The first quantified listing of the information at the bedside of a ventilator patient in the adult ICU.
Using the modified Delphi technique,1 three RT students in their last semester were asked to participate in the development of a list of all information potentially available to the RT at the bedside of an adult ventilator patient. Their lists were to be based on personal observation and experience in at least two different adult ICUs, using common volume ventilators.
After the first lists were compiled, the group and a faculty facilitator pared down the items. This procedure was repeated twice. The final list was put into the current format. It consists of 98 separate items of directly observable information distributed among the following five categories: ventilator function, patient/ventilator interface, patient, external monitoring, and immediate patient environment. A sixth category, communicated information (medical record and other caregivers), potentially contained at least 10 separate information items.
The results indicate that RTs must assimilate a substantial amount of information every time they approach a patient receiving ventilatory support. How many of the 98 items the individual RT actually looks at has yet to be studied, and probably varies from patient to patient and from situation to situation. In addition, this study only looked at adult ICU patients. The list would probably be shorter for patients in postacute care, and longer for neonatal/pediatric patients and patients receiving nonconventional forms of ventilatory support (jet ventilation).
William A. French, MA, RRT, is clinical director of the respiratory therapy program at Lakeland Community College, Kirtland, Ohio. The author acknowledges the assistance of Christina Egan, CRT; John Gallagher, RRT; and Dawnell Zukoski, CRT.
1. Type of ventilation/ventilator
2. Mode of ventilation
5. Ventilator set rate
6. Set tidal volume
8. Flow pattern
10. Positive end-expiratory pressure (PEEP)
11. Pressure support
12. Flow by
13. Set pressure
15. Alarm settings
16. Status alarms
17. Sigh frequency
18. Sigh volume
19. Type of humidification
20. Appearance of ventilator circuit
21. Type of suction device
22. Source gas
23. Previous settings/changes
Immediate Patient Environment
Additional Information (not directly observable)
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