logging in or signing up Mechanical ventilation.ppt monikajoseph Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 728 Category: Education License: All Rights Reserved Like it (1) Dislike it (1) Added: April 29, 2011 This Presentation is Public Favorites: 2 Presentation Description No description available. Comments Posting comment... By: tockzkcot (8 month(s) ago) can you give me a copy of this ppt? thank you. Saving..... Post Reply Close Saving..... Edit Comment Close By: ANCYJOSEPH (9 month(s) ago) haiii .. can u plzzz reply me ? Saving..... Post Reply Close Saving..... 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Traditionally divided into negative-pressure. ventilation, where air is essentially sucked into the lungs, or positive pressure ventilation, where air is pushed into the trachea When a ventilator is used ,positive pressure forces air into the lungs. The +ve pressure is necessary for gas exchange & keep the alveoli open. The goals of continues mechanical ventilation (CMV): : The goals of continues mechanical ventilation (CMV): Maintain adequate ventilation. Deliver precise concentration of FIO2 Deliver adequate Tidal Volume to obtain an adequate minutes ventilation and oxygenation. Lessen the work of breathing in those patients who can not sustain adequate ventilation on their own. Cont…….d : Cont…….d Bradypnea or apnea with respiratory arrest Acute lung injury and the acute respiratory distress syndrome Tachypnea (respiratory rate >30 breaths per minute) Vital capacity less than 15 mL/kg Arterial partial pressure of oxygen (PaO2) with a supplemental fraction of inspired oxygen (FIO2) of less than 55 mm Hg Respiratory muscle fatigue Obtundation or coma Hypotension Acute partial pressure of carbon dioxide (PaCO2) greater than 50 mm Hg with an arterial pH less than 7.25 Neuromuscular disease Types of Ventilators : Types of Ventilators several types of mechanical ventilation: Pressure –cycled ventilation: deliver a volume of gas to the airway using position pressure during inspiration. The benefit of this type is a decreased risk of lung damage from high inspiratory pressures, which is particularly beneficial for neonates who have a small lung capacity. This type of ventilation is usually used for short-term therapy (less than 24 hours). pressure controlled ventilation 2)Volume – cycled ventilation : 2)Volume – cycled ventilation Volume – cycled ventilation (volume-controlled or volume –limited): Volume-cycled ventilation, the most common form of ventilation cycling used for adult patients, A pressure limit can be set to prevent the occurrence of dangerously high airway pressure This type delivers a preset tidal volume then allows passive expiration. This is ideal for patients with acute respiratory distress syndrome (ARDS) or bronchospasm This type of ventilator is the most commonly used in critical care environments. 3) Time- cycled ventilation : 3) Time- cycled ventilation Time- cycled ventilation: Time-cycled ventilators deliver oxygenation over a preset time period. These types of ventilators are not used as frequently as the volume-cycled and pressure-cycled ventilators Time-cycled ventilation occurs as the inspiratory phase begins and gas flows through the ventilator circuit into the patient's lungs the inspiratory phase ends and the patient passively exhales Mode of ventilation : Mode of ventilation The modes of ventilation can be thought of as classifications based on how to control the ventilator breath . Control (volume or pressure) ventilation (CV). Assist control or continuous mandatory ventilation (CMV) Synchronous intermittent mandatory ventilation (SIMV). Positive end expiratory pressure (PEEP) Constant positive airway pressure (CPAP) Cont………..d : Cont………..d Pressure support ventilation (PSV) Volume assured pressure support ventilation (VAPSV) Independent lung ventilation (ILV) High frequency ventilation (HFV) Inverse ratio ventilation (IRV) 1) Control (volume or pressure) ventilation (CV). : 1) Control (volume or pressure) ventilation (CV). 2) Assist control or continuousmandatory ventilation (CMV) or (AC) : 2) Assist control or continuousmandatory ventilation (CMV) or (AC) 3)Synchronous intermittent mandatory ventilation (SIMV). : 3)Synchronous intermittent mandatory ventilation (SIMV). 