MIAMI DADE COLLEGE
MEDICAL CENTER CAMPUS
SCHOOL OF HEALTH SCIENCES
RESPIRATORY CARE PROGRAM
COURSE OUTLINE
RET 2284L – PRINCIPLES OF MECHANICAL VENTILATION LABORATORY
COURSE DESCRIPTION:
Laboratory for RET 2284. This course is designed to provide training in the practical
application and skills associated with critical care procedures and mechanical ventilation
utilized in respiratory care.
Instructor:
Office:
Phone:
Class Day/Time:
Office Hours:
E-Mail:
REQUIRED TEXTBOOKS/SUPPLIES:
1. Wilkins, Egan’s Fundamentals of Respiratory Care, 9th edition
Mosby publ., ISBN: 0-323-01813-0
2. Oakes, D.F. & Shortall, S.P. (2009). Ventilator Management: A Bedside
Reference Guide. Health Educator Publications, Inc.
3. Pilbeam, S.P. & Cairo, J.M. (2006). Mechanical Ventilation: Physiological &
Clinical Applications, 4th edition. Mosby.
4. Pilbeam, S.P. & Cairo, J.M. (2006). Mechanical Ventilation: Physiological &
Clinical Applications Workbook, 4th edition. Mosby
Be sure to purchase the MOST recent edition available for each text. All required texts are
available in the Campus Bookstore.
Students with documented disabilities should contact the campus ACCESS office in advance for
information on appropriate policies and procedures for obtaining assistance. No retroactive
accommodations can be provided. The ACCESS office is located in room # 1345-1 at 305 2374048. Additional information can be obtained at
http://www.mdc.edu/medical/studentservices/access
Any changes to this syllabus, the class schedule, testing, assignments, etc., will be
communicated via e-mail or posted on the instructor’s webpage - it is each student’s
responsibility to monitor these regularly.
RET 2284L – PRINCIPLES OF MECHANICAL VENTILATION LABORATORY
Miami Dade College Learning Outcomes
Miami Dade College has adopted the General Education Outcomes listed below. Upon
completion of a program of study at the Medical Center Campus, graduates from Miami
Dade College should emulate these outcomes.
1.
Communicate effectively using listening, speaking, reading and writing skills.
2.
Use quantitative analytical skills to evaluate and process numerical data.
3.
Solve problems using critical and creative thinking and scientific reasoning.
4.
Formulate strategies to locate, evaluate, and apply information.
5.
Demonstrate knowledge of diverse cultures, including global and historical
perspectives.
6.
Create strategies that can be used to fulfill personal, civic, and social
responsibilities.
7.
Demonstrate knowledge of ethical thinking and its application to issues in
society.
8.
Use computer and emerging technologies effectively.
9.
Demonstrate an appreciation for aesthetics and creative activities.
10.
Describe how natural systems function and recognize the impact of humans on
the environment.
This course provides intentional learning experiences to address outcomes (I, 2, 3, 4, 6
and 8).
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RET 2284L – PRINCIPLES OF MECHANICAL VENTILATION LABORATORY
SPECIFIC COURSE OBJECTIVES:
1.
The course work will be divided into modules, with specific objectives for each
module.
2.
You will be responsible for completing all module assignments, lab activities,
competencies, and practicum exams in order to satisfy all course objectives.
3.
Practicum exams will be given following the completion of each module, as well
as at any time the instructor deems appropriate.
It is the student’s responsibility to be present for all scheduled examinations.
Students who are absent for exams, but provide suitable justification and
documentation (physician’s note or other appropriate evidence), will be allowed
to take a makeup exam at full credit. If the absence is unexcused, or adequate
documentation is not provided, the student may make up the exam but will not
receive a grade higher than 80% C. Makeup exams must be scheduled by the
student and will be given at the convenience of the instructor. The format of any
make-up exam is at the discretion of the instructor, cf. Respiratory Care Program
Policies and Procedures, Section Three: Assignments and Tests, #3.
5.
The final grade will be computed based on the following:
I. Practica / Exams
100%
GRADING SCALE
A = 100 - 94
B = 93 - 87
C = 86 - 80
-----------------------D = 79 - 73
F = 72 - below
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RET 2284L – PRINCIPLES OF MECHANICAL VENTILATION LABORATORY
TABLE OF CONTENTS - MODULE
MODULE 1.0 – NON-INVASIVE POSITIVE PRESSURE VENTILATION (NPPV)
MODULE 2.0 – INITIATING MECHANICAL VENTILATION
MODULE 3.0 – MANAGEMENT OF MECHANICAL VENTILATION
MODULE 4.0 – VENTILATIOR DISCONTINUATION
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RET 2284L – PRINCIPLES OF MECHANICAL VENTILATION LABORATORY
MODULE 1.0 – NONINVASIVE POSITIVE PRESSURE VENTILATION (NPPV)
General Objective:
Upon completion of this module, the student will demonstrate procedures for initiating
noninvasive positive pressure ventilation.
