SDE: Clinical Guidelines Ch7P

Clinical Procedure Guidelines for Connecticut School NursesPrintable version | Back to Contents
7
Specialized Health Care Procedures

P. Mechanical Ventilation

Definition

An electric or battery-powered machine that delivers positive pressure to the lungs using a variety of different settings based on the studentís individual needs.

Purpose

To aid in maintaining pulmonary gas exchange, acid-base balance, and support the work of breathing either continuously or intermittently based on the studentís individual needs.

Methods

In the school setting, there are a variety of portable mechanical ventilation units that can be used with a student; each one requires a connection with a tracheostomy.

Equipment

There are a variety of portable mechanical ventilation machines from a variety of manufacturers that can be used in the school setting. Since this is an area of frequent technological advances, it is recommended that the nurse obtain specific information from a manufacturer for each mechanical ventilation device as well as the medical provider managing the studentís care.

Procedures

  1. Procedures required for mechanical ventilation in school requires the ability to safely and effectively care for a student with a tracheostomy (see Tracheostomy Care and Suctioning procedure).
  2. Each ventilator requires instructions from the specific manufacturer of the ventilator.
  3. Additional procedural considerations include:
    1. Oxygen administration (see Oxygen Therapy procedure):
      1. Most studentsí mechanical ventilation will require some level of supplemental oxygen. This is based on a studentís individual needs.
      2. All students require emergency oxygen. Schools must also have on hand, emergency back-up oxygen.
    2. Pulse Oximetry (see Pulse Oximetry procedure):
      1. Students with mechanical ventilation should have their own pulse oximeter.
      2. A back-up pulse oximeter should be in schools where there is a student with a mechanical ventilator.
    3. Emergency back-up ventilators are generally not indicated in school, however, an emergency back-up source of electricity or a generator is indicated.

Delegation Considerations

The level of continuous skilled assessment required for a student with mechanical ventilation requires a registered nurse, licensed practical nurse (if appropriate), or a respiratory therapist.

Select Nursing Considerations

Each nurse responsible for the care of a student requiring mechanical ventilation must have an understanding of the underlying disease process and reason for requiring a tracheostomy and mechanical ventilation. The nurse must also have a comprehensive understanding of the studentís baseline physical exam, including saturation of peripheral oxygen (Sp02), respiratory effort, breath sounds, pulmonary secretions, and any additional acute or chronic health problem that may affect the studentís respiratory status. Training is also required on the specific brand and type of ventilator the student uses in school.

 




Content Last Modified on 3/29/2017 9:08:01 AM