Patient safety
A useful strategy for promoting the safety of the mechanically ventilated patient is to utilise a health assessment framework. The Emergency Care Cycle is one health assessment framework that facilitates a systematic and comprehensive approach to patient assessment. This framework has two components: the Primary survey (see Table 1) which identifies immediate life-threatening events, and the Secondary survey (see Table 2) which often utilises a head-to-toe systems approach to assess the functional status of each body system (Nettina, 2006). The safety considerations in the care of the mechanically ventilated patient will be discussed
utilising this framework (Fig. 1). Some overall patient safety considerations are worth noting first. Patients receiving mechanical ventilation in ICU require continuous observation and monitoring. For this reason a nurse/patient ratio of 1:1 is recommended (ACCCN, 2005). This ensures that the patient can be closely monitored and that response to any alarms can be rapid (Winters and Munro, 2004). Promoting safety for the ventilated patient also involves ensuring emergency equipment (see Table 3) is available in the event of accidental extubation or ventilator failure (Yeh et al., 2004). Routine safety measures utilised when caring for any critically ill patient should also be applied. These include checking intravenous infusions; checking patient equipment and alarm settings; ensuring the correct attachment of monitoring devices and appropriateness of alarm settings.