Whether due to complications from premature birth, illness or injury, the path to recovery and growth is often a challenging one for our youngest and most fragile children.Surprisingly, many of the ventilator dependent patients cared for at home are children. Children on ventilators present additional challenges related to creating an environment that nurtures normal growth and development and socialization.
Many children with special health care needs are susceptible to airway obstruction and the complications that can arise from it. This is particularly for children who may have difficulty swallowing saliva due to congenital disease, as well as children with tracheostomies, children on home ventilators and children with continuous positive airway pressure (CPAP) devices.
Home care for ventilator-assisted children improves psychosocial development and reduces medical costs compared with hospital care.Infants and children may develop chronic respiratoryfailure from ventilator muscle weakness, decreased central respiratory drive, or chronic lungdisease.In many cases, prolonged mechanicallyassisted ventilation becomes necessary when patients cannot be successfully weaned from the ventilator.
A home ventilator is a machine that provides continuous breathing support for your child. The ventilator does not change the underlying clinical condition of your child. Its function is simply to provide air to the lungs and to remove waste gas (carbon dioxide). Some children require ventilator support 24 hours a day, while some need support for shorter times or only for sleep. Home ventilators are generally small, relatively light and portable. Most of the time, the ventilator is powered from electrical outlets, but most of them have internal built-in batteries for use for short trips outside of the home.
Ventilator safety checks at home:
1. Before putting the child on vent at home, make sure he looks healthy and is breathing comfortably.
2. Make sure the ventilator settings are same as ordered by the doctor.
3. Check for kinks (bends) in the tubing.
4. Are all the tubing, circuits and connections in place?
5. Make sure that the child’s head is higher than the humidifier is. Check that there is plenty of water in the humidifier. Fill with sterile water if it is too low.
6. Change the circuit tubing if too much water is dripping. Water can drip into child’s trachea if the tubing is lifted above the level of the child’s head, and this causes extreme irritation to child’s fragile lungs.
7. Test the internal battery life after fully charging it at home by plugging it in. Then run the ventilator off of the electrical outlet and on the battery. Time
how long it can support the child’s breathing.
Before your child is discharged home, the staff at the hospital will develop a teaching plan to help you learn the skills and to identify support systems necessary to care for your child at home.
Some of the areas that you should be familiar with are:
1. Your child’s disease and treatment
2. Tracheostomy care
3. Details of ventilator & oxygen Equipment Company and nursing agency.
4. Ventilator care
5. How to handle unexpected or emergency situations?
6. Community resources and support services
Caring for a child who is ventilator dependent requires 24/7 care and involves a level of skill and knowledge that exceeds the typical parent’s experience. Ventilator-dependent children are a high-risk population. Complications with the artificial airway or the ventilator are potentially life threatening. The nurses need to be highly skilled in routine and emergency tracheostomy and ventilator management. Please talk to your doctor for more information on how to care for someone who is on ventilation.