Training activity information
Details
Stabilise patient on portable ventilator for transfer
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
Considerations
- Check availability of compatible ventilation modes
- Communication of discrepancies with the clinical team
- Patient centred care and support
- Monitoring for changes prior to leaving the Critical Care Department
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- What do you need to know before stabilising a patient on a portable ventilator for transfer? This includes understanding the patient’s ventilatory requirements, the functionality of the portable ventilator, the necessary settings and parameters, and any potential technical or clinical challenges. Consider the technical requirements for ventilation, monitoring, and suction equipment.
- What do you anticipate you will learn from this experience of stabilising a patient on a portable ventilator? Consider the specific skills and knowledge you hope to gain, such as troubleshooting ventilator issues during transfer, ensuring adequate oxygenation and ventilation during transport, and understanding the differences between stationary and portable ventilation. Think about your existing knowledge of ventilation and patient monitoring.
- What actions will you take in preparation for this stabilisation process? This could involve reviewing the operation manual for the portable ventilator, discussing the patient’s ventilation needs with the medical team, checking the availability and functionality of necessary accessories (e.g., oxygen cylinders, power supply), and considering potential complications (e.g., ventilator malfunction, dislodgement of airway) and how to manage them.
- Acknowledge any concerns you may have about managing ventilation during transfer.
In action
- What are you doing as you stabilise the patient on the portable ventilator? Pay attention to your actions. How are you setting up the ventilator? How are you connecting it to the patient? Why are you choosing specific ventilator parameters?
- What decisions are you making as you stabilise the patient? This might involve adjusting ventilator settings based on the patient’s response, troubleshooting alarms, or ensuring adequate oxygenation and ventilation.
- What aspects of stabilising the patient on the portable ventilator feel intuitive (e.g., connecting circuits, basic troubleshooting), and what requires more conscious effort (e.g., interpreting ventilator waveforms, adjusting complex parameters)?
- How effective are your actions in achieving stable ventilation for transfer? Are the patient’s respiratory parameters within acceptable limits? Are there any alarms or indications of instability?
- What challenges are you facing during the stabilisation process? This might include equipment malfunctions, difficulty in achieving stable ventilation, or patient distress.
- What can you learn from this stabilisation process as it unfolds? Are you gaining a better understanding of the portable ventilator’s operation or the patient’s response to ventilation?
- How does this task connect to your knowledge of respiratory physiology, ventilation techniques, and patient monitoring?
- Are there alternative approaches you could be considering for stabilising ventilation for transfer (e.g., different ventilator modes or settings)?
- What support or guidance might you need in this moment if you encounter difficulties in stabilising the patient? Would the assistance of a more experienced colleague be necessary?
- Are you working within your scope of practice when stabilising this patient on a portable ventilator for transfer?
On action
- Begin by summarising the key steps you took to stabilise the patient on the portable ventilator for transfer. What initial ventilator settings did you use?
- What were the patient’s immediate physiological responses upon being connected to the portable ventilator?
- Did you observe any changes in vital signs or respiratory parameters?
- Did you encounter any technical aspects or challenges related to setting up or using the portable ventilator?
- What adjustments (if any) did you need to make to the ventilator settings or the patient’s condition to ensure stability for transfer?
- What did you learn about the practical application of stabilising a patient on a portable ventilator?
- Did you gain a better understanding of how to optimise ventilator settings for a patient who is about to undergo transfer, taking into account potential challenges during transport?
- In what ways did your reflection-in-action (during the stabilisation process) influence your decisions regarding ventilator settings or patient management? Did you adjust your approach based on the patient’s real-time responses?
- What areas for continued development in your ability to stabilise patients on portable ventilators for transfer have been identified?
- Do you need more familiarity with specific portable ventilator models or troubleshooting techniques?
- How can you apply the learning from this experience to future patient transfers requiring portable ventilation?
- Will you approach the initial setup or monitoring process differently?
- Identify the actions / ‘next steps’ you will now take to support the assimilation of what you have learned. This might involve reviewing portable ventilator manuals, practising in a simulated environment, or seeking further supervision during similar procedures.
- What support or resources might you need to further develop your skills in stabilising patients on portable ventilators for transfer?
Beyond action
- Reflect on your experience of stabilising a patient on a portable ventilator for transfer. With increased knowledge of respiratory physiology, ventilation strategies, and the practicalities of patient transfer, are there any aspects of the process, such as ventilator settings, monitoring requirements, or troubleshooting potential issues, that you now understand more comprehensively?
- Have you observed more experienced colleagues managing patients on portable ventilators? How did their approach to pre-transfer stabilisation, including equipment checks, ventilator adjustments, and physiological monitoring, compare to your own experience? What specific techniques, considerations, or problem-solving strategies did they employ that you can learn from?
- Review your reflect-on-action notes from this DTA. What additional learning points can you now identify regarding the nuances of stabilising a ventilated patient for transport, considering factors like patient acuity, transport duration, and available resources? What further actions might you take to enhance your skills in this complex area?
- Have you discussed the challenges and critical steps involved in stabilising ventilated patients for transfer with colleagues, perhaps in debriefings after transfers or in discussions about best practice? Did these discussions offer alternative approaches or insights into anticipating and managing potential complications during transport?
- How has the practical experience of stabilising a patient on a portable ventilator contributed to your overall understanding of respiratory support in critical care and the specific considerations for its continuation during transfer? Have the skills you developed, such as adjusting ventilator parameters based on physiological monitoring, troubleshooting ventilator alarms and equipment issues, and effective communication with the transfer team, been transferable to other situations involving ventilated patients or critical care procedures?
- Since this DTA, have you been involved in subsequent patient transfers requiring portable ventilation? How has your confidence and competence in the pre-transfer stabilisation process, including anticipating potential challenges and implementing preventative measures, evolved? How has subsequent experience influenced your approach to ventilator management and patient monitoring during transport?•
- What transferable skills (e.g., technical proficiency with complex medical devices, ability to interpret and respond to real-time physiological data, effective problem-solving under pressure, teamwork and communication in a dynamic environment) did you develop or enhance through this DTA?
- What are your plans for continued development in the area of stabilising patients on portable ventilators for transfer? This might include seeking further training on advanced ventilation modes, participating in simulated transfer scenarios with a focus on ventilator management and troubleshooting, or reviewing relevant national and local guidelines on safe patient transfer.
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 4 |
Outcome
Apply, or remove, equipment during any stage of the transfer of critically ill patients. |
| # 5 |
Outcome
Discuss and agree a transfer plan with the multi-disciplinary team ensuring the best interests of the patient, and all elements of their care, are considered throughout. |
| # 6 |
Outcome
Communicate effectively with the patient, relatives and the multi-disciplinary team at all stages of the process. |
| # 7 |
Outcome
Assess changes in the patients’ physiological variables, or in the equipment performance, during transfer; and remedy or apply contingency measures as required. |