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Interfacility Ventilator Management 

Interfacility Ventilator Management
Interfacility Ventilator Management
Acute Care Casebook

Christopher Galton


Treating persistent hypoxia while attempting to transport a patient from one health care setting to a destination facility can be one of the most stressful situations emergency medical services providers face. In some cases, the primarily pathology may not be well defined. This case reviews the approach to managing a critically ill patient who is mechanically ventilated and is being transferred to a quaternary center for continued management. The case works through a differential diagnosis of hypoxemia in a mechanically ventilated patient. It also includes dynamic adjustments of the ventilator to maximize success and reduce any potential iatrogenic complications. Finally, adequate sedation is pivotal to promote ventilator synchrony and patient comfort. This case illustrates the nuances of sedation and when neuromuscular blockade should be considered.

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