To be honest going into respiratory school I was not sure how I would feel about the ICU or trauma cases not having the experience prior. Then one day in clinic we had two code blue situations where I got to see the whole medical team come together to do their best to take care of the patient. Everybody thinking on their feet, supporting each other- to save a life. I had the opportunity to do chest compressions on the second code. I swear my heart rate must have been 150bpm as I was trying to block out the commotion around me to concentrate on delivering 100 compressions per minute. It was a rush that I can’t quite explain. I felt important….I was contributing to potentially saving a life, which is the very reason I decided to go into health care to begin with. Ever since this experience I’ve had a thirst to get a taste of ICU clinical rotations which start this summer.
That being said, preparation for ICU clinical rotation is extremely imperative! Patients are in critical conditions and vast decisions are made based on the best clinical assessment. In school I just started my mechanical ventilation course, which will be a vital competency I need to master in hopes of being a RRT. Respiratory therapists are considered the experts on the mechanical ventilator and it’s application. In many acute situations ventilator associated pneumonia (VAP) can occur in as many as 24% of patients. VAP is defined as pneumonia occurring more than 48 hours after a patient has been intubated and received mechanical ventilation. Several complications can occur during mechanical ventilation which is why as a respiratory therapist you must know not only the ventilator but your patient inside and out. Listed below are just a few complications on mechanical ventilation.
Mechanical Ventilation Hazards & Complications:
That being said, preparation for ICU clinical rotation is extremely imperative! Patients are in critical conditions and vast decisions are made based on the best clinical assessment. In school I just started my mechanical ventilation course, which will be a vital competency I need to master in hopes of being a RRT. Respiratory therapists are considered the experts on the mechanical ventilator and it’s application. In many acute situations ventilator associated pneumonia (VAP) can occur in as many as 24% of patients. VAP is defined as pneumonia occurring more than 48 hours after a patient has been intubated and received mechanical ventilation. Several complications can occur during mechanical ventilation which is why as a respiratory therapist you must know not only the ventilator but your patient inside and out. Listed below are just a few complications on mechanical ventilation.
Mechanical Ventilation Hazards & Complications:
- Overventilation--> can lead to: cerebral hemorrhage, seizures, arrhythmias, and poor oxygen release at the tissues
- Decreased Cardiac Output (especially in inverse I:E ratios)--> results in hypotension and poor perfusion
- Airway Obstruction
- "Fighting" the ventilator--> results in increased work of breathing (WOB) and increased intrathoracic pressure
- Airway Displacement
- Atelectasis (due to underventilation)
- Pulmonary Infection: both viral and bacterial (gram positive being the most common and gram negative being the most destructive)
- Increased Deadspace Ventilation--> causes an increase in VD/VT, venous admixture, and ventilation to the upper lung zones
- Ventilator Dependence (especially with end-stage Emphysema)