Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/263
Title: Use of invasive mechanical ventilation in Australian emergency departments.
Authors: Rose, Louise
Gerdtz, Marie F.
Issue Date: 2009
Publisher: Wiley
Place of publication: Australia
Publication Title: Emergency Medicine Australasia
Volume: 21
Issue: 2
Start Page: 108
End Page: 116
Abstract: Objective: There are few published reports describing the use of invasive mechanical ventilation in EDs. We explored the characteristics of patients receiving mechanical ventilation, the ventilator modes and parameters used as well as the duration of ventilation and the nature of ventilator decision-making in Australian ED. Methods: We conducted a 2 month prospective survey of adult patients who received invasive mechanical ventilation in 24 Australian ED. Data forms were completed by ED staff during the patient's ED presentation. We documented ventilator settings post intubation, after a 1 h stabilization period, and immediately before ED discharge or extubation. The person responsible for selection of ventilator settings was noted at each time point. Results: Data were recorded on 307 patients. Altered mental status (179/307 [58%, 95% CI 53–64]) was the most common indication for mechanical ventilation. Volume-controlled modes were most frequently used at all measured time points; with a median tidal volume of 8 mL/kg. Responsibility for initial selection of ventilator settings was shared between ED physicians (157/307 [51%, 95% CI 46–57]), ED nurses (111/307 [36%, 95% CI 31–42]) and ICU or paramedic staff (9/307 [3%, 95% CI 1–5]) (not recorded 30/307 [10%, 95% CI 6–13]). Ongoing responsibility for titration of ventilation was more commonly that of the ED nurse. Conclusion: The application of mechanical ventilation was similar to descriptions reported in the critical care literature both in Australia and internationally. Decision-making responsibilities were shared by ED medical and nursing staff. This was based upon research undertaken at Ballarat Health Services.
URI: http://hdl.handle.net/11054/263
Resource Link: http://onlinelibrary.wiley.com/doi/10.1111/j.1742-6723.2009.01167.x/abstract
ISSN: 1742-6731
Internal ID Number: 00253
Health Subject: EMERGENCY DEPARTMENT
EMERGENCY MEDICINE
MECHANICAL VENTILATION
RESPIRATORY
CASE STUDY
ACUTE RESPIRATORY FAILURE
ARTIFICIAL RESPIRATION
OUTCOME
RESPIRATION
Type: Journal Article
Article
Appears in Collections:Research Output

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