Are there industrywide standards on the proper use of endotracheal tubes and monitoring of intubated patients?
A. There are standards, and these standards have recently been put into place by several national organizations. The American College of Chest Physicians (Northbrook, Ill.), the Society for Critical Care Medicine (Des Plaines, Ill.) and the American Association of Respiratory Therapy (Irving, Texas) have finally developed protocol for when a patient should be weaned and extubated. That protocol is not accepted everywhere because some hospitals have their own protocol that has been working fine for them. So, to answer your question, if there is a national standard, not everyone follows it. Q. Are there specific recommendations clinicians can follow? A. The Institute for Healthcare Improvement (Cambridge, Mass.) has recommendations on what to do for patients on a ventilator. They should sit at a 30 to 45 degree-upright position, have a daily sedation vacation coupled with a daily assessment of a patient’s readiness for weaning, implement peptic ulcer disease prophylaxis and treat deep ve
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