Artificial respiration refers to the mechanical or manual provision of ventilation for a patient who is unable to breathe effectively on their own. The primary goal is to maintain adequate gas exchange—delivering oxygen to the tissues and removing carbon dioxide. In emergency settings across Nigerian healthcare facilities, timely initiation of basic life support prevents irreversible brain damage and cardiac arrest.
Recognizing when a patient requires artificial ventilation is a core competency for nurses. Waiting for complete respiratory arrest is dangerous; intervention should occur when signs of impending respiratory failure appear.
Assessment findings that indicate a need for respiratory support include:
When natural breathing stops or fails, manual ventilation bridges the gap until advanced equipment arrives. The most common tool in clinical wards and emergency bays is the self-inflating bag-valve-mask device, commonly known as an Ambu bag.
Effective manual ventilation requires achieving a proper seal over the patient's nose and mouth using the C-E clamp technique. The nurse holds the mask with one hand shaped like a 'C' on top and an 'E' lifting the jaw, while squeezing the bag with the other hand. Delivering breaths too rapidly or with excessive force can push air into the stomach, causing gastric distension and increasing the risk of aspiration.
Advanced airway devices secure an open pathway to the lungs when basic maneuvers fall short. Nurses play a crucial role in preparing equipment, assisting the physician or anesthetist, and maintaining the airway post-insertion.
A common misconception is that suctioning should be done routinely on a set timetable. Instead, nurses must suction only when clinical signs like audible secretions, coughing, or a sawtooth pattern on the ventilator monitor indicate a need.
Mechanical ventilators take over the work of breathing using positive pressure to push air into the lungs. Setting up and managing these machines requires careful monitoring of settings such as tidal volume, respiratory rate, and oxygen concentration.
| Ventilator Parameter | Description | Nursing Focus |
|---|---|---|
| Tidal Volume | Amount of air delivered per breath | Prevent lung overexpansion |
| Respiratory Rate | Number of breaths delivered per minute | Monitor for hyperventilation |
| FiO2 | Fraction of inspired oxygen | Keep as low as safely possible |
Daily nursing care includes providing meticulous oral hygiene to prevent ventilator-associated pneumonia, repositioning the patient to avoid pressure ulcers, and ensuring alarms remain active at all times.
Patients receiving artificial respiration face several risks that demand constant vigilance from the nursing team. Complications range from ventilator-associated pneumonia and barotrauma to accidental tube displacement.
When a ventilator alarm sounds, the nurse must never silence it without checking the patient first. If the cause of distress is unclear, disconnect the machine immediately and use a manual resuscitation bag to ventilate the patient with 100 percent oxygen while calling for medical assistance. Always check connections, tubing kinks, and airway placement before adjusting machine settings.
Weaning is the gradual process of transitioning a patient from mechanical ventilator support back to spontaneous breathing. Success depends on the resolution of the underlying condition, adequate nutritional status, and psychological readiness.
During the weaning trial, nurses monitor vital signs, work of breathing, and blood gas results closely. Signs of weaning failure include rising heart rate, sweating, nasal flaring, and falling oxygen levels. Once the tube is removed, post-extubation care focuses on keeping the airway clear, monitoring for stridor or hoarseness, and providing humidified oxygen.