Mechanical Ventilation Essay Example

duty to identify and address any potential or existing issues in order to successfully wean patients from mechanical ventilation (MV). The Journal of Advanced Nursing outlines three stages of weaning for healthcare professionals to understand when the underlying cause for the patient's need for MV has not been resolved. Weaning commences once the patient's condition has stabilized.

During the weaning process, there can be various outcomes. One possibility is that the patient has been successfully weaned and can independently breathe for at least 24 hours. Alternatively, the patient may still rely partially on ventilator support or continue to be completely dependent on mechanical ventilation. Unfortunately, death is also a potential outcome. While the physician starts the weaning process, it is ultimately the nurse's duty to oversee its progress. As the primary caregiver directly involved in patient care, the nurse is responsible for detecting any behavioral changes first.

The nurse possesses vital knowledge of person-patient interactions, which serves as a therapeutic tool during the weaning process. Nurses are well-acquainted with the utilization of MV in critical care patients (International Journal of Nursing Terminologies and Classifications). The Journal of Advanced Nursing states that "critical care nurses play a crucial role in the management of mechanical ventilation and weaning." They are responsible for administering the therapy, monitoring patient reactions, and preventing possible complications associated with MV. Consequently, they also make the decision on when weaning should take place.

Patients undergoing mechanical ventilation (MV) are typically in the critical unit (CU) and must recover sufficiently to resume spontaneous breathing before intervention can begin. The timing of weaning depends on the patient's specific condition. For example, individuals who have had

open-heart surgery or suffer from chronic obstructive pulmonary disease may start weaning within a few hours. However, premature babies or burn victims may experience a delay of several days or weeks before beginning the weaning process (Nursing 2006). Nurses should consider different approaches to weaning as without an appropriate protocol, it could potentially increase the patient's mortality rate.

In North America, weaning teams are preferred (Journal for Advanced Nursing, 2006). Each team member has a significant role in the weaning process. There are members from various disciplines who focus on weaning the patient, and an outcome manager who documents the process. They create a weaning plan using weaning board and flow sheets. Cohen et al conducted a study which found that the weaning process is less successful when there is insufficient communication and proper documentation between team members.

Implementing effective communication and documentation resulted in a significant decrease in ventilator time and ICU stay. Additionally, it was confirmed that an organized protocol is essential for ensuring compliance among medical staff while not impacting mortality negatively. Before starting the weaning process, it is crucial to evaluate patients' physical and psychological condition. Generally, there are three distinct patient groups eligible for weaning.

The text below describes different groups of patients on mechanical ventilation (MV). The first group, which comprises approximately 70% of patients on MV, includes candidates who can be easily weaned. Their initial attempt at spontaneous breathing is a success. The second group, accounting for about 25% of MV patients, consists of individuals whose first attempt at spontaneous breathing failed. This failure is often caused by weakened muscles, and they need to spend about seven more

days on MV before a renewed weaning attempt can be made. The last group, constituting around 5% of patients, are particularly challenging to wean and fall into the post-extubation period.

Early mobilization of the patient, well-controlled use of sedation, and an early sedation vacation can often minimize muscle weakness (Nursing 2006). Rapid weaning, also known as short-term weaning, is typically for patients who are expected to recover quickly. The aim is to remove them from mechanical ventilation within six to eight hours. These patients are often extubated in the operating room as soon as anesthesia effects fade, and this procedure is overseen by anesthesia staff (Nursing 2006).

A well-designed, multi-disciplinary protocol is crucial for the evaluation and execution of rapid weaning. Nurses and respiratory therapists lead this process, which has been found to be better than physician-directed weaning. This superiority stems from nurses being present at the patient's bedside and able to promptly and effectively make changes during the weaning process. Long-term weaning is for patients who struggle with transitioning from mechanical ventilation (MV) to spontaneous breathing (Nursing Standard 2009). While no specific weaning method has proven to be more advantageous than others, these patients typically benefit from having a tracheostomy.