A ventilator is designed to circulate breathable air into and out of the lungs mechanically and also to provide the mechanism of breathing for a patient who is physically not able to breathe sufficiently.

The ventilator:

•    It has got tubes that connect to the person through a breathing tube. The breathing tube is placed in the person’s mouth or in an opening through the neck into the windpipe (trachea).
•    Is attached to a computer with knobs and buttons that are controlled by a respiratory therapist, nurse, or doctor.
•    Makes noise and has alarms that alert the health care team when something needs to be fixed or changed.

How does it feel?

The ventilator does not cause pain by itself. Some people don’t like the feeling of having the tube in their mouth or nose.

Because the tube passes between the vocal cords into the windpipe, they cannot talk. It is also uneasy to eat by mouth when this tube is in place. A person may feel uncomfortable as air is pushed into their lungs. Sometimes a person tries to breathe out when the ventilator is trying to push air in. This is fighting against the ventilator and makes it harder for the ventilator to help.

People on ventilators may be given medicines (sedatives

or pain controllers) to make them feel more comfortable. These medicines may also induce sleepiness. Sometimes, medications that temporarily prevent muscle movement (neuromuscular blocking agents) are used to allow a person to breathe with the ventilator and are typically used when a person has very severe lung injury; they are stopped as soon as possible and always before ventilator support is removed.

Complications related to mechanical ventilation can be divided into:

• airway-associated complications
• complications in the response of patients to mechanical ventilation
• complications related to the patient’s response to the device for mechanical ventilation.

Complications of the artificial airway may be related to intubation and extubation or the endotracheal tube. Complications of mechanical ventilation, which arise because of the patient’s response which primarily causes significant side effects to the lungs.

Mechanical ventilation may increase the alveolar/capillary permeability by overdistension of the lungs, called volutrauma

OR

it can exaggerate lung damage due to the involvement or less involvement of collapsed alveoli causing ATELECTRAUMA and may also cause subtle damages due to the activation of inflammatory processes causing BIOTRAUMA. Complications caused by mechanical ventilation, besides those involving the lungs, can also have significant effects on other organs and organic systems.

STOPPING USAGE

As soon as the person starts recovering from the disorder which led to lung dysfunction, doctors try to decrease the usage of the support for breathing. They may temporarily turn the ventilator off to see if the person’s lungs are able to function without support. Such trials are done under careful surveillance so that the ventilator can be quickly restarted if the need arises. One should take proper care of patient on ventilator.

A mechanical ventilator is mainly used to make breathing easier for very sick people. Another reason for which ventilator is used is to help raise the oxygen level. Sometimes, a patient receives mechanical ventilation when they have an unstable or unpredictable health condition.

The main benefits of mechanical ventilation are the following:

•    Helps the patient get as much oxygen as he or she needs.
•    The patient doesn’t have to work as hard to breathe.
•    The patient’s breathing has an opportunity to become normal.
•    Preserves a stable airway.
•    Allows medications to heal the body and work properly.

Improvement of gas exchange, promoting optimal communication, maintenance of a patient airway, prevention of trauma, minimizing anxiety, and absence of cardiac and pulmonary complications are the major goals for a client receiving mechanical ventilation. This is also followed in pediatric ventilator nursing care.

Here are six nursing diagnosis (NDx) and nursing care plans (NCP) for patients who are under mechanical ventilation:

•    Deficient Knowledge
•    The risk for Ineffective Protection
•    Impaired Spontaneous Ventilation
•    Ineffective Airway Clearance
•    Anxiety
•    The risk for Decreased Cardiac Output

This article discusses the top ten essentials of nursing care of patient on ventilator.

Care essential 1: Review communications

Care essential 2: Check ventilator settings and modes

Care essential 3: Suction appropriately

Care essential 4: Assess pain and sedation needs

Care essential 5: Prevent infection

Care essential 6: Prevent hemodynamic instability

Care essential 7: Manage the airway

Care essential 8: Meet the patient’s nutritional needs

Care essential 9: Wean the patient from the ventilator appropriately

Care essential 10: Educate the patient and family

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