1. Patient-Ventilator System Checks
CHSB Cardiopulmonary Department
Patient-Ventilator System Checks

2. Objective
Upon completion of this course, the participant will be able to:
State the objectives for checking a mechanical ventilator
Describe circumstances in which a ventilator check is indicated
Verbalize contraindications and hazards associated with conducting a ventilator check
Understand the importance of assessing the outcome of a ventilator check

3. Patient-Ventilator System Check
AARC Definition: A patient-ventilator system check is a documented evaluation of a mechanical ventilator and of the patient’s response to mechanical ventilatory support (RCJournal, 1992).

4. Ventilator Check Objectives
To evaluate and document the patient ‘s response to mechanical ventilation at the time of the check
To assure and document the proper operation of the mechanical ventilator
To verify and document that the ventilator is functioning and is properly connected to the patient

5. Ventilator Check Objectives
To verify and document that appropriate alarms are activated
To verify and document that inspired gas is properly heated and humidified
To verify and document that inspired oxygen concentration is measured with every change in FIO2 or, at least, every 24 hours
To verify and document that the ventilator settings comply with physician orders

6. Ventilator check: Indications
A patient-ventilator system check must be performed Q2 hours in the adult and neonatal critical care units and Q4 hours on medical floors and sub-acute areas.
In addition, a check should be performed:
Prior to obtaining blood samples for analysis of blood gases and pH
Prior to obtaining hemodynamic or bedside pulmonary function data
Following any change in ventilator settings
As soon as possible following an acute deterioration of the patient’s condition
Any time that ventilator performance is questionable
Following a patient transport

7. Contraindications
There are no absolute contraindications to performance of a patient- ventilator system check. If disruption of PEEP results in hypoxemia, bradycardia, or hypotension, portions of the check requiring disconnection of the patient from the ventilator may be contraindicated

8. Hazards
Disconnecting the patient from the ventilator during a patient-ventilator system check may result in hypoventilation, hypoxemia, bradycardia, and /or hypotension
Prior to disconnection, preoxygenation and hyperventilation may minimize these complications
When disconnected from the patient, some ventilators generate a high flow through the patient circuit that my aerosolize contaminated condensate, putting both the patient and clinician at risk for nosocomial infection

9. Assessment of Outcome
Routine patient-ventilator system checks should prevent untoward incidents, warn of impending events, and assure that proper ventilator settings, according to physician’s order, are maintained

10. References
RCJournal. (1992). AARC Clinical Practice Guideline: Patient-Ventilator System Checks. Retrieved from Community Hospital of San Bernardino. (2012). Assessment and Documentation of Ventilator Care: Policy Retrieved from \\chsb-nas-002a\usergroups\edu-pol\CHSB - Policies and Procedures\Clinical Services Manual\Cardiopulmonary\ Assessment and Documentation of Ventilator Care.pdf