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

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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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