Cgabryszek at 17:34, 19 June 2025

2025-06-19T17:34:17Z

← Older revision		Revision as of 12:34, 19 June 2025
Line 62:		Line 62:
	# Connect patient to ventilator.		# Connect patient to ventilator.
	# Monitor patient for Peak Inspiratory Pressure (PIP) less than 40 cmH2O. If PIP is above 40 cmH2O follow DOPES pneumonic.		# Monitor patient for Peak Inspiratory Pressure (PIP) less than 40 cmH2O. If PIP is above 40 cmH2O follow DOPES pneumonic.
			'''<u>Adult Ventilator Volumes-Based on ideal body weight per patient height</u>'''
	~~===~~ '''Adult Ventilator Volumes-Based on ideal body weight per patient height''' ~~===~~
	{\| class="wikitable"		{\| class="wikitable"
	\|'''Male (mL)'''		\|'''Male (mL)'''
Line 151:		Line 150:
	\|'''700'''		\|'''700'''
	\|}		\|}
	~~<blockquote>~~
	~~===== '''Men: IBW (kg) = 50 + 2.3 x (Height (in) - 60)''' =====~~

	=~~====~~ '''Women: IBW (kg) = 45.5 + 2.3 x (Height (in) - 60)~~''' =====~~		* '''<big>Men: IBW (kg) = 50 + 2.3 x (Height (in) - 60)</big>'''
	</~~blockquote~~>		* '''<big>Women: IBW (kg) = 45.5 + 2.3 x (Height (in) - 60)</big>'''

	~~===== '~~''~~Post-Mechanical ventilation sedation~~'~~'' =====~~

			'''Post-Mechanical ventilation sedation'''
	# Sedation Options:		# Sedation Options:
	## Ketamine (Ketalar) 1mg/kg IV/IO every 30 minutes or as needed.		## Ketamine (Ketalar) 1mg/kg IV/IO every 30 minutes or as needed.
Line 171:		Line 167:
	## Spontaneous movement		## Spontaneous movement
	## Patient-ventilator dyssynchrony		## Patient-ventilator dyssynchrony
			'''<u><big>If the patient does not tolerate the ventilator or if there are issues ventilating, disconnect, manually bag, and reevaluate the patient.</big></u>'''
	~~===~~ '''If the patient does not tolerate the ventilator or if there are issues ventilating, disconnect, manually bag, and reevaluate the patient.''' ~~===~~

Cgabryszek at 17:32, 19 June 2025

2025-06-19T17:32:56Z

← Older revision		Revision as of 12:32, 19 June 2025
Line 151:		Line 151:
	\|'''700'''		\|'''700'''
	\|}		\|}
			<blockquote>
	===== '''Men: IBW (kg) = 50 + 2.3 x (Height (in) - 60)''' =====		===== '''Men: IBW (kg) = 50 + 2.3 x (Height (in) - 60)''' =====

	===== '''Women: IBW (kg) = 45.5 + 2.3 x (Height (in) - 60)''' =====		===== '''Women: IBW (kg) = 45.5 + 2.3 x (Height (in) - 60)''' =====
			</blockquote>

	===== '''Post-Mechanical ventilation sedation''' =====		===== '''Post-Mechanical ventilation sedation''' =====

Cgabryszek at 17:32, 19 June 2025

2025-06-19T17:32:24Z

Show changes

Cgabryszek: Created page with "'''Purpose:''' To facilitate airway management in patients with airway compromise. This is not meant as a substitute for other appropriate therapeutic measures per standing operating procedures. '''Appropriate Personnel:''' EMT Paramedics in approved services. '''Indications:''' 1. Post Rapid Sequence Intubation (RSI) patients. 2. Cardiac Arrest/Respiratory Arrest patients what have airway secured with intubation or cricothyrotomy. '''Potential Exclusion..."

2025-06-19T17:26:11Z

Created page with "'''Purpose:''' To facilitate airway management in patients with airway compromise. This is not meant as a substitute for other appropriate therapeutic measures per standing operating procedures. '''Appropriate Personnel:''' EMT Paramedics in approved services. '''Indications:''' 1. Post Rapid Sequence Intubation (RSI) patients. 2. Cardiac Arrest/Respiratory Arrest patients what have airway secured with intubation or cricothyrotomy. '''Potential Exclusion..."

New page

'''Purpose:''' To facilitate airway management in patients with airway compromise. This is not meant as a substitute for other appropriate therapeutic measures per standing operating procedures.

'''Appropriate Personnel:''' EMT Paramedics in approved services.

'''Indications:'''

1. Post Rapid Sequence Intubation (RSI) patients.

2. Cardiac Arrest/Respiratory Arrest patients what have airway secured with intubation or cricothyrotomy.

'''Potential Exclusion Criteria:'''

1. Inability to adequality secure patient’s airway with intubation or cricothyrotomy.

2. Pediatric patients age less than 8 years or less than 24kg of ideal body weight.

3. Required tidal volume of less than 170mL.

4. Patient unable to tolerate mechanical ventilator therapy.

5. Poor oxygenation/perfusion with mechanical ventilator therapy.

6. Unable to maintain sedation during transport.

7. Pneumothorax - tension pneumothorax (actual or suspected).

8. Pulmonary over-pressurization syndrome (blast injury, water ascent injury, etc.).

'''Considerations:'''

1. Patients who are already ventilator dependent and have their own ventilators with them should (if possible) be transported with their own equipment.

