Page 66 - Norco Patient Orientation Handbook e-book
P. 66
Discuss potential side effects: Hyper/hypoventilation, cardiac arrhythmias, bradycardia, impaired cardiac
output, barotrauma, etc.
Review settings as prescribed by physician.
Note: Only a qualified Norco clinician or health care professional should alter ventilator parameters.
Explain the purpose of the backup ventilator. Have the back up vent charged and ready for use at all times.
Demonstration
Plug ventilator/BiPAP S/T into properly grounded outlet. Do not use an extension cord.
Define ventilator/BiPAP S/T controls and settings (i.e., IPAP, EPAP, tidal volume, respiratory rate, PEEP,
sensitivity, flow, I:E ratio, ventilator mode).
Review alarms and alerts (i.e., high/low pressure, apnea backup low minute ventilation, etc.)
Note: Never disable alarms and alerts. If oxygen is used, follow safety guidelines for oxygen in the
handbook. (See Norco clinician for proper oxygen placement into circuit). Bleed in oxygen with adapter
attached proximal to the equipment interface.
Ensure that backup oxygen is in place to maintain patient for at least six hours.
Discuss external monitors: Oximetry (recommended) for ventilator patients.
Explain ventilator internal and external battery times: Patient should have at least six hours of battery
backup.
Explain ventilator/BiPAP S/T circuit assembly: Trach adaptors, exhalation valve line, PAP line, PEEP,
volume, breathing filter, etc.
Review humidifier controls and accessories.
Educate patient on the signs and symptoms of infection. Tell patient to contact their physician if they
experience symptoms of infection or respiratory distress.
Discuss the purpose of emergency bag/mask ventilation. Have enough oxygen available for six hours of
backup. Ensure that an ambu-bag is in place and functional to run on 10-15lpm of oxygen.
Explain monthly clinician follow up.
Caregiver should receive training on CPR.
Cleaning/Maintenance/Troubleshooting
For BiPAP S/T circuits, follow the cleaning procedure listed under CPAP/BiPAP S in this handbook.
For ventilator patients, change circuit, in-line suction catheter, humidification chamber and air outlet filter
Bi-monthly, or more frequently depending upon circuit type. Discuss common causes of ventilator-
associated pneumonia (VAP- see education sheet).
If needed, wipe down the exterior of the ventilator/BiPAP S/T with damp, soapy cloth and wipe with a clean
dry cloth.
Change BiPAP disposable filters monthly. Wash the gray ventilator intake filters monthly by hand in warm
soapy water (antibacterial liquid soap). Rinse well and let air-dry.
If using humidification on ventilator/BiPAP S/T clean the chamber weekly. (Soak humidifier chambers in
a 1:3 white vinegar and water solution daily for 20 minutes.) If using a disposal humidification chamber,
change weekly.
If ventilator fails, go to backup.
If tracheostomy tube accidentally comes out (decannulation), go to backup tracheostomy tube.
In case of emergency, dial 911.
Explain common causes for high/low pressure alarms: 1) Disconnect, 2) Occluded trach, 3) Occluded
circuit, 4) Changes in resistance/compliance.
Functional check schedule: Performed monthly.
Preventive Maintenance Schedule: Performed every 10,000 hours.
