Weak muscle effort, airway obstruction, and damaged lung tissue cause hypoxia. Central Nervous System Diseases and injuries can affect the respiratory system in the brain. Nerve damage can interfere with messages being sent between the lungs and the brain. Drug overdose can depress the brain. These and other respiratory problems are so severe that some people cannot breathe on their own. Or they cannot maintain enough oxygen in the blood. These persons often need mechanical ventilation.
Mechanical ventilation is using a machine to move air into and out of the lungs. Oxygen enters the lungs, and carbondioxide leaves the lungs.
Persons on Mechanical Ventilation have artificial airways. Depending on the person’s problems, an endotracheal tube or tracheostomy tube is used.
Ventilators have alarms that warn when something is wrong. One alarm is for when the person gets disconnected from the ventilator.
When any alarm sounds, first check to see if the person’s endotracheal tube or tracheostomy tube is attached to the ventilator. If it is disconnected, attach the tube to the ventilator. Then notify the nurse immediately about the alarm. Do not reset alarms. Remember, the person is on ventilator because of respiratory difficulties. The person can die if not connected to the ventilator.
It may takes weeks to get the person off the ventilator. The respiratory therapists and RN plan the weaning process.
For ventilator dependent person, the RN teaches you how to care for each patient. Family members are taught how to assist with the person’s care. Always make sure that an RN is available by phone when you are in the person’s home. Make sure delegated tasks are allowed by your state and agency.
Care of Persons Receiving Mechanical Ventilation
– Keep the signal light within the person’s reach
-make sure there is enough slack on hoses and connecting tubing. They should not pull on the endotracheal or tracheostomy tube.
-answer signal light promptly. Remember, the person depends on others for basic needs.
-explain who you are and what you are going to do whenever you enter the room.
-orient the person to day, date, and time.
-tell the nurse immediately if the person shows signs of respiratory distress or discomfort.
-do not change any settings on the ventilator or reset alarms.
-provide means of communication. Remember the person on mechanical ventilation cannot talk.
-use established hand or eye signals for “yes” and “no”. All health team members (nursing staff, doctors, respiratory therapists, and others) and the family must use the same signals, otherwise, communication does not occur.
-ask questions that have simple answers. The person may not have the strength to write out long reponses.
-be careful what you say when within the person’s hearing distance. The person may pay close attention to what is being said. Do not say anything that could upset the person.
-watch your nonverbal communication. Although seriously ill and unable to speak, the person may be very aware of nonverbal messages. Avoid communicating worry and concern to the person.
-take time to comfort and reassure the person. Tell the person what you are going to do and why. Also tell the person about such things as the weather, pleasant news events, and gifts and cards.
-meet the person’s basic needs for personal and oral hygiene, elimination, and activity (repositioning, range-of-motion exercises, sitting in a chair) as directed by the nurse.
-apply a moist wash cloth or lubricant to the person’s lips from drying and cracking.
-use touch to reassure and control the person.
-tell the person when you are leaving the room and when you will be back.