Page 515 - Clinical Application of Mechanical Ventilation

Procedures Related to Mechanical Ventilation 481

gathered and assembled. For equipment using rechargeable batteries such as ven-
tilator and monitor, maintain a full charge with electrical power until time for de-
parture. For other equipment such as pulse oximeter and laryngoscope handle, new
batteries should be installed. Monitors are calibrated and appropriate alarm limits
During transport, the pa- set based on the patient’s condition. Small “E” size oxygen cylinders with wrench
tient is monitored throughout
the entire period to ensure must be full. In the event of delay, the oxygen content should be at least twice the
stable hemodynamic status, volume needed for a one-way transport.
adequate oxygenation, and
ventilation. All tubes and lines should be secured prior to transport. During transport, the
patient is monitored throughout the entire period to ensure stable hemodynamic
status, adequate oxygenation, and ventilation. All ventilator parameters are checked
and adjusted to ensure proper functioning. A log should be kept to document all
monitoring data, adverse reactions, and interventions.
On arrival, bedside monitors and ventilators at the destination hospital are used.
The position and function of the patient’s endotracheal tube are checked and docu-
mented. Pretransport ventilator settings and appropriate alarm limits are set on the
ventilator after the patient has been stabilized from the transport. Finally, a verbal
report is given to the therapist at the destination hospital, and the written documen-
tation is filed with the patient’s medical record.

Hazards and Complications

There are many hazards and complications associated with transport of mechan-
ically ventilated patients. They range from hyperventilation during manual ven-
tilation en route to a remote location to equipment failure. Table 14-6 summa-
rizes the potential complications during transport and solutions for remediation.

Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) produces images for detection of abnormalities
in the body organs not distinctively assessable by conventional imaging techniques.
The strong magnetic field generated by the MRI scanner may draw certain metal
objects toward the scanner. Steel oxygen transport cylinders and many ventilators
are potential sources of a projectile risk to the patient and others. For this safety
reason, only aluminum oxygen cylinders should be used (Morgan et al., 2002). All
transport equipment coming near the MRI scanner must be resistant to the mag-
Transport equipment netic field produced by the scanner.
coming near the MRI scanner
must be resistant to the Some transport ventilators are capable of providing mechanical ventilation safely
magnetic field produced by in an area where MRI is in use. Some MRI-compatible ventilators are IC-2A (MRI)®
the scanner.
and MVP-10 (MRI)® (Bio-Med Devices, Guilford, CT); pNeuton Model A and
Model S (Airon, Melbourne, FL); Omni-Vent® (Allied Healthcare Products, Inc.,
St. Louis, MO), MAXO Vent, (Maxtec, Salt Lake City, UT); and RespirTech PRO®
2
(Vortran Medical Technologies, Sacramento, CA). When pressure control mode is
used, the delivered volume may decrease in conditions of decreasing compliance or
increasing airflow resistance. Monitoring the expired tidal volume is essential during
transport with a mechanical ventilator.

Copyright 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.