All Posts Tagged: Recovery

The Importance of Ventilator Weaning in Recovery

There’s no question that mechanical ventilation has saved countless lives. It provides life-sustaining oxygen for patients who can’t breathe on their own – but weaning them off of a ventilator is a challenging task that requires a variety of skills, technologies, and teamwork.

Hospitals today are developing more effective weaning protocols while ventilator manufacturers are creating improved technology that helps better reach the goal of restoring full breathing function in patients whenever it’s possible. Here’s a look at the many factors that emphasize the importance, and challenge, of ventilator weaning.

The Challenges of Ventilator Weaning

Sedation is a fact of life for most patients on long-term ventilation, but sedation can prolong dependence on the ventilator, as well as impact cognitive functioning. Some doctors suggest using non-sedating medications, which allow for earlier weaning. The impact of heavy sedation includes not only cognitive effects, but also can result in long-term neurologic issues, and even post-traumatic stress disorder.

One of the challenges with sedation, however, is that it can affect every patient differently. Research has shown that patients who are typically calm in normal life will most likely remain calm on a ventilator, while patients who struggle with issues such as drugs, alcohol or anxiety issues can have more problems while on ventilation.

Another factor that has been shown to help hasten weaning is mobility. Hospitals that stress early mobilization programs for patients on ventilators have seen good results. It’s healthy for both the mind and body; in fact, the muscles in the diaphragm weaken because they don’t have to do any of their normal work during ventilation. Moreover, all of the muscles can weaken because they’re used much less than they were prior to the patient’s illness, and combined with sedation can result in weakness after just four or five days on a ventilator.

Enhanced Technology

The scientific community has made great strides in the past decade in terms of developing technology that prevents or limits complications associated with mechanical ventilation. Additionally, both safety and workflow have been improved to help enhance the ICU environment.

Additional improvements, such as the addition of microprocessor control and electronic medical record systems, have helped advance technology, as well. In general, devices today are more sensitive to patient interaction while capturing important patient clinical data. And having ventilator data remotely available provides access to clinicians with the necessary tools to make important decisions – whether they’re at the patient’s bedside or not.

The Importance of Teamwork

The process of successfully weaning a patient off of a ventilator is best served by a team approach that includes respiratory therapists, nurses, physicians, physical therapists and other clinicians. It’s important that all parties involved stick with protocols that may have been established by the respiratory therapist. Protocols also need to be reviewed periodically and compared with hospitals of similar size.

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Why Wound Care is a Critical Part of Recovery

To say wound care has been around a long time is an understatement. It can, in fact, be traced back to the earliest civilizations, and the ancient Greeks were among the first to stress the importance of wound healing.

Wound care has obviously come a long way since then, and it’s importance in the role of recovery cannot be stressed enough. Here’s a look at why would care plays such a vital role in the recovery process:

Wound Care: The Basics

There are two ways that wounds heal: regeneration or scar formation. During regeneration, tissue that has been damaged is replaced by tissue of the same type. This preserves the proper function of the area of the body that has been injured. In scar formation, the damaged tissue is replaced by fibrous scar tissue which doesn’t have the same properties as the original tissue.

The Importance of Wound Care in Recovery

Proper wound care prevents infection and other complications, and also helps speed up the healing process with less scarring.

 

  • Preventing Infection
    By keeping continual attention on the wound dressings and bandages the risk for infection and other complications is greatly decreased. A health professional can make medically-important decisions through changing the dressings, noting the wound’s progress, as well as by making observations of bleeding, temperature, discharge and smell. In general, wounds should be cleaned once a day with disinfectant specific to wound care, clean water or saline, as well as applying clean dressings.

  • Speeds Healing
    A potentially dangerous myth is that wounds heal faster if left uncovered, which simply isn’t true. Covering the wound throughout the healing process actually hastens the healing process. Moreover, properly maintained bandaging provides additional protection against infection.

  • Minimizes Scarring
    Keeping the wound soft through the healing process helps to minimize scars while not allowing hard scabs to form. Antibiotic ointments – and other treatment options recommended by your physician – applied during the early stages of healing will keep the skin around the wound soft and pliable.

 

Once the wound has healed enough that there’s no risk of infection, antibiotic ointment can be replaced with vitamin E oil, aloe vera gel, or petroleum jelly. Massaging the area while working with the thicker scar tissue to keep it from becoming stiff is also important. Softer skin will heal with a less noticeable scar.

It’s important to note that the wound healing process is complex and fragile. Interruption or failure can lead to non-healing chronic wounds involving factors such as diabetes, arterial or venous disease, infection, and the metabolic deficiencies of old age.

 

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