Introduction
Mechanical ventilation is indicated for numerous
clinical and physiological reasons. The nursing
management of the mechanically ventilated
patient is challenging on many levels: from the
acquisition of highly technical skills; expert knowledge
on invasive monitoring; and implementation
of interventions to care for the patient. Each
critically ill patient brings the clinical rationale for
mechanical ventilation and additional complexities
associated with their illness. It is recognised that
the reason for mechanical ventilation and patient
admission impacts on patient assessment and management.
However, there are core evidence-based
collaborative principles which underpin the nursing
management of such patients in the intensive care
unit (ICU), those being patient safety: patient
and equipment assessment; and patient comfort:
patient position; hygiene; management of stressors
and; pain and sedation management.
To identify the evidence supporting practice a
thorough review of current literature was undertaken
using the following steps: electronic search
conducted of MEDLINE, CINAHL, EMBASE and PsychReview
databases for articles published between
1995 and 2006 and; key words used were mechanical
ventilation, patient assessment, airway management,
sedation and comfort.
Many confounding variables exist in the care of
the critically ill mechanically ventilated patient in
the ICU. Consequently not all practice may be supported
by evidence. As evidence-based literature
addressing the overarching care of the mechanically
ventilated patient is scant, for the purpose of
this paper common practice is supported by expert
IntroductionMechanical ventilation is indicated for numerousclinical and physiological reasons. The nursingmanagement of the mechanically ventilatedpatient is challenging on many levels: from theacquisition of highly technical skills; expert knowledgeon invasive monitoring; and implementationof interventions to care for the patient. Eachcritically ill patient brings the clinical rationale formechanical ventilation and additional complexitiesassociated with their illness. It is recognised thatthe reason for mechanical ventilation and patientadmission impacts on patient assessment and management.However, there are core evidence-basedcollaborative principles which underpin the nursingmanagement of such patients in the intensive careunit (ICU), those being patient safety: patientand equipment assessment; and patient comfort:patient position; hygiene; management of stressorsand; pain and sedation management.To identify the evidence supporting practice athorough review of current literature was undertakenusing the following steps: electronic searchconducted of MEDLINE, CINAHL, EMBASE and PsychReviewdatabases for articles published between1995 and 2006 and; key words used were mechanicalventilation, patient assessment, airway management,sedation and comfort.Many confounding variables exist in the care ofthe critically ill mechanically ventilated patient inthe ICU. Consequently not all practice may be supportedby evidence. As evidence-based literatureaddressing the overarching care of the mechanicallyventilated patient is scant, for the purpose ofthis paper common practice is supported by expert
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