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vent settings

Discussion in 'Clinical Rotations' started by Joel Fleischman, Mar 24, 2007.

  1. Joel Fleischman

    Joel Fleischman Senior Member 7+ Year Member

    What is the appropriate order to note vent settings in the ICU?
    I have been told..
    Mode/FiO2/RATE/PEEP
    is incorrect
     
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  3. Bertelman

    Bertelman Maverick! 7+ Year Member

    4,197
    9
    Feb 11, 2006
    Had a Cooch
    I'd start with mode, but what you do next often depends on the mode.

    After mode, go with rate or volume, depending on the vent setting.
    ...pressure control, I'd lead with volume then peak pressure then rate
    ...rate/volume control, I'd lead with rate then TV
    ...FiO2 next
    ...then PEEP

    To be quite honest, though, I'd ask the person who told you what you were doing was wrong. Clearly they have certain demands.
     
  4. It depends on the facility....the two most common I've seen:
    For volume ventilation-
    Mode/FiO2/TV/Rate/PEEP

    For pressure ventilation-
    Mode/FiO2/Peak Pressure/Rate/PEEP

    You're best bet is to ask the person that told you were making an error or to ask the RTs on staff at the facility as they would know what is expected.
     
  5. oldbearprofessor

    oldbearprofessor Administrator Rocket Scientist Physician Faculty SDN Advisor 10+ Year Member

    5,942
    773
    Mar 13, 2002
    This is common, but nowadays, we don't set the oxygen in the NICU but have standing weaning orders.

    Sometimes we'll write the pressure as peak/peep as in 25/5, in which case we would write

    "sIMV, 25/5, rate - 40 and 50% Fi02, wean 02 per protocol" type of orders. If on pressure support, this is added after the pressure orders as in "25/5, PS -12, IMV - 30, Fi02 -50%"

    and DKM - we need you on the neo forum, so play nice in your posts on pre-allo so you don't get booted again....
     
  6. It's nice to know I'm needed. :D BTW check the Lounge....I'm trying to learn to be more humble and would appreciate advice.
     
  7. oldbearprofessor

    oldbearprofessor Administrator Rocket Scientist Physician Faculty SDN Advisor 10+ Year Member

    5,942
    773
    Mar 13, 2002
    Post it somewhere else and I'll answer if you're serious. Unmoderated forums on SDN are not my place.
     
  8. JobsFan

    JobsFan 10+ Year Member

    832
    334
    Jan 19, 2005
    australia
    ICU's I've worked at (ex ICU nurse) do it like this ...

    Mode, Rate, Tidal Volume ---- Then FiO2, peep
    SIMV 14 X 550ml ..... 50% O2 and 10cmH2O peep, you could then talk about pressures generated, and ABGs.the first bit effects the patient's CO2, the second bit effects the O2


    if it's a PC mode, it's

    Mode, Rate, PC level above peep.... then .... Fio2 and Peep.... you could then talk about volumes generated, and ABGs

    i cant wait to get back to ICU
     
  9. Adcadet

    Adcadet Long way from Gate 27 10+ Year Member

    Thats how I did it. I wrote my orders to mimic my notes. Maybe it's a regional thing? The attending I mostly worked at come from Colorado.
     

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