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Nursing and infection-control issues during high-frequency oscillatory ventilation

Sweeney, Anne-Marie RN, BSc, BScN, CNN(N), CNN(C), PHCNP, MN; Lyle, Joseph BSc, MBA, RRCP; Ferguson, Niall D. MD, FRCPC, MSc

doi: 10.1097/01.CCM.0000155918.29268.84
Scientific Review

Objectives: To review the specific nursing and infection-control issues that arise during the care of patients receiving high-frequency oscillatory ventilation (HFOV).

Data Source: Published articles, governmental guidelines, and hospital procedures and practices.

Data Summary: Nurses, respiratory therapists, and other clinicians caring for patients receiving HFOV need to be aware of specific differences in patient assessment, including close observation for symmetric chest-wall vibrations. In addition, management of sedation with or without neuromuscular blockade and effective communication with the patients are essential nursing skills needed with the use of HFOV. From an infection-control standpoint, HFOV is considered a high-risk respiratory procedure because of the inability to effectively filter all respiratory secretions. Appropriate infection-control precautions, including patient location and use of personal protective equipment, need to be considered when implementing HFOV in the intensive care unit.

Conclusions: Important infection-control and nursing issues exist that are specific to the use of HFOV. These issues should be addressed with appropriate staff education before the implementation of HFOV in an intensive care unit.

From the Toronto Western Hospital, University Health Network (AMS, JL, NDF); the Michener Institute of Applied Health Sciences (JL); and the Interdepartmental Division of Critical Care Medicine and the Department of Medicine, Division of Respirology, University of Toronto (NDF), Toronto, Ontario, Canada.

© 2005 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins