Ventilation Support

Course Outline

Relationship to High Intensity Daily Personal Activities.

This module supports delivery of ventilator management practice standard.

Where ventilation dependency may be invasive or non-invasive and may involve a tracheostomy. (Refer Tracheostomy Module)

CONTEXT: A support plan for ventilator management has been developed and is overseen by a relevant health practitioner, and each participant is involved in the assessment and development of their support plan.

LEARN ABOUT: Workers will understand the support needs such as: Basic functions and key commonalities that are consistent across ventilation. Set up and operation of ventilation support and the accessory related equipment; what risks to look for and action required to respond to risks, incidents, and emergencies.

LEARN ABOUT: Ventilation and accessory equipment such as Bilevel Positive Airway Pressure (BiPAP), and Continuous Positive Airway Pressure (CPAP) machines, humidifiers, oxygen use, manual ventilation devices (Air-Viva) and airway clearance devices, suctioning, (Tracheostomy Module).

Workers will understand the need to access to appropriate policies and procedures, timely supervision, support, equipment which may include back up ventilator equipment, and consumables required to provide ventilation support.

SCOPE: Workers will understand their limitations, the scope of what they can follow safely and when to escalate the care needs responsibilities, including supervision and delegation arrangements and activities requiring more than one worker. • Roles and responsibilities of others involved in supporting the ventilation needs of the participant this may include, carers, health practitioners, equipment suppliers and other support workers.

TRAINING: In addition to general training in a range of different types of ventilators and ventilation methods, support workers are encouraged to follow the self-assessment tool for reflection and development It may be required by your employer for you to have initial supervised practice, to meet the specific needs of each participant you support including the appropriate use of equipment. (Air-VIVA)

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Nurses and Nursing Education - Ventilation Support

Preparation Skills & Knowledge

Understands the support plan, ventilator settings, alarm meanings and functions can operate and confirms they are correct
Understanding of the participants level of ventilator dependency.
- How do I breathe in?
- How do I breathe out?
- How do I humidify?
Reads the advanced care directive where the participant has one in place.
Checks with the participant on their expectations, capacity, and preferences for being involved in the delivery of support.
Checks with the participant on their preferences for communication, including the use of aids, devices and/or methods.
Communicates with the participant using participant-specific communication strategies, communication aids, devices, or resources.
Prepares for hygiene, infection control. PPE
Safety checks and understands the required equipment and consumables are available and ready for use.
Will check with the participant for any specific factors or adjustments needed at the time support is provided. (Program changes- Day-Night -Physio).
Supports the participant to place and fit the correct mask (Day/Night) as documented in the support plan
Commences and maintains manual ventilation (Air-Viva)as required at correct interface point (Tracheostomy or Mask)
Monitors supply and condition of consumables, non-consumables for routine ventilator use and emergency related consumables, non-consumables and equipment.
Understands troubleshooting procedures to conduct maintenance, including replacement of tubes, and external batteries.
Will follow emergency procedures back-up ventilator, resuscitation bags, oxygen requirements and suctioning equipment.
Actively involves the participant in their support, as outlined in their plan and to the extent they choose.
For workers who support participants with non-invasive ventilation:
- Assists the participant to fit and adjust their breathing mask for noninvasive ventilation.
For workers who support participants with invasive ventilation through a tracheostomy:
- Actively manages invasive ventilation, including monitoring circuits and the need for cuff inflation or deflation. • Supports the participant to clean and maintain healthy condition of the stoma.

Preparation Skills & Knowledge

Basic anatomy of the respiratory system.
Musculoskeletal problems associated with respiration and common conditions that can result in respiratory failure, including condition/s specific for the participant.
Signs and symptoms of respiratory distress for example, drowsiness, reduced alertness, breathing rate, nose flaring, colour changes, wheezing.
Indicators of deteriorating skin condition and techniques to ensure breathing masks are fitted and positioned correctly to minimise discomfort and reduce the risk of pressure sores.
Signs of a healthy stoma and how these can change over time.
Indicators and action required to respond to common health problems at the stoma site, such as wetness or signs of infection or inflammation.
Common indicators to initiate emergency procedures including the use of back up and manual ventilators. For example, loss of electricity or battery failure in the ventilator machine
Reporting responsibilities, including handover, recording observations and incident reporting.

Review of outcomes

Checks with the participant to discuss any changes needed to the ventilation support they are receiving.
Identifies, documents and reports information where a support plan is not meeting a participant’s needs.
Supports the participant to provide feedback and request changes to their support plan as required.

Air Viva

Identify when someone will require ventilation using an Air-Viva
Be able to effectively use an Air-Viva to ventilate someone in a routine and emergency situation.
Maintain emergency equipment to ensure it is always ready for use.
State where an Air-Viva should be located to ensure safety.