Specific Objectives:
1.1
Gather and assemble the equipment needed to initiate NPPV (ventilator, circuit,
humidification device, and patient adjunct)
1.2
Perform an Operation Verification Procedure (OVP) to verify the functionality of
the ventilator and the integrity of the breathing circuit (commonly referred to as
“system leak test.”
1.3
Identify and manipulate all controls and alarms on the ventilator
1.4
Apply the appropriate initial settings and alarms, e.g., IPAP, EPAP, FiO 2, backup
rate, high/low pressure alarms, etc.
1.5
Select and fit the patient with the appropriate type/size interface (nasal or fullface mask)
1.6
Initiate NPPV and evaluate the effectiveness of ventilation via ventilator/patient
synchrony, VT, system leak, vital signs, breath sounds, SpO2, and arterial blood
gases (ABG)
1.7
Troubleshoot system malfunctions, e.g., circuit leak, poorly fitted patient
interface, etc.
1.8
Adjust settings to correct oxygenation/ventilation abnormalities
1.9
Record relevant data in the medical record and communicate pertinent
information regarding the patient’s clinical status to the appropriate members of
the health care team
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RET 2284L – PRINCIPLES OF MECHANICAL VENTILATION LABORATORY
MODULE 2.0 – INITIATING MECHANICAL VENTILATION
General Objective:
Upon completion of this module, the student will demonstrate procedures for initiating
mechanical ventilation.
Specific Objectives:
2.1
Identify the controls, alarms, and monitors on various brands and types of
mechanical ventilators
2.2
Gather and assemble the equipment needed to initiate mechanical ventilation
(ventilator, circuit, humidification device, etc.)
2.3
Perform an Operation Verification Procedure (OVP) to verify the functionality of
the ventilator and the integrity of the breathing circuit (commonly referred to as
“system leak test”)
2.4
Using “ideal body weight” and patient diagnosis, be able to calculate and
implement initial ventilator settings in various ventilator modes
2.5
Initiate mechanical ventilation and evaluate its effectiveness
2.6
Appropriately set monitoring alarms
2.7
Adjust ventilator settings to correct oxygenation/ventilation abnormalities
2.8
Troubleshoot system malfunctions
2.9
Record relevant data in the medical record and communicate pertinent
information regarding the patient’s clinical status to the appropriate members of
the health care team
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RET 2284L – PRINCIPLES OF MECHANICAL VENTILATION LABORATORY
MODULE 3.0 – MANAGEMENT OF MECHANICAL VENTILATION
General Objective:
Upon completion of this module, the student will demonstrate the ability to perform a
patient – ventilator systems check
Specific Objectives:
3.1
Be able to identify and discuss data in the patient’s medical record that would be
clinically pertinent to the care of the patient on mechanical ventilation
3.2
Be able to perform an appropriate physical assessment:
a. Sensorium
b. Vital signs, EKG, SpO2, ETCO2, breath sounds
c. Determine need for tracheal suctioning and perform if necessary
d. Physical examination of the thorax and extremities
e. Evaluation of urine input/output
3.3
Be able to assess and adjust cuff pressure/volume
3.4
Be able to perform humidifier maintenance
3.5
Be able to evaluate and record mechanical and spontaneous respiratory rates,
volumes and pressures
3.6
Be able to analyze and interpret waveforms
3.7
Be able to calculate and evaluate dynamic compliance (CD), static compliance
(CS), and airway resistance (Raw)
3.8
Be able to detect and measure auto-PEEP and recommend and / or implement
strategies to correct
3.9
Be able to administer bronchodilators to a mechanically ventilated patient via
SVN or MDI
3.10
Be able to change ventilator circuit for a mechanically ventilated patient
3.11
Record relevant data in the medical record and communicate pertinent
information regarding the patient’s clinical status to the appropriate members of
the health care team
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RET 2284L – PRINCIPLES OF MECHANICAL VENTILATION LABORATORY
MODULE 4.0 – VENTILATIOR DISCONTINUATION
General Objective:
Upon completion of this module, the student will demonstrate an understanding of the
procedures and techniques related to the discontinuation of a mechanical ventilator
Specific Objectives:
4.1
Be able to discuss data identified in the patient’s chart that would be clinically
pertinent to considering ventilator discontinuation
4.2
Be able to gather and assemble the equipment needed to measure spontaneous
breathing parameters (minute ventilation, respiratory rate, V T, maximum
inspiratory pressure [MIP])
4.3
Be able to measure spontaneous breathing parameters on a mechanically
ventilated patient and calculate a rapid, shallow, breathing index (RSBI)
4.4
Be able to discuss the patient’s potential for successful ventilator discontinuation
based on spontaneous breathing parameters, RSBI, and other clinical and
laboratory findings, e.g., chest radiograph, complete blood count (CBC),
electrolytes, etc.
4.5
Be able to discuss and implement strategies to begin ventilator discontinuation,
e.g., spontaneous breathing trial (SBT), SIMV, pressure support ventilation (PSV)
4.6
Be able to determine if ventilator discontinuation strategies are successful or not
4.7
Be able to discuss strategies to implement should ventilator discontinuation fail
4.8
Be able to gather the necessary equipment for extubation
4.9
Be able to perform extubation
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