How do the nurses determine WHEN to take you off the vent?

[Mary]

Working as vigorously (and diligently) as possible with the breathing blowers (what are they called?) that help dry out and strengthen the lungs is another thing I'll set up as a task for myself.

Incentive spirometer is the name you're trying to recall, I believe.

 

[Ross]

Incentive spirometer is the name you're trying to recall, I believe.

Most hated device known to heart surgery patients.

 

[Bina]

Spirometer.....stupid exercise.....I used to try and hide the darn thing

 

[Mary]

I have no memory of coming off the tube or waking while still on it. Thankfully.

I do wonder though.... many of us here have had other surgeries aside from OHS. Doesn't all major surgery require entubation? I had two abdominal surgeries in years past and must have been entubated for them but have no memory of it then either.

Is it because we are entubated longer with OHS than for other surgeries that it is such an issue for us with heart sugeries vs. other major surgery?

Jim,
Not all major surgeries require intubation. Sometimes they use a device invented in the 80's, a LMA,instead of the anesthesia vent. Here's a link to it. http://en.wikipedia.org/wiki/Laryngeal_mask_airway

 

[sonavogel]

Incentive spirometer is the name you're trying to recall, I believe.

That's the one!

 

[Mitral-Man]

That vent tube was one of my biggest questions back when my surgery took place. It ended up being a non-issue like everyone elses experience. I was dazed but I do remember bitting the tube and getting yelled at by the nurse. This happened several times. I think she jucied me each time to put me out again. Then I remember waking up enough and hearing the rythm of the built-in alarms on the breathing machine. I finally put two and two together and noted that I was contrlling the rythm of the alarms by breathing. So I tried as hard as I could to get breathing on my own (vent was till in yet). It wasn't long after that those alarms were singing and shortly after the nurse removed the tube. So, my advice, whe tey switch the audio on of those alarms and you note it, make those alarms sign as loud as you can and the tube will be removed soon after.....Gary

 

[Dennis S]

I hope I don't make things worse by being honest. The vent was the worst experience of my life, by far. I tend to come out of anesthesia very quickly. I was thinking I had a stake down my throat & trying to pull it out with both hands (not a good idea, BTY) when I got juiced again. It was gone when I came to a second time.

 

[perkicar]

Mary, you're a doll--not that I know what the hell any of it means, but it obviously means a great deal when you're in the ICU.

I think I'm going to do a cut and paste of the stats and have a T-shirt made (size XL) of them, for my husband to hang on to--and to drape over me (as best he can) when he comes to yell (or whisper) in my ear that I've come through--if/when that times comes, that is!)--just to give the nursing staff a laugh.

Ice chips!!

OMG--ice chips when you're finally off the vent are the best thing you'll ever taste! My mouth was super dry and they were just marvelous!

I am a nurse and I was more concerned about waking up on the vent than I was getting my sternum sawed in half. I remember waking up and I wasn't fighting the vent at all--I was just really frustrated to not be able to communicate verbally. That was about 3:30 pm and I think I was taken off around 5-ish?
As others have said, there is a weaning protocol, where they look at what oxygen concentration you are using, how many breaths you initiate and how deep they are, and also how much CO2 you are breathing out. They usually do a CPAP trial where you are on the vent but essentially breathing on your own, with the vent giving you a little extra if you aren't taking a deep enough breath. Respiratory will evaluate you, as well as the pulmonary docs, probably look at a blood gas, and if all looks good, out comes the tube! I think the most unpleasant part was the suctioning just before they pulled the tube.
You'll be fine--the anticipation is worse than the surgery.

 

[sonavogel]

Gary, thank you for the valuable information! I think that when/if it's time for surgery for me, since I'm likely to have enough running room, I will visit the hospital ICU and ask the nurses the show me the vent hook-up and explain what they watch for and how a patient coming up from anesthesia can best facilitate the vent process. I'll ask about the alarms and see if I can hear them while I'm there--that'll set up a sense memory.

Dennis, I'm grateful for your recollection--there are enough different accounts from people that it makes sense to have some remember the vent as being pretty awful. I may be one of those, in the end, although I hope not. I'm sorry it was that way for you, but I'm glad you posted about it--I'd rather know.

Perkicar, many thanks for the clear account! It seems to me that I can best help myself in advance by trying to develop my lung capacity and deep-breathing exercises (as best I can, that is) in the period of weeks before a surgery like this. That may help get me off the vent sooner--and it certainly should help me once I'm tackling the incentive spirometer!

 

[Ross]

Trust me hon, you'll be so far out of it, that it's not going to be an issue at all.

 

[Susan BAV]

If there is another heart surgery vent experience for me, I will make sure they know I want Versed.

I knew what to expect because of my first heart surgery vent experience, which was frightening; but this past heart surgery vent experience was absolutely horrible.

 

[Ross]

I've been on the vent more times then most people ever see in there lives. If it's placed properly, it's going to tick you off because you can't speak and you have the sensation of something in your throat. I've had good and bad experiences, but not from the heart surgery intubations.