What is Positive End Expiratory Pressure (PEEP)?
Positive End Expiratory Pressure (PEEP) is a mode of therapy used in mechanical ventilation. In simpler terms, PEEP refers to the pressure in the lungs (alveolar pressure) above atmospheric pressure that exists at the end of expiration. It is employed to keep the alveoli open during the exhalation phase of breathing, thereby improving oxygenation and preventing alveolar collapse.
Why is PEEP Important in Nursing Care?
In nursing care, the implementation of PEEP is crucial for patients experiencing respiratory distress or failure. It helps in maintaining adequate oxygenation and reducing the work of breathing. Nurses must be vigilant in monitoring patients on PEEP to avoid potential complications such as barotrauma or volutrauma, which can result from excessive pressure.
How is PEEP Administered?
PEEP is administered via mechanical ventilators. Nurses play a critical role in setting and adjusting the PEEP levels as per the physician’s orders and the patient's condition. The typical method involves:
Initial PEEP settings are usually between 5-10 cm H2O, which can be adjusted based on patient response.
Continuous monitoring of oxygen saturation, arterial blood gases, and other respiratory parameters.
Regular assessment of the patient's respiratory status, including breath sounds and chest movement.
Nurses must be adept at identifying early signs of these complications and taking appropriate measures to mitigate them.
Regularly check vital signs, including heart rate, blood pressure, and oxygen saturation.
Assess the patient’s level of consciousness and overall comfort.
Monitor arterial blood gases (ABGs) to evaluate the effectiveness of ventilation and oxygenation.
Inspect the ventilator settings and alarms frequently to ensure they are within the prescribed range.
Observe for signs of respiratory distress, such as increased work of breathing, restlessness, or cyanosis.
Regularly repositioning the patient to promote ventilation and prevent pressure ulcers.
Practicing meticulous infection control measures to reduce the risk of VAP.
Collaborating closely with the interdisciplinary team to adjust PEEP settings as needed.
Providing adequate sedation and pain management to ensure patient comfort.
Educating the patient and family members about the purpose and benefits of PEEP therapy.
Conclusion
Positive End Expiratory Pressure (PEEP) is a vital component of
mechanical ventilation that enhances oxygenation and prevents alveolar collapse. For nurses, understanding the indications, administration, monitoring, and potential complications of PEEP is essential in providing high-quality care. By adhering to best practices and maintaining vigilant monitoring, nurses can significantly improve patient outcomes in those requiring respiratory support.