4) Positive end expiratory pressure (PEEP) : 4) Positive end expiratory pressure (PEEP) 5) Constant positive airway pressure (CPAP) : 5) Constant positive airway pressure (CPAP) 6) Pressure support ventilation (PSV) : 6) Pressure support ventilation (PSV) 7) Volume assured pressure support ventilation (VAPSV) : 7) Volume assured pressure support ventilation (VAPSV) 8) Independent lung ventilation (ILV) : 8) Independent lung ventilation (ILV) 9) High frequency ventilation (HFV) : 9) High frequency ventilation (HFV) Weaning from ventilator : Weaning from ventilator The physician decides when to begin gradually removing or weaning the patient from the CMV. The modes of the ventilator that depend on the client’s initiating a breath can be used as modes for weaning. The decision is usually based on assessment s made by nurses and respiratory therapist. The length of time required for successful weaning generally relates to the underlying disease process and to the patient’s state of health before the ventilator was used. Extubation Criteria : Extubation Criteria Are weaning parameters in an acceptable range? 1 Respiratory Rate 2. blood pressure. 3 Pulse Are secretions controlled? it should be less and controlled . Can the patient protect their airway? they can cough normally to any reflex especially during suction. Is cough reflex adequate? Is the patient alert? the patient should be responsive and alert to the call b) Extubation Technique : b) Extubation Technique a) Patient is placed in reverse trandelenberg Head up Legs up b) Monitoring prior to extubation Vital Signs c) Arterial blood Gases : should be measured occasionally every half to one hour and the normal range: pH: 7.35-7.45 PCo2: 35-45 Po2:80-100 Hco3-:22-24 3) Post extubation support : 3) Post extubation support 1) Pressure support: 2) Weaning parameters Respiratory Rate <30 tidal volume of the alveoli > 250 cc Patient comfortable Arterial Blood gases should be measured post extubation till the patient recover You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
Mechanical ventilation.ppt monikajoseph Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 728 Category: Education License: All Rights Reserved Like it (1) Dislike it (1) Added: April 29, 2011 This Presentation is Public Favorites: 2 Presentation Description No description available. Comments Posting comment... By: tockzkcot (8 month(s) ago) can you give me a copy of this ppt? thank you. Saving..... Post Reply Close Saving..... Edit Comment Close By: ANCYJOSEPH (9 month(s) ago) haiii .. can u plzzz reply me ? Saving..... Post Reply Close Saving..... Edit Comment Close By: nada112 (10 month(s) ago) thanx but i want to download this ppt Saving..... Post Reply Close Saving..... Edit Comment Close By: monikajoseph (11 month(s) ago) thnx Saving..... Post Reply Close Saving..... Edit Comment Close By: sunsosun (12 month(s) ago) thank you for your effort Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript Mechanical ventilation and its mode : Mechanical ventilation and its mode Conducted by: Ms.Monika (clinical instructor) Army college of nursing ,jalandahar cantt Definition : Definition The use of a machine to take over active breathing for a patient. It is used when a patient can no longer breath on his own due to injury, illness, or general anesthesia during surgery. Cont…………d : Cont…………d normal respiration begins with the contraction of the diaphragm and respiratory muscles to create –ve pressure. A vacuum is created & air flow in. Traditionally divided into negative-pressure. ventilation, where air is essentially sucked into the lungs, or positive pressure ventilation, where air is pushed into the trachea When a ventilator is used ,positive pressure forces air into the lungs. The +ve pressure is necessary for gas exchange & keep the alveoli open. The goals of continues mechanical ventilation (CMV): : The goals of continues mechanical ventilation (CMV): Maintain adequate ventilation. Deliver precise concentration of FIO2 Deliver adequate Tidal Volume to obtain an adequate minutes ventilation and oxygenation. Lessen the work of breathing in those patients who can not sustain adequate ventilation on their own. Cont…….d : Cont…….d Bradypnea or apnea with respiratory arrest Acute lung injury and the acute respiratory distress syndrome Tachypnea (respiratory rate >30 breaths per minute) Vital capacity less than 15 mL/kg Arterial partial pressure of oxygen (PaO2) with a supplemental fraction of inspired oxygen (FIO2) of less than 55 mm Hg Respiratory muscle fatigue Obtundation or coma Hypotension Acute partial pressure of carbon dioxide (PaCO2) greater than 50 mm Hg with an arterial pH