2. If the patient is 28 weeks pregnant or greater contact medical control.

'''Pre-treatment:'''

1. Connect Ventilator tubing.

2. Connect ventilator to oxygen source.

3. Perform pre-operations tests.

'''Initial ventilator settings for adult male in cardiac arrest:'''

1. Determine need for mechanical ventilation.

2. Set mode to AC-Volume.

3. Set rate to 12 BPM.

4. Set tidal volume to 6-8mL/kg of ideal body weight(based on height).

5. Set PEEP to 5 cmH2O.

'''6. Ensure flow trigger is set to off.'''

7. Set FiO2 to 100%.

8. Connect patient to ventilator.

'''Initial ventilator settings for adult female in cardiac arrest:'''

1. Determine need for mechanical ventilation.

2. Set mode to AC-Volume.

3. Set rate to 12 BPM.

4. Set tidal volume to 6-8mL/kg of ideal body weight (Based on height).

5. Set PEEP to 5 cmH2O.

'''6. Ensure flow trigger is set to off.'''

7. Set FiO2 to 100%.

8. Connect patient to ventilator.

'''Initial Ventilator settings for Adult Post-RSI:'''

1. Determine need for mechanical ventilation.

2. Set mode to AC-Volume.

3. Set rate to 12-20 BPM titrate to maintain ETCO2 between 35-45 mmHg (If suspected head-injury with signs of herniation target ETCO2 of 30-35 mmHg by increasing respiratory rate).

4. Set tidal volume to 6-8 mL/Kg of ideal body weight (based on height).

5. Set PEEP to 5 cmH2O

6. Set FiO2 to 100% (Titrate FiO2 down by 10% every 10 minutes to maintain and SpO2 of >95%).

7. Connect patient to ventilator.

8. Monitor patient for Peak Inspiratory Pressure (PIP) less than 40 cmH2O. If PIP is above 40 cmH2O follow DOPES pneumonic.

'''Adult Ventilator Volumes-Based on ideal body weight per patient height'''
{| class="wikitable"
|'''Male (mL)'''

'''6mL/kg'''
|'''Male (mL)'''

'''8mL/kg'''
|'''Height'''
|'''Female (mL)'''

'''6 mL/kg'''
|'''Female (mL)'''

'''8mL/kg'''
|-
|'''250'''
|'''325'''
|56 inches (4’8”)
|'''225'''
|'''275'''
|-
|'''275'''
|'''360'''
|58 inches (4’10”)
|'''250'''
|'''325'''
|-
|'''300'''
|'''400'''
|60 inches (5’0”)
|'''275'''
|'''350'''
|-
|'''330'''
|'''425'''
|62 inches (5’2”)
|'''300'''
|'''400'''
|-
|'''350'''
|'''475'''
|64 inches (5’4”)
|'''325'''
|'''425'''
|-
|'''375'''
|'''500'''
|66 inches (5’6”)
|'''350'''
|'''475'''
|-
|'''400'''
|'''550'''
|68 inches (5’8”)
|'''375'''
|'''500'''
|-
|'''425'''
|'''575'''
|70 inches (5’10”)
|'''425'''
|'''550'''
|-
|'''450'''
|'''625'''
|72 inches (6’0”)
|'''450'''
|'''600'''
|-
|'''500'''
|'''650'''
|74 inches (6’2”)
|'''475'''
|'''625'''
|-
|'''525'''
|'''700'''
|76 inches (6’4”)
|'''500'''
|'''650'''
|-
|'''550'''
|'''725'''
|78 inches (6’6”)
|'''525'''
|'''700'''
|}
'''Men: IBW (kg) = 50 + 2.3 x (Height (in) - 60)'''

'''Women: IBW (kg) = 45.5 + 2.3 x (Height (in) - 60)'''

'''Post-Mechanical ventilation sedation'''

A. Sedation Options:

1. Ketamine (Ketalar) 1mg/kg IV/IO every 30 minutes or as needed.

2. Midazolam (Versed) 2 mg IV/IO every 30 minutes or as needed.

3. Fentanyl (Sublimaze) 50mcg.

B.    Ketamine is favored in hypotensive patients

C.    Be certain to watch for hypotension or shock with Versed and Fentanyl.

D. Close monitoring of the patient is required, and adequate minute ventilation must be maintained and close monitoring of airway patency, including appropriate suctioning should be performed. End-tidal CO2 monitoring should be performed on all intubation patients if available.

E.    Signs for under sedated patient include but are not limited to:

a. Elevated heart rate

b. Elevated blood pressure

c. Spontaneous movement

d. Patient-ventilator dyssynchrony

'''If the patient does not tolerate the ventilator or if there are issues ventilating, disconnect, manually bag, and reevaluate the patient.'''

5-13 MECHANICAL VENTILATION - Revision history

Cgabryszek at 17:34, 19 June 2025

Cgabryszek at 17:32, 19 June 2025

Cgabryszek at 17:32, 19 June 2025