Invasive mechanical ventilation (IMV) is a type of life support that uses a machine to help a person breathe when they cannot do so on their own. IMV is often used for patients who have severe respiratory failure due to various causes, such as COVID-19, acute respiratory distress syndrome (ARDS), pneumonia, or trauma.
IMV involves inserting a tube called an endotracheal tube (ETT) through the mouth or nose and into the windpipe (trachea). The ETT is connected to a ventilator, which is a machine that delivers oxygen-rich air into the lungs and removes carbon dioxide-rich air out of the lungs. The ventilator can also adjust the pressure, volume, and rate of the air delivered to match the patient’s needs.
IMV can be lifesaving for patients, but it can also have serious complications, such as lung injury, infection, bleeding, or vocal cord damage. Therefore, IMV requires careful monitoring and management by trained staff who follow strict protocols for initiation, maintenance, and weaning of the device.
As a nurse, taking care of IMV patients is one of your challenging and rewarding roles. Taking care of IMV patients involves assessing the patient’s condition and response to ventilation; ensuring the proper placement and function of the ETT and ventilator; preventing and managing complications of IMV; providing comfort and communication to the patient and family; and collaborating with other health care professionals to plan and implement the best care for the patient.
To help you perform your role effectively and safely, here are some BEST tips on how to take care of IMV patients:
B – Be vigilant and attentive. Monitor the patient’s vital signs, oxygen saturation, blood gases, chest x-ray, and ventilator settings every hour or as ordered by the physician. Evaluate the patient’s level of sedation, pain, agitation, and delirium. Record and report any changes or abnormalities to the physician immediately. Watch out for signs of complications such as ventilator-associated pneumonia, barotrauma, ventilator-induced lung injury, thromboembolism, and tracheostomy-related problems.
E – Ensure the proper placement and function of the ETT and ventilator every shift or as ordered by the physician. Check the position of the ETT by auscultating the chest and abdomen, measuring the length of the ETT at the teeth or lips, and comparing it with the initial radiograph or ultrasound. Ensure that the ETT is secured with tape or a device to prevent accidental extubation. Check the function of the ventilator by inspecting the tubing, connections, alarms, filters, humidifier, and battery. Ensure that the ventilator settings are appropriate for the patient’s condition and match the physician’s orders. Perform suctioning of the ETT as needed to remove secretions and prevent obstruction.
S – Support the patient’s comfort and communication every shift or as ordered by the physician. Provide oral hygiene, skin care, eye care, and positioning to prevent pressure ulcers and infections. Administer sedatives, analgesics, neuromuscular blockers, or anticoagulants as prescribed by the physician. Use nonverbal cues such as gestures, writing, or pictures to communicate with the patient. Involve the family in the care plan and provide emotional support and education.
T – Team up with other health care professionals every shift or as ordered by the physician. Coordinate with the respiratory therapist, physiotherapist, dietitian, pharmacist, social worker, and other members of the multidisciplinary team to provide holistic care for the patient. Participate in daily rounds and u
