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Ventilator Management, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Mechanical ventilation is machine generated flow of gas into and out of the lungs that acts as a substitute for normal respiratory function

Basic Concepts: Physiology and Pulmonary Me...

Diagnosis

Signs and Symptoms

  • Indications for mechanical ventilation:

    • Failure to oxygenate:

      • Diffusion defect (i.e., pulmonary edema, pneumonitis, pneumonia)

      • Severe ventilation/perfusion mismatch (i.e., PE,...

Treatment

Pre-Hospital

Respiratory support per local EMS protocol 

Initial Stabilization/Therapy

  • Cardiac monitor

  • BP monitoring

  • Pulse oximetry

  • End-tidal CO2 monitoring when available

Ed Treatment/Procedures

Cr...

Follow-Up

Disposition

Admission Criteria

ICU admission required for all intubated patients 

Pearls and Pitfalls

  • Physiology can help you troubleshoot the vent. Remember that you control ventilation by adjusting the TV and RR and that you control oxygenation by adjusting PEEP and FiO2. Peak pr...

Additional Reading

  • Gabrielli  A, Layon  AJ, Yu  M, eds. Critical Care. 4th ed. Philadelphia, PA: Wolters Kluwer, Lippincott Wiliams and Wilkins; 2009.

  • Gattinoni  L, Protti  A, Caironi  P, et al. Vent...

Codes

ICD9

V46.11 Dependence on respirator, status 

ICD10

Z99.11 Dependence on respirator [ventilator] status 

SNOMED

444932008 dependence on ventilator (finding) 

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