen
demand.
Schedulecareactivitiesatonetime
Approachsoftlyandgently

11. Humidification
Inadequatehumidificationofthe
inspiredairmayresultinincreased
volumeandviscosityofsecretions
andthisincreasesriskofairway
obstruction.

12. Skin care
Skinhygieneshouldbemaintained
properly.
Spongebathwithtepidwater.
Mildmoisturizerscanbeused.

13. Eye Care
Ventilatedbabyisoftensedatedand
increasetheriskofcornealulceration
orinfection.
Eyesshouldbecleanedwithsterile
wetswabsfrominnercanthusto
outercanthus.

14. Biochemical Monitoring
Bloodinvestigations:LFT,RFT,
electrolytes.
ABGanalysis
Bloodculture:indicatedbefore
changingantibiotics.

15. Suctioning
Strictlyasterileprocedure
Suctioncathetersize6,8and10fr
Durationisshort–entireprocedurenot
morethan10–20sec
Suctionpressure-60-80mmhgfor
neonatesandinfants

16. SUCTIONING

21. Articles Required
A big tray containing:
Sterile suction catheter (6-8 fr)
Normal saline / sterile water
Sterile gloves
Face mask
Stethoscope
A sterile tray containing:
Sterile bowl
Gauze pieces