less than 7.25 Neuromuscular disease Types of Ventilators : Types of Ventilators several types of mechanical ventilation: Pressure –cycled ventilation: deliver a volume of gas to the airway using position pressure during inspiration. The benefit of this type is a decreased risk of lung damage from high inspiratory pressures, which is particularly beneficial for neonates who have a small lung capacity. This type of ventilation is usually used for short-term therapy (less than 24 hours). pressure controlled ventilation 2)Volume – cycled ventilation : 2)Volume – cycled ventilation Volume – cycled ventilation (volume-controlled or volume –limited): Volume-cycled ventilation, the most common form of ventilation cycling used for adult patients, A pressure limit can be set to prevent the occurrence of dangerously high airway pressure This type delivers a preset tidal volume then allows passive expiration. This is ideal for patients with acute respiratory distress syndrome (ARDS) or bronchospasm This type of ventilator is the most commonly used in critical care environments. 3) Time- cycled ventilation : 3) Time- cycled ventilation Time- cycled ventilation: Time-cycled ventilators deliver oxygenation over a preset time period. These types of ventilators are not used as frequently as the volume-cycled and pressure-cycled ventilators Time-cycled ventilation occurs as the inspiratory phase begins and gas flows through the ventilator circuit into the patient's lungs the inspiratory phase ends and the patient passively exhales Mode of ventilation : Mode of ventilation The modes of ventilation can be thought of as classifications based on how to control the ventilator breath . Control (volume or pressure) ventilation (CV). Assist control or continuous mandatory ventilation (CMV) Synchronous intermittent mandatory ventilation (SIMV). Positive end expiratory pressure (PEEP) Constant positive airway pressure (CPAP) Cont………..d : Cont………..d Pressure support ventilation (PSV) Volume assured pressure support ventilation (VAPSV) Independent lung ventilation (ILV) High frequency ventilation (HFV) Inverse ratio ventilation (IRV) 1) Control (volume or pressure) ventilation (CV). : 1) Control (volume or pressure) ventilation (CV). 2) Assist control or continuousmandatory ventilation (CMV) or (AC) : 2) Assist control or continuousmandatory ventilation (CMV) or (AC) 3)Synchronous intermittent mandatory ventilation (SIMV). : 3)Synchronous intermittent mandatory ventilation (SIMV). 4) Positive end expiratory pressure (PEEP) : 4) Positive end expiratory pressure (PEEP) 5) Constant positive airway pressure (CPAP) : 5) Constant positive airway pressure (CPAP) 6) Pressure support ventilation (PSV) : 6) Pressure support ventilation (PSV) 7) Volume assured pressure support ventilation (VAPSV) : 7) Volume assured pressure support ventilation (VAPSV) 8) Independent lung ventilation (ILV) : 8) Independent lung ventilation (ILV) 9) High frequency ventilation (HFV) : 9) High frequency ventilation (HFV) Weaning from ventilator : Weaning from ventilator The physician decides when to begin gradually removing or weaning the patient from the CMV. The modes of the ventilator that depend on the client’s initiating a breath can be used as modes for weaning. The decision is usually based on assessment s made by nurses and respiratory therapist. The length of time required for successful weaning generally relates to the underlying disease process and to the patient’s state of health before the ventilator was used. Extubation Criteria : Extubation Criteria Are weaning parameters in an acceptable range? 1 Respiratory Rate 2. blood pressure. 3 Pulse Are secretions controlled? it should be less and controlled . Can the patient protect their airway? they can cough normally to any reflex especially during suction. Is cough reflex adequate? Is the patient alert? the patient should be responsive and alert to the call b) Extubation Technique : b) Extubation Technique a) Patient is placed in reverse trandelenberg Head up Legs up b) Monitoring prior to extubation Vital Signs c) Arterial blood Gases : should be measured occasionally every half to one hour and the normal range: pH: 7.35-7.45 PCo2: 35-45 Po2:80-100 Hco3-:22-24 3) Post extubation support : 3) Post extubation support 1) Pressure support: 2) Weaning parameters Respiratory Rate <30 tidal volume of the alveoli > 250 cc Patient comfortable Arterial Blood gases should be measured post extubation till the patient recover