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    Ventilasi Mekanik & Interpretasi GCS: Tri Antika Rizki Kusuma Putri

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    sundaryanisitumorang
    Ventilators are used to treat respiratory failure by assisting or replacing patient breathing. Key settings include tidal volume, PEEP, FiO2 and mode. Modes include controlled ventilation which does all breathing, assist-control which assists spontaneous breaths, and PSV which provides pressure support. Tubes can be endotracheal or tracheostomy. Ventilator alarms require assessing causes like secretions or tube issues. Consciousness scales like AVPU and GCS are used to monitor patients on ventilators. Careful consideration of settings, alarms and weaning are important for safe ventilator use.

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    Ventilasi Mekanik & Interpretasi GCS: Tri Antika Rizki Kusuma Putri

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    sundaryanisitumorang
    27 views17 pages
    Ventilators are used to treat respiratory failure by assisting or replacing patient breathing. Key settings include tidal volume, PEEP, FiO2 and mode. Modes include controlled ventilation which does all breathing, assist-control which assists spontaneous breaths, and PSV which provides pressure support. Tubes can be endotracheal or tracheostomy. Ventilator alarms require assessing causes like secretions or tube issues. Consciousness scales like AVPU and GCS are used to monitor patients on ventilators. Careful consideration of settings, alarms and weaning are important for safe ventilator use.

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    Ventilators are used to treat respiratory failure by assisting or replacing patient breathing. Key settings include tidal volume, PEEP, FiO2 and mode. Modes include controlled ventilation which does all breathing, assist-control which assists spontaneous breaths, and PSV which provides pressure support. Tubes can be endotracheal or tracheostomy. Ventilator alarms require assessing causes like secretions or tube issues. Consciousness scales like AVPU and GCS are used to monitor patients on ventilators. Careful consideration of settings, alarms and weaning are important for safe ventilator use.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    27 views17 pages

    Ventilasi Mekanik & Interpretasi GCS: Tri Antika Rizki Kusuma Putri

    Uploaded by

    sundaryanisitumorang
    Ventilators are used to treat respiratory failure by assisting or replacing patient breathing. Key settings include tidal volume, PEEP, FiO2 and mode. Modes include controlled ventilation which does all breathing, assist-control which assists spontaneous breaths, and PSV which provides pressure support. Tubes can be endotracheal or tracheostomy. Ventilator alarms require assessing causes like secretions or tube issues. Consciousness scales like AVPU and GCS are used to monitor patients on ventilators. Careful consideration of settings, alarms and weaning are important for safe ventilator use.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    of 17

    Ventilasi Mekanik & Interpretasi

    GCS
    Tri Antika Rizki Kusuma Putri
    Mengapa Ventilator?
    • Impending or existing respiratory failure
    • Failure to oxygenate (inadequate exchange of gases at
    the alveolar level, as seen in acute respiratory distress
    syndrome [ARDS])
    • Failure to ventilate (decreased mental status or
    decreased lung compliance)
    • Combination of both
    • Airway protection
    Apa yang harus diperhatikan?
    • What type of airway is in place?
    • What are the ventilator settings and what do they
    all mean?
    • What do I do if the vent alarms?
    • What to I do if the vent fails?
    • How do I plan treatment in conjunction with vent
    weaning?
    Airway Management

    Endotracheal Tube (ETT)


    ● Can be placed orally
    (most common) or
    nasally
    ● Passes through the vocal
    cords

    Tracheostomy tube
    ● Cuff or cuff less
    ● Inserted below the vocal
    cords
    ● Used in more long-term
    airway management
    Ventilator Settings

    Actual respiratory
    rate

    Type of ● Tidal Volume


    respirati ● PEEP
    on ● Mode (type of assist given by
    vent)
    ● Rate (Breaths per minute.Adjusted
    Mode based on patient’s own
    Set respiratory FiO respiratory rate)
    rate 2
    PEEP ● FiO2(amount of O2 being
    delivered)
    Ventilator Settings

    Positive End-Expiratory Pressure Oxygen Therapy


    (PEEP)
    ● Pressure given in expiratory phase to ● Prolonged exposure to high levels of
    prevent closure of the alveoli and allow oxygen can be toxic to the lungs
    increased time for O2 exchange ● High FiO2 (>.5) can lead to atelectasis
    ● Used in pts who haven’t responded to ● Balancing act between FiO2 and PEEP
    treatment and are requiring high amount
    of FiO2
    ● PEEP will lower O2 requirements by
    recruiting more surface area
    ● Normal PEEP is approximately 5cmH20.
    Can be as high as 20cmH20
    Mode ventilator

    Controlled Ventilation Assist Control (A/C)


    ● Ventilator meginiasiasi semua usaha
    nafas, mengatur rate dan tidal volume ● Ventilator tidak akan mem blok usaha
    ● Ventilator mem-BLOCK semua usaha napas spontan dari pasien, bahkan
    napas spontan diberikan tambahan TV
    ● Biasanya digunakan di setting OR ● Mesin set pada minimum rate sehingga
    (paralyzed and sedated patients) apnea tidak akan terjadi meski tidak ada
    usaha napas spontan dari pasien
    ● Kerugian: hiperventilasi, vent
    dysynchrony, breath-stacking
    Assist Control “Breath-
    (A/C) Stacking”
    Mode ventilator

    Synchronized Intermittent
    Ventilation (SIMV)
    ● Mirip dengan mode A/C, tetapi pasien bisa
    bernapas spontan diantara assisted
    breaths
    ● Bisa menggunakan primary mode atau
    ketika weaning mode
    ● Bisa menyebabkan low RR pada pasien
    yang tidak memberikan napas spontan
    Mode ventilator

    Pressured Support Ventilation


    (PSV)
    ● Biasa juga disebut “spontaneous mode”
    ● Mesin memberikan pressure tambahan
    ● Pasien kontrol rate, tidal volume, dan
    minute ventilation
    ● TV berubah-ubah
    Mode ventilator

    Continous Positive Airway Pressure Bi-Level Airway Pressure (BiPAP)


    (CPAP) ● Menggunakan masker bi-pap
    ● Positive airway pressure diberikan pada ● Mirip dengan CPAP (but can be set at one
    saat inspirasi dan ekspirasi pressure for inhalation and another for
    ● Mesin men suplai oksigen exhalation)
    ● Meningkatkan pertukaran gas ● Biasa digunakan pda pasien sleep apnea,
    ● Usaha napas spontan dari pasien maupun pasien CHF dan gagal napas
    ● Bisa juga diberikan secara non invasive untuk pencegahan intubasi
    dengan menggunakan masker oksigen
    terutama pada pasien yang sering
    mengalami sleep apnea
    Alarm

    ● Sekret
    ● Kinked tubing/malposition
    ETT
    ● Pasien menggigit
    tubing/fighting vent
    ● Water in tube/water
    traping
    ● Bronchospasm
    ● Pneumothorax
    ● Decreased compliance
    Consciousness Level

    Consciousness can be
    defined as a state of
    awareness of self and
    environment.

    Terdapat 2 komponen
    kesadaran: arousal &
    cognition

    Arousal RAS
    Assessment
    The AVPU scale
    Alert, Verbal/Voice, Pain,
    Unrensponsive

    Glasgow Coma
    Scale
    E-4, V-5, M-5
    Assessment
    Assessment
    Assessment

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