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Wednesday, July 27, 2011

Ventilator Set-up Protocol

In order to prevent ventilator acquired pneumonia many hospitals are creating ventilator protocols.  There are three types of ventilator protocols:

1.  Set up :  Provides guidelines for initial settings
2.  Maintenence:  Allows you to make changes based on gases, SpO2 and EtCO2
3.  Weaning:  Allows you to always be thinking about extubating

For an example of a maintenance and weaning protocol click the links provided above.  Below is an example of a set up protocol:

Here are the initial vent settings allowed per protocol:
  1. FiO2: 40%, and increase to main SpO2 >92% (or as specified by physician).

  2. VT: 6-10 ml/kg IBW (for Acute Lung Injury or ARDS use 6 ml/kg IBW)

  3. PRVC: 10-14 BPM

  4. PEEP: 5

  5. ABG within 30 minutes post set-up

  6. Automode: per RT discretion

  7. Maintain cuff pressure >20

  8. Suction and send sputum to lab

  9. Perform oral care Q2 hours

  10. elevate head of bed 40 degrees
Ventilator settings are then managed in accordance with the ventilator management protocol and the extubation protocol.


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