Mr. A is an 18-year-old 80-kg African American man admitted to the intensive care unit after...

answer:

Mr.A 18 years old have suffering with conditions like gun shot injury and also he has ARDS.

patients put on mechanical ventilator for prevention of complication strategy which useful are:

• supportive care (oxygenation for prevent further damage of cells of body)
• ventilator support
• positioning of patients
• sedation and medications to prevent movement
• fluid management
• ECMO
• further diagnosis

there is also important things when manage this patient with ARDS is maintain perfusion,positioning,protective lung ventilation,protocol weaning and prevent complications like deep vein thrombosis,pressure ulcer,decreased nutritional status,VAP etc.

for prevention of complication:

DVT: warm and moist compresses, elevate affected leg,anticoagulants,analgsic

pressure ulcer: proper adequate nutrition , skin care, pressure relieving devices(air mattress)

VAP: antibacterial antibiotics ,management of air way, frequently suctioning , aseptic techniques.

MECHANICAL VENTILATION is lung protective ventilation is only supportive therapy that can clearly improve survival in patient with ARDS and post surgical complications, however mechanical ventilation can lead to lung injury by different mechanisms , according to the mode of ventilator patient lastly seen stabilized but if there is no progress in patients there may be need to put patients on ECMO if more damage in lungs

ECMO is extracorporeal membrane oxygenation which providing prolong cardiac and respiratory support to patient whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life.

indication and uses are:

• hypoxemic respiratory failure
• hypercapnic respiratory failure with an arterial Ph <7.20
• cardiogenic shock
• cardiac arrest

so in condition of mr.A the best technology useful after mechanical ventilator is ECMO and also according his critical condition continuous observation is also important .there may be can changes in ventilator according to condition of the patient.