Ventilator Liberation: Navigating Spontaneous Breathing Trials
Presented by Karen LaRoché
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Ventilator liberation through spontaneous breathing trials is an evidence-based practice that is adopted by many institutions. However, the successful utilization of this standard is variable based on the understanding of how to apply the process and the clinical assessments by bedside staff. This course is intended to improve clinical decision-making regarding how to use patient assessment to navigate the spontaneous breathing trial process, identify clinical barriers to spontaneous breathing trial success, and strategize how to remove those barriers, including the implementation of effective and efficient team communication. Through interactive case studies and coverage of evidence-based guidelines, respiratory therapists working across acute and post-acute settings will be equipped with strategies to effectively navigate spontaneous breathing trials to support patients with ventilator liberation.
Meet your instructor
Karen LaRoché
With more than 30 years of adult critical care and trauma experience, Karen LaRoché has learned that critical thinking and evidence-based processes are at the root of not only patient safety and patient progress, but also staff satisfaction. She now works to share her experiences with others through professional education and…
Chapters & learning objectives
1. Identifying When to Perform Spontaneous Breathing Trials
A critical step in liberating a patient from the ventilator is the spontaneous breathing trial (SBT), but it’s not always clear when an SBT should be performed. This chapter discusses the process of critically evaluating patients who qualify for an SBT using evidence-based criteria, as well as how to decrease missed SBT opportunities by using critical thinking practices and patient advocacy.
2. How to Get Over Hurdles
There are many obstacles that can disrupt the spontaneous breathing trial process, but these can often be overcome if addressed appropriately. This chapter will identify common obstacles faced in the intensive care unit that may prevent spontaneous breathing trials from being initiated and will discuss strategies to aid in overcoming those obstacles.
3. Teamwork at the Bedside
Teamwork at the bedside is crucial to the success of your patient’s journey to ventilator liberation. Often, clinicians miss communicating key elements to the team, which can lead to delay or misalignment of implementing a successful SBT. This chapter will cover a framework for approaching communication and provide demonstrations of communication examples to highlight scenarios commonly seen at the bedside.
4. When to Consider Other Strategies
Even the best evidence-based practices will have patient populations that are outliers. This chapter will identify a few patient populations that are common outliers to the standard SBT strategy, discuss why the standard SBT strategy may be challenging for each, and present tools and assessments that may enhance the standard SBT methods to improve ventilator liberation success.
