Health practitioners from different regions have held their differences when it comes to prevention of ventilator-associated pneumonia. This has stemmed from differences in interpretation of literature talking about it and even the medical practices put forth to cub the condition. Hand-washing is one of the easiest ways of preventing this condition but not many give it attention. Below is a discussion on VAP prevention.
The first one is semi-recumbent positioning. Elevation of the head in ICU patients is strongly supported in all medical textbooks and journal. However, it has been noted that the approach is not used by many care givers. The trend is linked to the debate on the degree of elevation with some saying that a minimum elevation of thirty degrees and a maximum of forty degrees is enough.
Experts in the medical field have urged care providers to make sure the bed is elevated despite the controversy surrounding the elevation degree. This is because even the slightest elevation has been shown to be effective as opposed to having the patient lie flat. To note is that the beds of patients who have severe hypotension, undergone brain surgery or have certain fractures are not to be raised.
Withdrawal of sedatives and a weaning assessment should be conducted on a daily basis and if possible twice in a day. According to research, avoiding prolonged intubation minimizes the chances of the patients suffering from VAP. Therefore, the patient should be given a break of about eight hours every day to observe how well he or she fairs without the drugs. Spontaneous trials when it comes to independent breathing should be focuses on too.
Continuous secretion removal is encouraged in lowering the risk of VAP too. The newer tubes which have dorsal lumen made separately allow easier suctioning. This new tubes are very expensive by the virtue of them being silver-coated. However, if a life can be saved by using this tube, the extra expenses are not an issue. The problem with the old generation tubes is that their probability of malfunctioning is high.
Oral tubes are beneficial than nasal ones in Ventilator-associated pneumonia prevention. The nasally inserted tubes lead to sinus blockage which interferes with their drainage. If secretions remain there for long, they are likely to get infected and this is a major contributor to VAP. Nasal tubes should only be used in special cases when oral tubes are contraindicated.
Use of chlorhexidine gluconate in oral hygiene is a great approach too. Even though there is not much evidence in support of this, it has been reported to be very beneficial. Brushing the teeth, use of mouthwash and gum stimulation are procedures which are very easy not to mention that they do not cost much. Thus, health care providers should ensure that the patients benefit from this.
Provision of prophylaxis for stress ulcers has been recently cleared as an effective strategy in VAP avoidance. Sucrasulfate use has been confirmed to minimize VAP and gastric bleeding. Gastrointestinal bleeding is a major cause of ventilator-associated pneumonia though the mechanism through which this happens is not clearly outlined. Antacids, H2 blockers and PPIs produce a similar effect but research studies focusing on them have not received much attention.
The first one is semi-recumbent positioning. Elevation of the head in ICU patients is strongly supported in all medical textbooks and journal. However, it has been noted that the approach is not used by many care givers. The trend is linked to the debate on the degree of elevation with some saying that a minimum elevation of thirty degrees and a maximum of forty degrees is enough.
Experts in the medical field have urged care providers to make sure the bed is elevated despite the controversy surrounding the elevation degree. This is because even the slightest elevation has been shown to be effective as opposed to having the patient lie flat. To note is that the beds of patients who have severe hypotension, undergone brain surgery or have certain fractures are not to be raised.
Withdrawal of sedatives and a weaning assessment should be conducted on a daily basis and if possible twice in a day. According to research, avoiding prolonged intubation minimizes the chances of the patients suffering from VAP. Therefore, the patient should be given a break of about eight hours every day to observe how well he or she fairs without the drugs. Spontaneous trials when it comes to independent breathing should be focuses on too.
Continuous secretion removal is encouraged in lowering the risk of VAP too. The newer tubes which have dorsal lumen made separately allow easier suctioning. This new tubes are very expensive by the virtue of them being silver-coated. However, if a life can be saved by using this tube, the extra expenses are not an issue. The problem with the old generation tubes is that their probability of malfunctioning is high.
Oral tubes are beneficial than nasal ones in Ventilator-associated pneumonia prevention. The nasally inserted tubes lead to sinus blockage which interferes with their drainage. If secretions remain there for long, they are likely to get infected and this is a major contributor to VAP. Nasal tubes should only be used in special cases when oral tubes are contraindicated.
Use of chlorhexidine gluconate in oral hygiene is a great approach too. Even though there is not much evidence in support of this, it has been reported to be very beneficial. Brushing the teeth, use of mouthwash and gum stimulation are procedures which are very easy not to mention that they do not cost much. Thus, health care providers should ensure that the patients benefit from this.
Provision of prophylaxis for stress ulcers has been recently cleared as an effective strategy in VAP avoidance. Sucrasulfate use has been confirmed to minimize VAP and gastric bleeding. Gastrointestinal bleeding is a major cause of ventilator-associated pneumonia though the mechanism through which this happens is not clearly outlined. Antacids, H2 blockers and PPIs produce a similar effect but research studies focusing on them have not received much attention.
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