See also
Confirmation
CONFIRM Endotracheal Tube (ETT) placement by:
- Visualization of end tidal waveform on monitor (may be a delay of 2-3 breaths)
- Visualization of adequate chest rise with manual breath
- Presence of condensation in the ETT on exhalation
- Confirmation of breath sounds on auscultation
- Obtain chest x- ray
- Obtain blood gas (capillary/venous blood gas if arterial sample not accessible)
Ventilation Goals
Goals of ventilation should be :
- Normocarbia (ETCO2/ PaCO2: 35 to 45 mmHg)
- Saturations >92%
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References:
Vt: Tidal Volume
RR: Respiratory Rate
Ti: Insipiratory Time
PEEP: Positive End-expiratory Pressure
MV: Minute Ventilation
IBW: Ideal Body Weight
I:E: Inspiratory : Expiratory
Image
BC Children’s Hospital PICU Physicians RT. Acute Ventilation in Pediatrics [Internet]. 2024. Available from: https://www.childhealthbc.ca/file/PICU_Ventilation_Pediatrics
Maintenance
Ongoing sedation and analgesia:
- Morphine 10 to 20 mcg/kg/hour IV
- Midazolam 100 to 200 mcg/kg/hour IV
- Dexmedetomidine 0.1-1mcg/kg/hr IV (can be added if available)
Consider ongoing paralytic medications :
- Rocuronium – intermittent IV boluses of 1mg/kg as required while ensuring adequate sedation
See also