Sunday, November 8, 2015

The Best Techniques In VAP Prevention

By Mattie Knight

Health practitioners from different regions have held their differences when it comes to prevention of ventilator-associated pneumonia. This has stemmed from differences in interpretation of literature talking about it and even the medical practices put forth to cub the condition. Hand-washing is one of the easiest ways of preventing this condition but not many give it attention. Below is a discussion on VAP prevention.

Placing the patient in a semi-recumbent position has been demonstrated to be effective in preventing ventilator-associated pneumonia. However, this approach is not widely used because professionals in the health sector have not come to a consensus on the degree of head elevation. Some have given a range which is mainly from thirty to forty degrees but there are those who do not agreed with this.

Regardless of the height the bed has been raised to, the patient will fare on better with a raised bed than when the bed is flat. Thus, health care providers are encouraged to put this approach into place. Patients who have recently undergone neurosurgery, those with significant hypo-tension or have sustained certain fractures should be exempted from this approach as it will cause more harm than good.

Weaning assessment and sedation vacation are approaches which that have been commended in prevention of VAP too. It is a fact that patients who are extubated after a short while are less likely to suffer from VAP. Besides this, sedation vacations need to be timed. This involves withholding sedation drugs for a period of 6-8 hours every day if appropriate. This should be followed by spontaneous extubation and breathing trials conducted to assess whether the patient can maintain spontaneous breathing comfortably on his or her own.

Continuously removing secretions as they form is important too for patients at risk of developing this condition. There are new tubes in the market which have been made specifically for this purpose. They are far much better that the previous ones because they even have separately fitted dorsal lumens just over the cuff to make the suctioning process easy. Even though they cost more, their benefits are much compared to the cost.

Oral tubes are beneficial than nasal ones in Ventilator-associated pneumonia prevention. The nasally inserted tubes lead to sinus blockage which interferes with their drainage. If secretions remain there for long, they are likely to get infected and this is a major contributor to VAP. Nasal tubes should only be used in special cases when oral tubes are contraindicated.

Use of chlorhexidine gluconate in oral hygiene is a great approach too. Even though there is not much evidence in support of this, it has been reported to be very beneficial. Brushing the teeth, use of mouthwash and gum stimulation are procedures which are very easy not to mention that they do not cost much. Thus, health care providers should ensure that the patients benefit from this.

Stress ulcers prevention by prophylaxis provision is emphasized. This is a condition common for intubated patients and it has been shown to cause pneumonia. Thus, it is better to prevent its occurrence than treating it. Sucrasulfate is the most common prophylaxis in stress ulcer prevention. H2 blockers, proton-pump inhibitors and antacids effectiveness as prophylaxis has not been confirmed because few studies have focused on them.

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