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Ideal tidal volume chart8/7/2023 ![]() ![]() 1–4 Although the harmful effects of high-tidal volume ventilation (i.e., > 10 mL/kg. LPV has been associated with reducing mortality and pulmonary complications in patients with and without acute respiratory distress syndrome (ARDS). 1 Low tidal volume ventilation, also known as lung-protective ventilation (LPV), has been typically defined as less than or equal to 8 mL/kg of predicted body weight (PBW), as a strategy to improve outcomes in such patients. Patients who present to the emergency department (ED) requiring endotracheal intubation and mechanical ventilation for respiratory failure or protection of their airway are critically ill, and their ED care is crucial for their subsequent clinical outcomes. Patients under 65 inches in height may also be especially at risk of receiving non-LPV ventilator setting orders. CONCLUSIONSīased on these results, a brief ED provider educational intervention can significantly improve the utilization of LPV guideline-based settings. ![]() For patients under 65 inches in height, post-session LPV adherence increased from 13% to 53% (p = 0.01). All patients who were 67 inches or greater in height were ventilated appropriately before and after sessions. Patients ventilated using LPV increased from 70% to 82% after the educational sessions (p = 0.04). The pre and post-intervention occurrence rates of LPV setting orders were inferentially compared before and after educational sessions. Two additional materials (e.g., LPV reference charts, tape measures to gauge patients’ heights) were also posted in three ED resuscitation rooms and on cabinets containing emergency airway equipment. This information was presented at a series of four educational sessions for 25 attending physicians (n = two sessions) and 27 residents at conferences (n = two sessions). METHODSĪ 15-month retrospective chart review of ventilator settings and subject characteristics (N = 200) was conducted before and after a series of 10-15-minute educational sessions were delivered to improve LPV adherence. The objectives of this 2019-2020 community-based quality improvement project were to: a) identify patients at greater risk of not receiving LPV, and b) evaluate the effectiveness of a series of brief quality improvement educational sessions to improve LPV setting protocol adherence rates. Lung-protective ventilation (LPV) setting strategies are key considerations for this care. Patients requiring endotracheal intubation and mechanical ventilation in the emergency department (ED) are critically ill, and their ventilator management is crucial for their subsequent clinical outcomes. ![]()
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