In: Nursing
Determine initial ventilator settings for the following patient. Describe not only what settings you will put her on but also the indication for ventilation and how the intubation and mechanical ventilation will be carried out.
Determine initial ventilator settings for the following patient. Describe not only what settings you will put her on but also the indication for ventilation and how the intubation and mechanical ventilation will be carried out.
Ans- First she is a 67 year old female .
Her weight is 288 pound means 120 kg aprroxmately
Her hight is 62 inch means 5 feet 2 inch.
So IBW for this patient is = 45.5+2.5×2=50.5kg
Patient having pulmonary edema with respiratory rate 36 and spo2 level 74.so due to pulmonary edema their lungs can not exchange gas properly due to fluid filled in alvolies.so their oxygen level in body is very low and respiratory destress and tachypneic.in that case plan for remove fluid from their lungs and ventilate to the lungs in high pressure than normal breath . In that case we can put non invasive ventilation or can put invasive ventilation .if patient manage by non invasive ventilation then no need for intubation .if patient can't manage then ready for ventilation.
First we counseling to patient and patient party regarding this condition the take a consent for invasive procedure.then inform to duty doctor and ready to the patient side for intubation.
For this patient 7 to 7.5mm tube required.
Arrange everything what ever required for this procedure and proper positioning given the proper ventilation given through ambu bag and mask .then proper sedate to the patient as per instructions of physician .then keep ready suction and tube and laryngoscope then doctor will put the tube and checked it is in place or not.then immidiately connect ventilator .for that case initial setting is tidal volume 300ml , respiratory rate 16,peep 6, fio2 100, then gradually we can modify after patient stabilize and followed by their abg value .if physician not present in emergency case we can do same procedure .