Mechanical ventilators have become a widely recognized medical device after the important role they played in saving the lives of patients with severe lung complications resulting from Covid-19 infection. Respiratory training courses are specifically designed to ensure registered respiratory therapists can work with a ventilator and troubleshoot any problems that might arise during the procedure. The job responsibilities of an RT are vital, which is why continuing education credits are made mandatory by most states for license renewal.
The Role of a Ventilator in Respiratory Protection
A ventilator is a machine that does the breathing for you. Regular breathing involves negative pressure in which air flows into your mouth when you inhale. In the case of a mechanical ventilator, positive pressure is used to force air into the lungs. The effect is almost similar to what happens with a leaf blower.
Ventilators or life support machines form an integral part of the respiratory protection program in emergency rooms and critical care units. They are also recommended by the American Lung Association for patients that cannot breathe on their own. These lifesaving respiratory machines deliver oxygen directly to the lungs. In some cases where patients are unable to exhale, these machines are also responsible for pumping out carbon dioxide.
Ventilators deliver oxygen through intubation, which is basically a tube inserted through a patient’s mouth or nose. In other cases, it may be placed directly into the windpipe or trachea through a surgical procedure called a tracheostomy. The opposite end of the tube connected to the ventilator pumps out air and oxygen into the lungs of the patient.
The air is humidified and warmed before it enters the body. The ventilator is also supposed to maintain positive air pressure to prevent alveoli or the small air sacs in the lungs from collapsing. These machines can be set to control the number of times the air is pumped into the lungs per minute. The patient’s respiratory rate, heart rate, and blood pressure, among other respiratory selections, are constantly monitored.
Such basic information is used by doctors, nurses, and respiratory therapists to make necessary adjustments to the ventilator. Patients showing signs of recovery from an injury, infection, or other medical conditions, can be started on the process of ventilator weaning. Based on this, it’s critical to exercise safety and caution while doing this.
The patients are taken through a series of trials where they are allowed to breathe in a self-paced manner. This is done on a voluntary basis while the patient is still connected to the ventilator. A breathing tube is removed once the patient is weaned off the machine.
When are Ventilators Used?
Mechanical ventilation is usually used on a temporary basis, depending on the diagnosis. They are often used during surgical procedures to aid a patient in breathing when asleep under general anesthesia. Patients suffering from serious lung diseases and other medical conditions may need a ventilator until they can recover fully. This type of care is usually provided for patients in the critical care unit.
Even where patients with impaired lung function are able to breathe on their own, they may feel shortness of breath or dyspnea. This can be an uncomfortable and distressing condition. Ventilators are intended to ease the breathing process to allow a patient to heal and rest. A respiratory therapist, with the help of other healthcare employees, will administer the necessary drugs and monitor the patient when on ventilator support.
Lung function can be affected by many diseases to the point where the patient needs to be placed on a ventilator to stabilize their condition. This includes:
- Respiratory infections, such as influenza, pneumonia, and coronavirus.
- Lung diseases, such as chronic obstructive pulmonary disease, asthma, lung cancer, and cystic fibrosis.
- Acute respiratory distress syndrome (ARDS).
- Brain injury.
- Damage to the muscles or nerves involved in breathing through myasthenia gravis, polio, upper spinal cord injuries, and amyotrophic lateral sclerosis.
- Drug overdose.
Patients that are unable to breathe on their own need ventilator support while their underlying condition, which caused the respiratory arrest or respiratory failure, is treated. Long-term ventilator support is usually needed when a patient is unable to regain their ability to breathe independently.
What to Do if a Ventilator Stops Working?
It’s fundamental that adequate and timely maintenance is performed on life support machines to prevent a tragedy from occurring. Modern ventilator machines have several components, including alarms. It’s pertinent for respiratory therapists to triage the alarm. While certain alarms can be nuisances, there may be a few indicating life-threatening situations.
There are several reasons for a ventilator to stop working or sound the alarm. This is what you should do in these instances.
Ventilator becomes inoperative
- Turn off the ventilator and restart it.
- Follow the instructions on the machine.
- Tag the ventilator for maintenance if it doesn’t operate properly. Check and replace with another ventilator promptly.
No gas delivery to the patient
- Make sure the high-pressure gas hose is tightly connected to the gas source.
- Check the air and oxygen pressure. The gas pressure gauge is usually located at the shut-0ff valve in most units.
- Check the cylinder tank gauges.
Low PIP (Peak Inspiratory Pressure)
- Check the circuit for disconnections and leaks. Tighten or reconnect any loose connections.
- Check the artificial airway cuff for deflation or leaks.
- Check the humidifier, inline suction system, and inline adapters for disconnections and leaks. Tighten the connections.
- Check the patient for any chest tube leaks. Consult the practitioner for necessary interventions.
- Make sure the proximal pressure line is unobstructed and connected.
Low Tidal Volume
- Check the circuit for disconnections or leaks and tighten them.
- Check for leaks and deflation in the artificial airway cuff.
- Check the humidifier, inline suction system, and inline adapters for disconnections and leaks.
- Check the patient for any chest tube leaks. Consult the practitioner for necessary interventions.
What if There is No Ventilator Around?
Mechanical ventilators are automated machines mimicking the functioning of lungs in patients that are unable to breathe on their own. These are commonly used in cases where the patient is experiencing dyspnea or severe shortness of breath. The reason for the condition to develop can be a respiratory infection, COPD, or ARDS.
In case a ventilator is not available, respiratory care professionals can have the patient lie in different positions. This includes their stomach. Lying in different positions helps the lungs aerate better. Giving patients more oxygen using nose tubes and other devices is another way of coping. Certain doctors are experimenting with the administration of nitric oxide to help improve oxygen and blood flow to the least damaged parts of the lungs.
These are a few alternative machines that can be used when a ventilator is not readily available.
Bilevel-positive airway pressure
A BiPAP machine delivers a pressurized flow of oxygen-rich air through a mask fitted tightly to the face of a patient. The treatment helps in preventing the tiniest compartments in the lungs from filling with fluid. It also ensures that oxygen gets delivered to the blood while the patient is kept conscious.
These machines pump anesthesia into the lungs during surgical procedures. They help patients with respiratory distress cope during covid times. Anesthesia machines are a step up from BiPap devices since they allow for better monitoring.
Distressed lungs cannot do a good job of removing carbon dioxide from the body. This builds up in the lungs resulting in toxicity. The Hemolung system works as a dialysis machine for the lungs. It prevents patients from developing ARDS when not on mechanical ventilation.
Continuing Education Credits for Respiratory Therapists
Continuing education units are necessary for respiratory therapists to renew their licenses. In relation to this, that is not the only reason why you should invest in a CE course. They help in furthering your knowledge about ventilators and other important things.
The field of respiratory therapy is forever advancing, with new technologies and techniques being implemented to help patients recover quickly. You can enhance your learning and career by staying current with well-designed continuing education units. Healthcare employers usually prefer respiratory professionals with enhanced skills.
TheCEPlace: Your Destination for Excellence in Online Respiratory Training Courses
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