When pediatric patients require mechanical ventilation in the emergency department, the emergency clinician should be prepared to select initial ventilator settings and respond to an intubated patient?s dynamic physiologic needs to ensure ongoing oxygenation, ventilation, and hemodynamic stability. Pressure-targeted ventilation is generally recommended in pediatric patients, with initial ventilator settings varying depending on age and the etiology of respiratory failure.
Our recent issue Mechanical Ventilation of Pediatric Patients in the Emergency Department reviews indications for mechanical ventilation and offers recommendations for ventilator settings and dosing of analgesics, sedatives, and neuromuscular blockers, with a focus on patient populations in whom the approach to mechanical ventilation may be different.
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Here are a few key points:
- Etiologies of respiratory failure that may indicate the need for mechanical ventilation in pediatric patients, as well as general indications for mechanical ventilation
- Which diagnostic studies should be performed upon initiation of mechanical ventilation
- Conventional modes of mechanical ventilation in pediatric patients, as well as which modes are preferred in infants and children
- Recommendations for initial ventilator settings and ongoing management, including oxygenation goals, ventilation goals, and use of analgesia, sedation, and neuromuscular blockade
Read the full issue and earn 4 CME credits!
Last Updated on January 26, 2023
The correct answer is actually to disconnect and allow patient to exhale. Then you can use BVM while adjusting I:E ratio on vent
disconnecting the patient from the ventilator and bag valve ventilation is OK. I do not understand the Bag-valve-MASk part because this means that the patient has to be detubated, which is not very wise to do.