With a diagnosis of acute respiratory distress syndrome (ARDS) missed in 30 percent of critically ill patients, it’s not surprising that correct tidal volume is used in only 60 percent of cases.
The defining features of ARDS include determining the level of oxygen and positive end-expiratory pressure (PEEP) that the patient requires, differentiating non-cardiogenic pulmonary edema and identifying bilateral opacities on chest radiograph.
“With all these criteria, you can see why it makes it difficult to nail down a diagnosis,” said Kathleen M. Vollman, clinical nurse specialist, Advancing Nursing LLC, and adjunct faculty for Michigan State University’s Clinical Nurse Specialist-Education Program in East Lansing.
So, how can nurses properly identify the patient with ARDS and intervene to prevent lung injury? Vollman taught us how during Tuesday’s session, “Evidence-Based Early Recognition and Management of ARDS Drives Outcomes: The Why and How.” The answer: the 8 Ps.
The 8 Ps is a set of evidence-based-care practices that include prevention, PEEP, pipes and pump, paralysis, positioning, protein and protocol-based care.
“It takes a maximum level of supportive care to make a difference for patients with ARDS,” Vollman says. “The studies have shown that supportive care clearly impacts their one-year, three-year and six-year functional well-being, cognitive well-being and mental health. It’s not just about getting patients through the critical component — the surviving — it is about the thriving. That is our ‘WHY.’”
Vollman will present again on Wednesday, 4:15-5:30 p.m., in room 205A.