Pmvbedsideevaluation
Pmvbedsideevaluation
Pmvbedsideevaluation
Airway Related Ox
Extubation
Date performed
length of Intubation
Tracheotomll
Date performed
_surgical _ percutaneous
Steroids:
Tracheostomll Tube
Type
Size
Cuffed vs. Cuffless
Infiated Deflated
Inhaled
POIIV Reason
Secretions
Oral
Amount
Consistency
Color
Tracheal
Amount
Consistency
Color
Ventilator Settings
AlC rate
Ventilator Weaning
Trach Collar
SIMV/PS
Start Date
Schedule
Progress on Trach Collar Trials:
Tidal Vol
FI02
SpontVol
PEEP/CPAP
Compliance
Airway Resist
SIMV rate
PS
Pro Control
PIP
PalvD
Progress on SIMV/PS:
Nutritional Status
NPO
Oral (Diet level)
Food Consistency
Tube Feeding
Comments:
Swallowing Status
Clears secretions
- Yes
HiStory of aspiration
Yes
History of reflux problems _Yes
Bedside Swallow
_Passed
3 phase esophagram
Passed
Stomach
Small Bowel
No
No
No
Failed
Failed
Cognltive-Communicatlon Status
_Alert
Comments
Oriented
Disoriented
_ Nonresponsive
Mouthing Words
32
No
Forced
Time of Day
02 SAT IHR
Resp Rate
Accessory Muscles
Yes
No
Cough
_Strong
Guarded
Weak
Clears Secretions
_Yes
No
Anxiety
- Yes
No
Explain:
Vocal Intensity
_Strong
Weak
Speech
_ Intelligible
_ Unintelligible
Aphasic
Vocal Quality
_Whispery
Clear
Raspv
o Communciation
o Swallowing
o Airway Strengthening
o Cognitive Reorientation
o Secretion Management
o End of Life Issues
Date
Signature
Date
33
S';gnature