Nursing Management of Mechanically Ventilated Patient in ICU

Mechanical Ventilation or Ventilator Patient in ICU:

In medicine, mechanical ventilation is a method of artificial ventilation for the patient where mechanical means is used to assist or replace spontaneous breathing.

Nursing management of mechanical ventilation patient in ICU
Fig: Nursing management of mechanical ventilation patient in ICU

Nursing Care Plan for Mechanical Ventilator Patient in ICU:

Initial Settings of Ventilators in Admitted Patient in ICU:


  • Manual resuscitator and appropriate size mask,
  • Cardiopulmonary monitor,
  • Pulse oximeter,
  • Suction equipment,
  • Intubation equipment,
  • Stethoscope,
  • Oxygen analyzer,
  • Pressure monitor,
  • Volume monitor,
  • Timepiece,
  • Device-specific humidification system,
  • Device-specific patient interface and circuit including water trap system capable of closed, disposal of condensation (when necessary).


  • Assure device readiness for use through evidence of calibration/performance verification.
  • Assess appropriateness of physician’s orders and set ventilator parameters accordingly. Initial settings as well as changes to ventilator parameters must be accompanied by physician’s orders.
  • Ensure proper device function with a test lung.
  • Connect the patient to the device. Assess the patient for tolerance and the patient ventilator system for good coordination and proper function.
  • Set all applicable alarms including alarms for thermal regulation of the humidification system.
  • Perform a thorough assessment of the patient-ventilator system. Document ventilator data as well as cardiopulmonary data Perform repeat patient-ventilator checks as per policy.
  • Monitor the patient continuously via cardiopulmonary monitor and pulse oximetry. Perform arterial pH and blood gas analysis and/or capnometry or transcutaneous monitoring as necessary and per physician order.
  • Make recommendations for changes to the ventilator care plan as appropriate.
  • Perform suctioning and other airway care interventions as clinically indicated to ensure optimal pulmonary management of the patient.
  • Perform routine circuit and related equipment changes as per Section policy and whenever required to restore integrity of the circuit or when the circuit is visually soiled.
  • Ensure that ventilator readiness data are filed according to section policy.

Post procedure:

  • Refer to the operator’s manual and/or procedure for specific cleaning instructions.
  • After appropriate disinfection and reassembly, perform a pre-use functional check according to Section policies.


1. A proper record of ventilator care should include documentation of at least the following every two hours:

  • Ventilator settings comply with physician orders.
  • The ventilator is functioning properly as evidenced by a check of measured volumes, rates, pressures, and Fi02.
  • Alarms are appropriately set.
  • Measured inspired gas temperature.
  • Transcutaneous oxygen saturation (Sp02), carbon dioxide, or end-tidal carbon dioxide values (when available).
  • The signature or initials of the person performing the patient-ventilator system check and the person’s credentials are documented at the time of the check.

2. A proper record of ventilator care should include documentation of the following, at least every twelve hours:

  • Alarms are activated and respond appropriately.
  • The patient’s artificial airway 1s secure and positioned as previously documented.
  • A manual resuscitator and appropriate size mask are available at the bedside.
  • Physician’s orders for ventilator parameters as written are up-to-date.
  • Physical assessment results are documented.

3. A proper record of ventilator care should include documentation of the following as needed:

  • Ventilator circuitry and/or manual resuscitation equipment is changed according to policy or as needed when visibly soiled or leaky.
  • Changes to the ventilator parameters are documented at the time of change, and circled for easy identification.
  • Airway care maneuvers (including suctioning) are documented when performed.

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