Prevention of ventilator-associated pneumonia (VAP)

[zakiyatasnim]

Pain relief, sedation and treatment of delirium

Establish a daily pain management goal. Assess pain every 4 hours (CPOT), measure sedation every 2 hours (RASS/BISS). Titrate analgesic and sedative infusion rates to achieve pain management goals. Use preemptive analgesia for known painful procedures. Screen for delirium with CAM-ICU (Confusion Assessment Method in the Intensive Care Unit) every shift to ensure early identification of patients with COVID-19. Use a centralized delirium prevention strategy, including pain management, sedation, communication, quality sleep, and early reinstatement of physical activity.


A group of ventilators is used to reduce ventilator-associated pneumonia, which also includes hand washing; increasing the patient's bed angle by 30-45° unless contraindicated; oral care every 4-6 hours using a japan number data disposable oral mucus extractor; maintaining endotracheal tube (ETT) cuff pressure at 30-35 cm H2O every 4 hours; maintaining enteral nutrition and monitoring gastric residual volume every 4 hours; daily assessment for the possibility of ventilator removal; use of washable tracheal tubes for continuous subglottic suctioning in combination with a 10 ml syringe suctioning every 1-2 hours and adjusting the suction frequency according to the actual amount of secretions. Remove subglottic retentate: The syringe containing the subglottic secretions is used directly to aspirate an appropriate amount of chlorine-containing disinfectant (2500 mg/L), then recapped and disposed of in a sharps container.

4. Sputum suction

Use a closed sputum suction system, including a closed suction catheter and a closed disposable collection bag, to reduce aerosol and droplet generation.
Sputum specimen collection: Use a closed suction catheter and appropriate collection bag to reduce droplet exposure.
5 Disposal of condensate from ventilators

Use disposable ventilator tubes with dual-circuit heating wire and automatic humidifier to reduce condensation. Two nurses should work together to quickly drain the condensation into a closed container with chlorine-containing disinfectant (2500 mg/L). The container can then be placed directly into a washing machine at 90 °C for automatic cleaning and disinfection.