HomeVA ProstheticsVA Handbook 1173.13 - Home Respiratory Care ProgramProcedures for Veterans on Ventilators

13.5. Procedures for Veterans on Ventilators

a. Ventilators which are required for the continuous mechanical ventilation of a patient will be furnished when prescribed only after the patient has been evaluated by the VA Respiratory Therapy Service.

b. Whenever a patient is totally dependent on a ventilator for continuous mechanical ventilation, a spare ventilator with accessories will always be furnished.

c. The veteran and family care takers will be thoroughly trained in the function and use of the ventilator and its accessories prior to discharging the patient.

d. All ventilators will be furnished in accordance with VA policies and procedures.

NOTE: A backup ventilator will be provided when the patient is discharged to the patient's home.

e. IPPB machines

(1) IPPB machines, which are used to deliver air under pressure into the patients lungs for periods of time, will be furnished when prescribed by a physician specializing in pulmonary disease.

(2) This equipment is used to treat patients with acute pulmonary edema and chronic obstructive pulmonary disease.

(3) Physicians should only consider an IPPB machine for medication administration after patients have had a trial with one or more of the types of devices with unsatisfactory results as determined by the physician and respiratory therapy personnel.

f. Rocking Beds

(1) Rocking beds which are specially designed to control respiration of a patient will be furnished when prescribed by a physician specializing in pulmonary medicine.

(2) Rocking beds may be rented if duration of use is expected to be short or, as an interim measure to permit discharge from an inpatient facility pending receipt of a rocking bed ordered for a patient.

(3) Rocking beds will only be installed by personnel familiar with their function, i.e., biomedical engineer, engineering staff accompanied by a respiratory therapist or the JCAHO accredited personnel of a commercial contractor who specializes in respiratory equipment. This is essential as the rate of respiration is controlled by the frequency of the rock and inspiration and expiration is controlled by the angle of the rock.

g. Phrenic nerve stimulators which are designed to initiate breathing through stimulation of the diaphragm via the phrenic nerve will be furnished, including batteries, when prescribed by the appropriate medical personnel. NOTE: Batteries to power phrenic nerve stimulators will be provided by Prosthetic Service.

h. Other less expensive, less complicated, and usually effective types of equipment are available for routine aerosolization of medications. These include cartridge inhalers, handheld nebulizers, and portable compressor nebulizers.

i. Other items of respiratory equipment may be purchased, when prescribed, in accordance with VA policy and procedures.


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