Spinal cord injury vent-liberation admission guidelines to Shirley Ryan AbilityLab.
Spinal Cord Injury Ventilator Admission Guidelines
MEDICAL READINESS GUIDELINES In addition to a patient’s medical clearance, it is important that the following are in place: • Patient has the potential to participate in three hours of therapy a day • Minimal returns for outpatient visits and diagnostic testing during rehabilitation stay • Appropriate physician follow-up plan is in place for after discharge from acute rehab facility • Patient must meet preadmission respiratory criteria • Patient must have two caregivers identified
MEDICAL STATUS Medical work-up to be complete and with treatment plan agreed upon by primary and consulting services.
RESPIRATORY • Vent patients are required to be on stable settings for 72 hours prior to transfer • Must have stable respiratory status to allow for 3 hours of therapy per day • Suctioning needed at a maximum frequency of every 4 hours • Trach guidelines:
• If new, first trach change must occur more than 24 hours prior to arrival • Any trach change of size or type should occur at least 24 hours prior to arrival • Respiratory treatments are a max of every 4 hours • Peep must be < 8 cm H20 unless required for leak speech • FiO2 less than or equal to 40% • Ventilator Modes used for Rehabilitation: AC/PC; AC/VC; SIMV/VC; SIMV (PC/PS) with a rate
MEDICATIONS
• PO/enteral/SQ only • Generally no IV push meds, except IV antibiotics • DVT Prophylaxis/anticoagulation plan established
DIET • PO diet or able to tolerate tube feeding to provide caloric and fluid requirements • PEG tubes are preferred • TPN patients need to be on a stable solution, cycled at night with a plan for discharge to home on TPN
These are guidelines. For more information, please speak with your Shirley Ryan AbilityLab liaison or consulting physician.
Page 1Made with FlippingBook - professional solution for displaying marketing and sales documents online