AACN Protocols for Practice: Care of

Care of Mechanically Ventilated Patients guides clinicians’ practice in the following categories: airway management, modes and methods of mechanical ventilation, weaning, sedation and neuromuscular blockade, nutrition support, and home care management of ventilator-assisted patients. Each protocol guides clinicians in the appropriate selection of patients, use and application of management principles, initial and ongoing monitoring, discontinuation of therapies or interventions, and selected aspects of quality control.

About the Protocols

vii

Acknowledgments

ix

Contributors

xi

Airway Management

1

(58)

Robert E. St. John

Maureen A. Seckel

Case Study

3

(1)

General Description

4

(1)

Performance Characteristics: Technical Standards for Tracheal Tubes

4

(1)

Competency

5

(1)

Ethical Considerations

6

(1)

Occupational Hazards

6

(1)

Future Research

6

(1)

Suggested Readings

7

(2)

Clinical Recommendations

9

(21)

Annotated Bibliography

30

(4)

Other References

34

(7)

Appendix 1A Equipment Guidelines for Intubation and Suctioning

41

(1)

Appendix 1B Comparison of Artificial Airways

42

(5)

Appendix 1C Types of Tracheostomy Tubes

47

(4)

Appendix 1D Communication Options for Patients With Artificial Airways

51

(3)

Appendix 1E Terminology Associated With Various Types of Suctioning Procedures

54

(3)

Appendix 1F High Risk Intubation/Reintubation

57

(2)

Invasive and Noninvasive Modes and Methods of Mechanical Ventilation

59

(36)

Lynelle N. B. Pierce

Case Study

61

(2)

General Description

63

(2)

Accuracy

65

(1)

Competency

66

(1)

Knowledge

66

(1)

Skills

66

(1)

Ethical Considerations

66

(1)

Occupational Hazards

67

(1)

Future Research

67

(1)

Suggested Readings

67

(1)

Clinical Recommendations---Volume-Targeted Ventilatory Modes

68

(4)

Clinical Recommendations---Pressure-Targeted Ventilatory Modes

72

(4)

Clinical Recommendations---Ventilatory Techniques: Lung Protection Strategies

76

(3)

Clinical Recommendations---Ventilatory Techniques: Noninvasive Possitive Pressure Ventilation

79

(5)

Annotated Bibliography

84

(5)

Other References

89

(6)

Weaning from Mechanical Ventilation

95

(66)

Suzanne M. Burns

Case Study 1: Short-Term Mechanical Ventilation

97

(1)

Discussion of Case Study 1

97

(1)

Case Study 2: Long-Term Mechanical Ventilation

98

(1)

Discussion of Case Study 2

99

(1)

General Description

99

(2)

Accuracy

101

(1)

Competency

101

(1)

Ethical Considerations

102

(1)

Occupational Hazards

102

(1)

Future Research

102

(1)

Suggested Readings

166

(1)

Clinical Recommendations

167

(10)

Annotated Bibliography

177

(5)

Other References

182

(1)

Appendix 4A Algorithm for Home Mechanical Ventilation

183

(1)

Appendix 4B Responsibilities of Team Members: Education and Preparation for Home Mechanical Ventilation

184

(2)

Appendix 4C Checklists

186

(3)

Appendix 4D Sample Medication Administration Record

189

(1)

Appendix 4E Decision Tree for Care

190

(1)

Nutritional Support for Mechanically Ventilated Patients

191

(62)

Carol Ress Parrish

Joe Krenitsky

Kate Willcutts

Case Study

193

(1)

General Description

193

(1)

Competencies

194

(1)

Ethical Considerations

194

(1)

Occupational Hazards

194

(1)

Future Research

194

(2)

Clinical Recommendations

196

(34)

Annotated Bibliography

230

(14)

Other References

244

(9)

Sedation and Neuromuscular Blockade in Mechanically Ventilated Patients

253

(2)

Jill Luer

Case Study 1

255

(1)

Case Study 2

256

(1)

General Description

257

(1)

Competency

258

(1)

Ethical Considerations

258

(1)

Future Research

258

(1)

Suggested Readings

258

(1)

Clinical Recommendations---Sedation

259

(7)

Clinical Recommendations---Neuromuscular Blockade

266

(4)

Annotated Bibliography

270

(7)

Other References

277

(3)

Appendix 6A Drugs Used for Sedation and Analgesia in the ICU

280

(2)

Appendix 6B Sedation Assessment Scales With Validity and Reliability in Adult Patients

282

(2)

Appendix 6C Neuromuscular Blocking Drugs Used in the ICU

284

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AACN Protocols for Practice: Care of Mechanically Ventilated Patients

Summary

Table of Contents

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