By Consortium for Spinal Cord Medicine
Medical perform advisor traces thatwould meet the desires of someone with contemporary onset spinal twine harm who's in resp misery. This rfile represents the easiest ideas that the Consortium for Spinal twine medication may provide given the supply of medical facts.
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Extra info for Spinal Cord Medicine Respiratory Management Following Spinal Cord Injury: Clinical Practice Guidline for Health-Care Professionals
Sample text
Chest x-ray. b. FVC. c. Sputum culture within 2 hours if admitted. d. ABGs after 1 hour of being placed on bedside ventilator. 2. VT—set per previous hospital setting. 3. RR—12. 4. Sigh—200–500cc greater than the VT with rate of 8x2 per hr. Sigh volume not to exceed 2200cc. 5. Flowrate—70 lpm. 6. Titrate O2 to maintain saturation greater than 92%. 7. PEEP—same as previous hospital setting. II. Limits to be used within ventilator protocol. A. Peak pressures not to exceed 40cm/H2O. 1. If peak pressure increases to a maximum of 40cm/H2O with any tidal volume or peak flow change, go back to previous settings and notify the physician.
Backup generator and alarms) and assistive technology as part of a safe and effective environment. (Scientific evidence–V; Grade of recommendation–C; Strength of panel opinion–Strong) A carefully prescribed power wheelchair allows for patient mobility, independent weight shifts, and portable ventilation. , suction, oxygen, IV therapy, nutritional therapy). An electric hospital bed with adjustments and appropriate overlay or mattress, a reclining padded commode chair for toileting and showering, a mechanical power lift for safe transfers, and a backup manual wheelchair are all necessary equipment (Consortium for Spinal Cord Medicine, Clinical Practice Guideline: Outcomes Following Spinal Cord Injury (1999).
D. SaO2 <92% with an FiO2 increase of 20 TORR higher than ordered. E. FVC <1/2 of documented patient baseline. F. Marked increase in spasms, diaphoresis, or change in mental status. F. NIF—negative inspiratory force. G. V—minute ventilation. III. All weans of 5 minutes or less are required to have at least 1 set of parameters (FVC, NIF). IV. All weans of greater than 5 minutes are required to have pre- and post-FVCs and if patient is able, NIFs as tolerated. V. RCPs are to stop each wean if wean discontinuation criteria are met and may totally discontinue weans if problems continue for three consecutive times.
