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SURFACTANT ADMINISTRATION PA - Coggle Diagram

- - - - I have another RT with me to take over ventilation for you
        
        Verbalize that you'd assess WOB, VS, & auscultate
        
        Set up Y-Piece for Suction & EtCO2
        "I'm just gonna set up my Y-piece so that I can suction & attach ETCO2 for us"
        Match Y-piece to tube size, attach ETCO2, & suction cath
        
        Ensure suction is turned on & set up!!!
        -80mmHg regulated
        -Make sure to test it before placing it on
        
        Attach Y-piece to ETT tube
        “Okay suction is turned on & I have ETCO2 set up, are you ready for me to attach this to the ETT?”
        
        Make the switch
        
        1 more item...
- - - - I’ll watch the monitor for us
        
        Watch monitor
        1) If ETCO2 starts to fall or drops to 0 = Do we have chest rise?
        A) No CR = Okay lets pull the catheter back
        -I’m going to increase Ti (give 2 breaths). Do I have chest rise?
        -Increase RR (give 2-3 breaths). Do I have chest rise?
        -Increase P’s by 2-3cmh20 - Do I have chest rise?
        Continue as long as HR is > 100bpm to establish ventilation
        As soon as HR < 100, suction the tube
        Once have ventilation, turn pressures back down!!
        2) If baby desatting, but still have CR = Let’s titrate FiO2 to keep sats > 80%
        3) If HR falls below 100 = Pulling out the catheter & suctioning
        
        Make sure that once you achieve ventilation & CR again, you titrate P’s, FiO2, & Ti to be appropriate for baby
        
        Once finished Administration
        “I would continue to ventilation for another 2-5 mins, making sure to keep an eye on our PIP as the surfactant distributes to the periphery of the lung & we’re getting an improvement in FRC & CL, I’ll have to lower my P’s. I’ll also be watching to wean FiO2 as their oxygenation should improve with the decrease in surface tension on their alveoli
        -I’m watching chest excursion as well to make sure we’re not over ventilating baby
        -And im looking to extubate as soon as possible once their CL & FiO2 improves