| Preparation |
| Clinical Standards for Procedures and Interventions. |
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| Performs calibration and system checks according to manufacturer guidelines prior to patient connection. |
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| Verifies provider order or protocol; reviews the chart for current and previous ventilator settings. |
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| Acknowledges the indications and goals of mechanical ventilation and evaluates for resolution of the underlying condition requiring ventilatory support. |
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| Implementation |
| Verifies ventilator is set to the correct prescribed settings. Confirms that the Bag Valve Mask (BVM) is present at the bedside with a spare airway and obturator for tracheostomy patients or an intubation box for endotracheal tube replacement if needed. |
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| Verifies alarm limits are appropriately set for high and low pressure, tidal volume, and minute ventilation according to patient condition. |
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| Ensures all gas connections are secure. Confirms that the ventilator and any compressor systems are plugged into a red emergency power outlet. |
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| Assesses the ventilator circuit for secretions or condensate and ensures that filters are clear and free of obstruction. |
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| If an active humidifier is present, ensures that the water bag is full, the heater is functioning properly, and the temperature is set to the appropriate level. |
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| If an HME is used, ensures that no condensate is present on the distal side and that the HME is functioning correctly. |
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| Assessment |
| Assesses Vital Signs. |
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| Verifies patient position is greater than 35 degrees in a semi-Fowler position to optimize ventilation and reduce aspiration risk. |
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| Performs oral care according to institutional policy to maintain airway hygiene and reduce the risk of ventilator-associated pneumonia. |
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| Evaluates airway size, depth, and placement as applicable to verify proper positioning and airway patency. |
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| Assesses skin integrity around the tracheostomy or endotracheal tube site and verifies that securement devices are correctly positioned and free from pressure injury. |
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| Evaluates ventilator waveforms and flow-volume loops to recommend adjustments to ventilator settings that optimize synchrony, compliance, and gas exchange. |
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| Assesses plateau pressure and driving pressure to ensure lung-protective ventilation within safe limits. |
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| Assesses tidal volume in milliliters per kilogram predicted body weight and evaluates PEEP and auto-PEEP to support effective ventilation. |
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| Monitors FiO2 and oxygenation to confirm appropriate gas exchange targets and prevent hypoxemia or hyperoxemia. |
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| Assesses humidification level and device performance to ensure adequate airway conditioning. |
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| Verifies cuff pressure and performs Airway Cuff Pressure Analysis to ensure an adequate seal and prevent tracheal injury. |
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| Assesses for Airway Suctioning (Inline Closed System) as indicated to maintain airway patency and minimize infection risk. |
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| Monitoring and Modifications |
| Observes patient-ventilator synchrony and modifies trigger sensitivity, inspiratory flow, or rise time as needed to improve comfort and performance. |
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| Assesses readiness for weaning by evaluating ventilator parameters, spontaneous breathing trials, and patient tolerance in collaboration with the care team. |
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| Post-Intervention |
| Documents all ventilator settings, assessments, changes, and patient responses in the medical record. |
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| Ensures ventilator wheels are locked and the display screen lock is engaged before leaving the bedside. |
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| Post-Intervention Management Steps. |
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