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Wednesday, August 18, 2010

guidelines to adjusting ventilator settings

So you're tired of doctors just making up ventilator changes. Here are the recommended AARC guidelines for adjusting ventilator settings. Study these, and impress a doctor or a nurse with your wisdom:

1. PaCo2 greater than 45 (or EtCo2 greater than 50)
  • Increase RR
  • Increase VT
2. PaCo2 less than 35 (or EtCO2 less than 30)
  • Decrease Rate
  • Decrease VT
3. PO2 less than 60 (or SpO2 less than 90%)
  • Increase FiO2 to 60%
  • Increase PEEP
  • Increase FiO2 to 100%
4. SpO2 greater than 95% (or appropriate oxygenation for patient)
  • Reduce FiO2 to 60%
  • Reduce PEEP to 5
This is to act as a guideline only to assist you in making the appropriate ventilator changes based on invasive ABG results and/ noninvasive EtCO2 and SpO2 monitoring. Of course you'll need to know your patient.

For a great review of EtCO2 monitoring check out this post.

For a printable cheat sheet with this information and more, click here.

For a printable cheat sheet for EtCO2 monitoring click here.

1 comment:

Tommy Drake said...

HI, thank you for this opinion. Your observation is really intriguing.
Etcoe