This is the commonest form of life support given in hospitals. This is basically a machine used to assist breathing.
When is it Required?
In cases where the patient is not able to breathe himself adequately to meet the body needs of oxygen, a ventilator is needed. This happens when you have some serious lung disease, like end stages of lung emphysema, atelectasis, fibrosis etc.
Or, if the muscles involved in breathing are paralysed or injured. It may also be needed in cases of poisonings, sever allergic reactions involving the airway, overdose of medications or any other condition where breathing is compromised.
How Does a Ventilator Work?
A slender, hypoallergen tube is inserted via your mouth or nose to enter the inner airways. This tube is attached to a machine which pumps air or oxygen rich air, as per the requirement, directly in to the inner airways with a considerable positive pressure.
This air, coming in with considerable pressure, enters the inner airways to inflate the lungs, providing full opportunity of gaseous exchange to place there.
Oxygen is taken in by blood vessels in the lungs and carbon dioxide is given out. Exhalation takes place by itself, due to elastic recoil of the lungs.
For How Long Does a Patient Need it?
Ventilatory support for breathing may be provided till the lungs heal up and take up their function on their own. Usually, this may take a week or so.
Gradual improvement may be visible in 3 to 5 days. The ventilatory support is withdrawn gradually.
Can a Person Speak While On Ventilator?
Usually Not. This is because the tube inserted in his airway passes through the voice box to enter inside the lower portion of his airways. So, the voice box is blocked.
Avoid encouraging the patient to say something while he is on ventilator.
What Gas Do We Give?
It’s usually air, which is humidified, filtered and warm. If some patients, especially those having heavily compromised lungs, require more oxygen concentration in air, they may be given air enhanced with oxygen.
Does it Pain While On Ventilator?
It may. You feel the discomfort of the tube going through your nasal passage down your airways. For the same reason, patients are usually sedated, that is, kept slightly drowsy while they are on this machine.
What Are The Chances of Survival in Such Patients?
This would differ from case to case. A person comes out of the ventilator when his lungs are healed and fit enough to take up their work. This may take 10 to 15 days.
It’s alright for a person to stay for 10 to 15 days on a ventilatory support. However, some may require this device for a month or more. An assessment needs to be made about the overall health and prognosis of the individual.
If all other vital organs of the patient are working well, this respiratory support may be continued.
Complications And Care to be Taken
Alveolar Over Distension
While providing air through the ventilator, a considerable positive pressure is used to push the air inside. Take care to adjust this pressure correctly in accordance with the patient’s age, gender and weight.
Higher than required pressure may rupture the lung alveoli and may result in bleeding inside the lung tissue.
The whole ventilatory apparatus, tubings and the air used need to be maintained clean. Any negligence may instilled infective bugs into the lung tissues and lead to infections.
While on ventilatory support, the patient is usually immobile and lying on bed. He is prone to developing pressure sores over his back, hips or shoulders. Frequent massages over these areas is required to prevent them. You may also use talcum powder to reduce friction.