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Source:

Nursing2015

July 2003, Volume 33 Number 7 , p 32hn1 - 32hn4

Author

  • DAVID W. WOODRUFF RN, CCRN, CNS, MSN

Abstract

Outline

  • Two basic types

  • Negative or positive pressure

  • Assessing patient and ventilator

  • Managing complications

  • Assess, prevent, and support

  • A few familiar terms

  • SELECTED WEB SITES

  • SELECTED REFERENCES



  • Graphics

  • Figure. No caption a...

  • Aaron Black, 67, was admitted to your unit last night with respiratory distress. This morning, the alarm on his bilevel positive airway pressure (BiPAP) machine sounds as you're taking shift report. Can you respond with confidence?

    Figure. No caption available. In this article, I'll explore the types of mechanical (assisted) ventilation, present some practical techniques for dealing with the patient and the machine, and spell out how you can help prevent complications.

    Two basic types

    Mechanical ventilation delivers oxygen via invasive and noninvasive techniques to support respiration in patients who can't breathe on their own.

    Invasive ventilation is administered through a tracheostomy or endotracheal tube, typically when the patient has severe respiratory distress or failure. He may not be able to maintain his own airway, or he may be receiving heavy sedation that leads to airway compromise.

    Noninvasive ventilation is administered short-term through an occlusive mask that fits tightly over the nose or the nose and mouth. The patient must be cooperative and able to manage his own airway and secretions. Noninvasive methods include BiPAP and continuous positive airway pressure (CPAP). Vomiting and aspiration are risks of therapy, but weaning is typically easier than with the invasive method.

    Now let's consider how mechanical ventilation compares with spontaneous ventilation.

    Negative or positive pressure

    During normal spontaneous inspiration, negative pressure in the thorax ...

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