Ventilator

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Spinal Cord Injury Ventilator Admission Guidelines

Medical Readiness Guidelines

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In addition to a patient’s medical clearance, it is important that the following are in place:

  • Patient has the potential to participate in three hours of therapy a day
  • Minimal returns for outpatient visits and diagnostic testing during rehabilitation stay
  • Appropriate physician follow-up plan is in place for after discharge from acute rehab facility
  • Patient must meet preadmission respiratory criteria
  • Patient must have two caregivers identified

Medical Status

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Medical work-up to be complete and with treatment plan agreed upon by primary and consulting services.

Respiratory

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  • Vent patients are required to be on stable settings for 72 hours prior to transfer
  • Must have stable respiratory status to allow for 3 hours of therapy per day
  • Suctioning needed at a maximum frequency of every 4 hours
  • Trach guidelines:
    • If new, first trach change must occur more than 24 hours prior to arrival
    • Any trach change of size or type should occur at least 24 hours prior to arrival
  • Respiratory treatments are a max of every 4 hours
  • Peep must be less than 8 cm H20 unless required for leak speech
  • FiO2 less than or equal to 40%
  • Ventilator Modes used for Rehabilitation: AC/PC; AC/VC; SIMV/VC; SIMV (PC/PS) with a rate

Medications

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  • PO/enteral/SQ only
  • Generally no IV push meds, except IV antibiotics
  • DVT Prophylaxis/anticoagulation plan established

Diet

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  • PO diet or able to tolerate tube feeding to provide caloric and fluid requirements
  • PEG tubes are preferred
  • TPN patients need to be on a stable solution, cycled at night with a plan for discharge to home on TPN

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These are guidelines. For more information, please speak with your Shirley Ryan 汤头条app liaison or consulting physician.

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