ABSTRACT
La Ventilación de Alta Frecuencia Oscilatoria (VAFO) es una modalidadde ventilación mecánica invasiva utilizada principalmente como técnicade rescate, que consiste en emplear volúmenes tidales muy pequeñosa frecuencias suprafisiológicas, con una espiración activa. La VAFOes una técnica sencilla y segura que mejora la oxigenación y la ventilacióncuando la ventilación mecánica convencional fracasa, por lo que seemplea fundamentalmente como técnica de rescate.El incremento en la utilización de esta técnica de ventilación en las unidadesde cuidados intensivos requiere que los profesionales de Enfermeríaestén familiarizados con su manejo y se sientan seguros del cuidado quetienen que proporcionar a los pacientes.El propósito de este trabajo es contribuir al conocimiento enfermero dela VAFO, describiendo en qué consiste, cuándo está indicado su uso y loscuidados enfermeros relacionados con su utilización, así como con la detecciónprecoz y prevención de las posibles complicaciones, que fueronconsensuados en nuestra unidad para la elaboración de un protocolo.La elaboración de un protocolo permite unificar criterios de actuación,optimizar el proceso de atención enfermera y disminuir el estrés de losprofesionales (AU)
High Frequency Oscillatory Ventilation (HFOV) is an invasive mechanicalventilation modality which is used primarily as a rescue techniqueand consists of employing very small tidal volumes at supraphysiologicalfrequencies, with active expiration. HFOV is a safe and simple techniquethat improves oxygenation and ventilation when conventional mechanicalventilation fails, which is why it is used mainly as a rescuetechnique.The increased use of this ventilation technique in intensive care unitsrequires that nursing professionals be familiarised with its managementand feel confident with the care they must provide to patients.The aim of this work is to contribute to nursing HFOV knowledge, by describingwhat this technique consists of, when it is indicated and the nursingcare related with is use, as well as with early detection and preventionof possible complications, which were agreed upon in our unitfor the development of a corresponding protocol.The development of a protocol enables the unification of interventioncriteria, the optimisation of the nursing care process and stress reductionin professionals (AU)
Subject(s)
Humans , High-Frequency Ventilation/methods , High-Frequency Ventilation/nursingABSTRACT
OBJECTIVES: To review the specific nursing and infection-control issues that arise during the care of patients receiving high-frequency oscillatory ventilation (HFOV). DATA SOURCE: Published articles, governmental guidelines, and hospital procedures and practices. DATA SUMMARY: Nurses, respiratory therapists, and other clinicians caring for patients receiving HFOV need to be aware of specific differences in patient assessment, including close observation for symmetric chest-wall vibrations. In addition, management of sedation with or without neuromuscular blockade and effective communication with the patients are essential nursing skills needed with the use of HFOV. From an infection-control standpoint, HFOV is considered a high-risk respiratory procedure because of the inability to effectively filter all respiratory secretions. Appropriate infection-control precautions, including patient location and use of personal protective equipment, need to be considered when implementing HFOV in the intensive care unit. CONCLUSIONS: Important infection-control and nursing issues exist that are specific to the use of HFOV. These issues should be addressed with appropriate staff education before the implementation of HFOV in an intensive care unit.
Subject(s)
High-Frequency Ventilation/nursing , Infection Control/methods , Humans , Intensive Care Units , Respiratory Distress Syndrome/therapyABSTRACT
La ventilación de alta frecuencia oscilatoria (VAFO) constituye un avance significativo en el manejo de niños con patología respiratoria crítica, y sus indicaciones y el rango de edad de aplicación son más amplios cada día. Las peculiaridades de los cuidados de enfermería en este grupo de pacientes críticos, esenciales de cara al éxito de la técnica, son aún más complejas si tenemos en cuenta que la experiencia con VAFO en nuestro país es escasa y limitada a pacientes neonatales, y que apenas existe literatura al respecto. Revisamos los aspectos teóricos fundamentales de la VAFO, presentamos nuestra experiencia preliminar, problemas detectados y secuencias de actuación asociadas, y el protocolo de cuidados de enfermería establecido en nuestra Unidad para pacientes entre 1 mes y 18 años sometidos a esta técnica (AU)
Subject(s)
Adolescent , Female , Child, Preschool , Infant , Male , Child , Humans , High-Frequency Ventilation/nursing , Nursing Care/methods , Respiratory Tract Diseases/nursing , Critical Care/methods , High-Frequency Ventilation/adverse effects , Patient SelectionABSTRACT
El artículo describe una modalidad de asistencia respiratoria mecánica utilizada en recién nacidos y niños con afecciones clínicas respiratorias introduciendo el uso del óxido nítrico (ON). Explica los cuidados de enfermería correspondientes y ofrece una breve referencia a las características de ON
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Nitric Oxide/therapeutic use , High-Frequency Ventilation/nursing , Nursing Care/standards , Nitric Oxide/administration & dosage , High-Frequency Ventilation/classification , High-Frequency VentilationABSTRACT
El artículo describe una modalidad de asistencia respiratoria mecánica utilizada en recién nacidos y niños con afecciones clínicas respiratorias introduciendo el uso del óxido nítrico (ON). Explica los cuidados de enfermería correspondientes y ofrece una breve referencia a las características de ON (AU)
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , High-Frequency Ventilation/nursing , Nitric Oxide/therapeutic use , High-Frequency Ventilation/classification , High-Frequency Ventilation/statistics & numerical data , Nitric Oxide/administration & dosage , Nursing Care/standardsSubject(s)
Critical Care/methods , High-Frequency Ventilation/nursing , Pediatric Nursing/methods , Child , HumansABSTRACT
This reflection on practice is written by two members of a primary nurse team at the Chelsea and Westminster intensive care unit (ICU)/nursing development unit (NDU). Johns's (1993) tool for structured guided reflection was used to reflect on the care of an ICU patient given by her primary and associate nurse. The issues highlighted include: The importance of knowing your patient through a primary nursing approach. Collaboration between the primary nursing team and the anaesthetists. Negotiation between the patient, her family and the primary nursing team. Empowerment of the patient to express her view.
Subject(s)
Critical Care/methods , High-Frequency Ventilation/nursing , Primary Nursing/methods , Aged , Cooperative Behavior , Female , Humans , Patient Advocacy , Patient Care Team/organization & administration , Power, Psychological , Terminal Care/methodsABSTRACT
The introduction of high-frequency oscillatory ventilation (HFOV) to the intensive care nursery has stimulated us to develop infant care protocols for babies so treated. We identified specific areas unique to the SensorMedics HFOV and initiated nursing techniques to address each of the following areas: assessment, airway care, feedings, positioning, and safety. In summary, while on HFOV, an infant's assessment and care need not be minimized.
Subject(s)
High-Frequency Ventilation/nursing , Neonatal Nursing/methods , Patient Care Planning , Clinical Protocols , High-Frequency Ventilation/adverse effects , High-Frequency Ventilation/instrumentation , High-Frequency Ventilation/methods , Humans , Infant, NewbornABSTRACT
High frequency oscillatory ventilation is a new mode of ventilatory support of acute respiratory failure in the pediatric population. Delineating the nursing care required of this fragile group of infants and children is challenging, because there is a paucity of published data and national clinical experience. The author reviews a management plan that was used to guide the care of over 40 patients, ranging in age from 1 months to 24 years, with acute respiratory failure supported on high frequency oscillatory ventilation. In total, seven patient-care problems and associated interventions are delineated.