News &Views

Your Guide to Ventilator Care and Management in A Skilled Nursing Facility

June 2019

Ventilator care and management are best by someone trained in this specialty. Learn more about it and the need for skilled nursing care here.

Mechanical ventilation is a life-saving intervention for many people with respiratory failure. Patients need close management to limit potential lung injuries from the ventilator.

Do you have a loved one using mechanical ventilation? You know the importance of finding the best available care.

Ventilator care and management are best when handled by someone with specialty training.

Learn more about skilled nursing and ventilator care management here.

Look for 24-Hour Care

If your loved one is on a home ventilator, she needs 24-hour skilled nursing care. It’s crucial that a knowledgeable nurse is available at all times.

Look for a facility offering skilled nurses that follow evidence-based practice guidelines. Ventilators used to be the purview of the ICU. But many people are now sent to subacute facilities while on mechanical ventilation.

Why a Ventilator?

Through positive-airway pressure, a ventilator provides adequate levels of oxygen in the bloodstream. When there’s not enough gas exchange in the lungs, the lungs stop releasing oxygen into the blood.

Sometimes respiratory failure happens when there’s a buildup of carbon dioxide in the blood. If the lungs can’t remove it, the respiratory system fails.

There are two types of respiratory failure:

Hypercapnic respiratory failure is when too much carbon dioxide and not enough oxygen are in the bloodstream.

Hypoxemic respiratory failure is not enough oxygen in the blood. The patient usually has normal or near-normal levels of carbon dioxide.

Both types of respiratory failure require mechanical ventilation.

Symptoms of Acute Respiratory Failure

Rapid breathing and confusion are symptoms of a high carbon dioxide level in the blood. If the oxygen levels are too low, the patient experiences an inability to breathe. The skin, lips, and fingertips have a bluish hue.

People with acute lung failure are restless, anxious, and sleepy. Irregular heartbeat, loss of consciousness, and shallow breathing are other symptoms. Profuse sweating is also a symptom.

What Are the Causes?

There are several causes of acute respiratory failure:

A spinal cord or brain injury sometimes causes respiratory failure. An injury to the brain sometimes disrupts the signals telling your lungs to breathe. In that case, ventilation is necessary.

Some people have allergic reactions that cause swelling of the throat. This inhibits the breathing process as the airway narrows.

In some cases, a patient overdoses on alcohol or drugs and can’t breathe for themselves. The respirator helps them breathe.

Infections, especially pneumonia, are a significant cause of respiratory failure.

A stroke sometimes causes severe breathing difficulties.

ARDS is low oxygen in the blood. It usually affects people with underlying health conditions. These might be pneumonia, sepsis, trauma or other conditions. Inhalation of smoke in a fire is another cause of ARDS.

Skilled Nursing for Ventilator Care

Depending on the type of respiratory failure your loved one has, he may not be on the respirator forever. Weaning off the respirator is often the goal.

It’s possible to care for a loved one on a ventilator at home. But 24-hour skilled nursing is preferable.

A nurse assesses for several things on an ongoing basis:

A patient on mechanical ventilation can’t always speak. But she can usually acknowledge whether she’s in pain. A skilled nurse has experience in making this type of assessment.

Anxiety medications help with agitation. As a family member, visit as often as possible. This also helps anxiety and agitation.

A nurse knows the ins and outs of infection prevention. Ventilator-assisted pneumonia (VAP) is a common complication. The nurse keeps a close eye on your loved one.

The nurse changes your loved one’s position regularly. She’ll exercise the patient’s limbs and help the patient sit up. The movements help decrease the chance of infection.

A nurse checks for proper airway management constantly. She’ll also perform routine oral hygiene, such as brushing the patient’s teeth.

Blood pressure checks ensure the patient’s stability. Another risk of mechanical ventilation is pneumothorax. This is when a lung collapses. Through constant monitoring, a nurse detects potential complications.

A patient on a ventilator can’t swallow. Feeding tubes providing liquid nutrition through the gut are preferable.

Benefits of the Respirator

It’s frightening when your loved one is on a mechanical ventilator. But ventilators often provide positive outcomes. The ventilator allows your loved one time to heal.

Breathing well helps a patient sleep. Good sleep is a significant factor in positive health outcomes.

Patients on mechanical ventilation need a sophisticated level of care. They need a well-organized, well-trained team. A skilled nursing facility provides this type of care.

Skilled nurses take care of a patient’s emotional as well as physical needs. Trained nurses communicate with the patient each time they enter a room.

The nurses communicate treatment plans and desired outcomes to the family and patient. They’re knowledgeable about best practices. They have experience and understand patient needs.

A skilled team implements an integrated plan of care. Treatment encompasses the patient’s physical, social, personal, and spiritual needs.

Ventilator Weaning

Weaning off the ventilator is the aim for many patients on mechanical ventilation. As the patient’s respiratory distress resolves, the team considers ventilator removal.

Weaning involves many factors such as:

The team evaluates these and other factors when deciding if or when to wean the patient.

Some patients wean gradually off of the ventilator over a period of weeks. Other patients may be weaned off of the ventilator sooner than that. Still, others are unable to come off the respirator.

The team at the skilled nursing facility works in the patient’s best interest. They provide the most up-to-date care available.

Providing the Best Possible Outcome

Is your loved one on mechanical ventilation? You want the best ventilator care available. You want a skilled nursing facility managing treatment for the best possible outcome.

Seeing your loved one on a respirator is scary. But mechanical ventilation is a common treatment. Place your loved one in the hands of a skilled professional.

Are you looking for the best ventilator care for your loved one? Contact our skilled nursing facility here.

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