ICU Nurse Observation Report

I was working in Intensive care unit, when I noticed that one of the vented patient’s pulse oximeter (ox) pleth was showing many artifacts and the saturation was 88. The other ICU nurse who was assigned to this patient was attending to a different patient, so I decided to check on the patient. I suctioned the patient, applied a new finger pulse ox, and noticed that patient pulse ox saturation started to drop. While I was assessing the patient, I noticed that the patient’s pulse oximeter (ox) saturation drop to 84, I called for help and thoroughly started checking the ventilator settings, and I noticed that there was ventilator tidal volume was set to be 400, but checking at the patient’s tidal volume number, it was 40. I quickly disconnect …show more content…
I explained my findings, and my interventions to rapidly changing patient’s condition. The respiratory therapist reset the ventilator and connected the ventilator back to patient. Within a minute, we noticed that the patient’s pulse ox saturation was low again down to 83 and it appeared that the patient was not receiving any tidal volume regardless the tidal volume was set to 400. The intensivist quickly disconnect the ventilator, connected the ET tube to ambu bag, and started bagging the patient just as I did before. It was certain that there was some malfunction in the ventilator. A new ventilator was connected and the after it was connected, the pulse ox saturation was within normal limits again. The intensivist, other nurses, and the respiratory therapist all admired my quick …show more content…
As an experienced ICU nurse, I knew that a low pulse ox with an artifact pleth can be incorrect, but should always be assessed. Furthermore, I called for help and quickly assessed the there might be an issue or malfunction with the ventilator. This showed my knowledge as an expert practitioner. This situation is an example of management of rapidly changing situation domain of nursing