ST - NYSPFP
ST. LUKE’S ROOSEVELT HOSPITAL CENTER
ASSESSMENT FOR WEANING READINESS
& WEANING PROTOCOL
Screening by RN & RRT –see ICU flow sheet
Physician signature ___________ Print_________ beeper _____
DATE:___________Time ________ ________[pic]
ST. LUKE’S ROOSEVELT HOSPITAL CENTER
ACUTE WEANING PROTOCOL FOR ICU PATIENTS
[pic]
[pic]
-----------------------
PATIENT FACTORS
□ Hemodynamically stabilizing:
□ Vital signs acceptable ( BP ≥ 90 systolic, HR ≈ 55 to 135 bpm)
□ Tapering/low doses of vasopressors
□ SpO2 ≥ 92%
□ Can follow simple commands
□ Adequate cough on command or spontaneously
□ Initiate good inspiratory effort
□ Not expected to follow commands
VENTILATOR PARAMETERS
□ FiO2 < 50%
□ PEEP ≤ 5 cm H20
ABG PARAMETERS
□ PaO2 ≥ 75 mmHg
□ pH > 7.25
MEETS ALL READINESS CRITERIA ?
YES
○ Orders placed and PROCEED with WEANING PAGE 2
○ New + screen – contact MD for decision about proceeding with weaning
NO
o Continue daily assessment, no weaning
o MD order to PROCEED with WEANING mode On PAGE 2
Sedation:
○Sedation protocol RASS = 0 or hold sedation
○ Hold feedings for weaning trial
SICU SBT Trial
CPAP = 5
PS 0
FI02 21%
20 Min then ABG
GOAL: PaO2 > 50
PaCO2 50 on RA
YES
NO
Return to previously
tolerated settings
Return to pre-trial ventilator
settings
Inform MD
................
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