Ventilator desaturation: Difference between revisions
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Troubleshoot | Troubleshoot | ||
*D - Displacement of tube | |||
**Attach end-tidal CO2 to verify and check depth (cm at lip) | |||
*O - Obstruction of tube/circuit | |||
**Use suction catheter to remove mucus plug, or make sure pt not biting down | |||
*P - Pneumothorax | |||
**Verify via US | |||
*E - Equipment failure | |||
**Connect to BVM | |||
*S - Stacked breaths - Auto-PEEP especially in COPD/Asthma pts | |||
**Disconnect from ventilator | |||
Fix | Fix | ||
*Disconnect vent and put light pressure on pt chest | |||
*Oxygen 100% | |||
**Bag and take time to evaluate your patient | |||
*Tube Position & Function | |||
**Pass bougie or suction all the way through the tube, OR take a look with DL | |||
*Tweak Vent Settings | |||
**Drop TV, then decrease RR, and then increase flow rate | |||
**Caution as it causes hypercapnia and resp acidosis, which is harmful in pts with increased ICP or tox ingestion | |||
*Sonography | |||
Auto-PEEP (Breath stacking) troubleshooting options | Auto-PEEP (Breath stacking) troubleshooting options | ||
Revision as of 15:41, 31 March 2015
- Immediately disconnect from ventilator (allows for expiration of stacked breaths)
- "DOPES like DOTTS" Mnemonic
Troubleshoot
- D - Displacement of tube
- Attach end-tidal CO2 to verify and check depth (cm at lip)
- O - Obstruction of tube/circuit
- Use suction catheter to remove mucus plug, or make sure pt not biting down
- P - Pneumothorax
- Verify via US
- E - Equipment failure
- Connect to BVM
- S - Stacked breaths - Auto-PEEP especially in COPD/Asthma pts
- Disconnect from ventilator
Fix
- Disconnect vent and put light pressure on pt chest
- Oxygen 100%
- Bag and take time to evaluate your patient
- Tube Position & Function
- Pass bougie or suction all the way through the tube, OR take a look with DL
- Tweak Vent Settings
- Drop TV, then decrease RR, and then increase flow rate
- Caution as it causes hypercapnia and resp acidosis, which is harmful in pts with increased ICP or tox ingestion
- Sonography
Auto-PEEP (Breath stacking) troubleshooting options
- Bronchodilators if COPD/asthma
- Decrease RR
- Decrease I:E ratio (increase expiratory time)
- Quicker inspiratory flow rate
- Decrease TV
- Increase sedation