CARE OF PATIENT ON

VENTILATOR
Ventilator-
 Ventilator is known as vent or breathing
machine.

 A ventilator is a device that supports or

recreates the process of breathing by
pumping air into the lungs.

 Mainly provided to the ICU patient.

Types of ventilator -
1. Face mask ventilator
2. Mechanical ventilator
3.Manual resuscitator bag
4.Tracheostomy ventilator
1.Face mask ventilator
 Isnon-invasive

method of
supporting a
person’s breathing
and oxygen levels.
To use one, a person
wears a mask that
fits over the nose
and mouth while air
blows into their
airways and lungs.
2.Manual Resuscitator bag-
 are pieces of
equipment that allow
people to control the
airflow of their
ventilator with their
hands. These devices
consist of an empty
bag, or “bladder,” that
a person squeezes to
pump air into the
lungs.
3. Tracheostomy ventilator-
 is a procedure
where a doctor
creates an opening
in the windpipe
and inserts a tube,
which allows air to
flow in and out.
This enables a
person to breathe
without using their
nose or mouth
4. Mechanical ventilation-
 machines that take over the breathing process
entirely. Doctors use these when a person
cannot breathe on their own.
 work via a tube in a person’s throat, pumping

air into the lungs and transporting carbon

dioxide away
 People with COVID-19 may need a mechanical

ventilator if they are critically ill.

PURPOSES-

 To maintain gas exchange in case of acute

and chronic respiratory failure.
 To maintain ventilatory support after CPR.
 To reduce pulmonary vascular resistance.
 To excrete increased CO2 production.
 To give general anaesthesia with muscle

relaxant.
Indication-
 head injury
 stroke
 lung disease
 spinal cord injury
 polio
 sudden cardiac arrest
 neonatal respiratory distress syndrome
 acute respiratory distress syndrome (ARDS)
 pneumonia
 sepsis
CARE OF PATIENT ON VENTILATOR-
1. Check ventilator setting and mode- Read
the patient’s order and obtain information the
ventilator.
Compare current ventilator setting with

setting prescribed by doctor.

Familiarize yourself with ventilato settings ,

alarm and action to it.

 Mechanically ventilated pt
require constant monitoring.
 The most important parameter

to track are-
a. PIP , exhaled tidal volume ,
minute ventilation(alarm
should be set on ventilator
for these parameters and
later it should be
investigated)
 Check vital sign per policy

specially blood pressure after

setting of ventilator changed.
2. suction appropriately-
 Suction only as needed (not

according to schedule).
 Hyperoxygenate patient before

and after suction to prevent

oxygen desaturation.
 Dont instill NS solution into ETT

in an attempt to promote
secretions removal.
 Limit suctioning to lowest level

needed to remove secretions.

 Suction for shortest duration as

possible,
3. assess pain and sedation needs-
 Pain should be addressed to ensure

patient comfort and potentially reduce

adverse events.
 Several tools like the numerical rating

scale has been validated in critically ill

patient .
 This scale uses a 0 to 10 scale .
4.Promote respiratory function-
• Auscultate lung frequently to
assess for abnormal sound.
• Suction as needed.
• Changes posture every 2 hourly.
• Secure ETT properly and change
lip site every 12 hourly.
• Monitor ABG value and pulse
oximetry.
5. Prevent from infection-
 Ventilator associated pneumonia is a complication.
• Strict hand washing.
• Aseptic technique with suctioning.
• Elevate head of bed 30-45 degree.
• Providing sedation vacation and assess patient
readiness to extubate.
• Providing peptic ulcer disease prophylaxis.
• Providing deep vein thrombosis prophylaxsis.
• Perform oral care with chlohexidine 2-4hr.
• Change circuit or humidifier when visibly soil.
6. prevent hemodynamic instability-
 To maintain-
1. Maintain or increase I.V
fluid as per order.

or
2. Administer dopamine or
nor-epinephrine if
ordered.
7. Manage airway / et tube or tracheotomy care-

 Proper cuff inflation ensures that

patient recieves the proper
ventilator parameters.
 Monitor cuff pressure is important.
 A patient with an oral ET tube

have an oral airway or bite block

in place that should be changed at
least 24hr.
 8. Physiological needs-
• Comfort
• Activity
• Nutrition and elimination of waste,

Patient are often not able to fulfill these needs by

themselves , nurse role is here is to
a) Seeing to comfort.
b) Determining input and output.
c) Blood chemistry to asses adequacy of IV nutrition
and so , on.
 9. Provide adequate nutrition-
 Should have feeding tubes.

• To fuel the immune system.

• Promotes wound healing.
• Prevent excess breakdown of lean body mass.
• Monitor input and output

10. Need to belong- (COMMUNICATION)

• Staff must communicate with the patient and patient must
be allowed to respond. Patient need constant reassurance.
• Provide writing tools or ask simple yes / no
question to which patient can express their
needs.
11.Need to know and understand-
• An explanation of diagnosis and treatment on the patient’s
level.

12. Need for recognition-

• Esteem ,dignity and respect.
• Patient must be treated with respect and addressed correctly.

13. Educate patient and family-

 Seeing a loved one in ventilator is frightening.
 Teach them why mechancl vntaltion is needed and
emphasize positive outcome.
 14. Self actualization-
• truth , privacy.
• Patient should have as much privacy as possible –
pull screens or close doors.
• The patient has the right to be told the truth.

15. Safety needs-

• prevent trauma and look for ventilator alarm.
• Maintain warm and adequate body temperature.
• Always keep side rails up.
• Visiting hour should be limited
16. weanthe patient from the ventilator
appropriately-
 thisweaning protocol promotes a
standarized assessment of each
patient readiness to wean from the
ventilator.
 Sedation vacation and sponatneous

breath trial should be given for

early extubation.
Complication-
 Delirium
 Muscle weakness
 Blood clot or sore
 Long-term vocal damage.
 Airway obstruction.
 Pneumonia
 Lung damage
 Aspiration
 Atelectasis
Reduce complication-
 closely monitoring people on ventilators for
signs of complications
 adjusting the air pressure and oxygen levels

to match a patient’s normal levels

 wearing personal protective equipment to

protect against viruses and prevent their

spread to others
 treating bacterial infections with antibiotics
 ensuring patients receive physical and

pulmonary rehabilitation after they leave ICU.