Mechanical Ventilation Initiation Orders

PLACE LABEL HERE MECHANICAL VENTILATION INITIATION ORDERS

The following orders will be implemented. Orders with a “” are choices and are NOT implemented unless checked. Initial all handwritten order modifications and the bottom of each page when indicated (multipage).

1. Calculate Ideal Body Weight:______kg Male IBW = 50 + 2.3 (height in inches – 60) Female IBW = 45.5 + 2.3 (height in inches – 60) 2. Use checked mode and settings:  CMV  SIMV  Pressure Control VT: 6-8 ml/kg VT: 6-8 ml/kg Exhaled VT: 4-6 ml/kg Rate: 10-16 BPM Rate: 10-16 BPM Rate: 16-25 BPM PEEP: +5 cm H2O PEEP: +5 cm H2O PEEP: +5 cm H2O FiO2: Keep Sat > 90% FiO2: Keep Sat > 90% FiO2: Keep Sat > 90% PS: 10 cm H2O PIP: 30 cm H2O I:E Ratio: 1:1

 Use these settings: Mode ____ VT ______Rate_____ FiO2 _____ PEEP_____ Pressure Support_____  Additional vent settings: ______3. ABGs: 30 min or after set up and notify physician

4. Adjust ventilator settings to maintain: pH 7.35 – 7.45 PaCO2 35 – 45 mmHg SpO2 ≥ 90 OR: pH ______PaCO2 ______SpO2 ______5. Aerosolized medication delivery:  MDI w/(drug) ______(dose) ______puffs (frequency) ______ MDI w/(drug) ______(dose) ______puffs (frequency) ______ MDI w/(drug) ______(dose) ______puffs (frequency) ______ Other: ______6. Chest x-ray for tube placement if not previously done 7.  Mechanical Ventilation Weaning Policy # 7504-10-04-04 when patient meets criteria MODE:  Tube compensation  CPAP  Other: ______ Pressure support plus CPAP DURATION:  30 min  2 hrs  Other: ______8. Head of bed at 30o unless otherwise specified 9.  Obtain a Sputum C & S 10. Sputum C & S on all Pneumonia or Suspected Pneumonia 11. Peridex (chlorhexidine) oral rinse 15 ml po BID, if not already ordered.

ADDITIONAL ORDERS: ______

______Date Time Physician Signature PID Number Copy to pharmacy

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