Improving ventilator management in the ED
Project Description: Often, after an intubation in the ED, the tidal volume will be set to 500 mL which is too much for the vast majority of patients. We have known for many years that large tidal volumes cause lung injury, and that outcomes of lung injury patients (ARDS) are better with tidal volumes around 6 ml/kg IBW. While traditionally tidal volumes of 8 ml/kg IBW have been thought to be “lung protective”, the literature supports that there is in fact no “safe” tidal volume threshold and that initiating lung protective ventilation with tidal volumes of 6 ml/kg IBW improve the outcomes of our patients, including in the ED, and likely confers a significant mortality benefit.. Therefore, we have worked with a multidisciplinary team involving the ED, Respiratory Care leadership and the MICU to derive a uniform approach to this issue and to provide education on the importance of appropriate tidal volumes.. With few exceptions, all patients should be started on a tidal volume of 6 ml/kg IBW.
QPI: Torben, Becker, (email@example.com)
Collaborators: Thomas, Payton, (firstname.lastname@example.org)
UF Health Big Aims: Zero Harm None
MeSH Keywords: Mortality, Ventilators, Mechanical, Pulmonary Ventilation, Tidal Volume, emergency department