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Episode of admitted patient care—duration of continuous ventilatory support, total hours NNNN

Identifying and definitional attributes

Metadata item type:Help on this termData Element
Short name:Help on this termDuration of continuous ventilatory support
Synonymous names:Help on this termDuration of mechanical ventilation
METeOR identifier:Help on this term652006
Registration status:Help on this termHealth, Superseded 12/12/2018
Tasmanian Health, Endorsed 10/01/2018
ACT Health, Final 09/08/2018
Definition:Help on this term

The total number of hours an admitted patient has spent on continuous ventilatory support.

Data Element Concept:Episode of admitted patient care—duration of continuous ventilatory support

Value domain attributes

Representational attributes

Representation class:Help on this termTotal
Data type:Help on this termNumber
Format:Help on this termNNNN
Maximum character length:Help on this term4
Unit of measure:Help on this termHour (h)

Collection and usage attributes

Guide for use:Help on this termTotal hours expressed as 0000, 0001, 0425 etc.

Data element attributes

Collection and usage attributes

Guide for use:Help on this term

Continuous ventilatory support or invasive ventilation refers to the application of ventilation via an invasive artificial airway. For the purposes of this data element, invasive artificial airway is that provided via an endotracheal tube or a tracheostomy tube.

An endotracheal tube can be placed orally or nasally. It is usually employed prior to a surgically placed tracheostomy tube.

With prolonged ventilation, or when prolonged ventilation is expected, a tracheostomy tube is placed surgically.

Collection methods:Help on this term

For the purposes of calculating the duration of continuous ventilatory support, begin calculation with one of the following:

  • Initiation of continuous ventilatory support. For example, for patients with endotracheal intubation and subsequent initiation of continuous ventilatory support, begin counting at the time of intubation. Patients with a tracheostomy, begin counting at the point when continuous ventilatory support is begun; or
  • Admission of a ventilated patient. For those patients admitted with continuous ventilatory support, begin counting the duration at the time of the admission.

End the calculation with one of the following:

  • Extubation (e.g. removal of endotracheal tube);
  • Cessation of continuous ventilatory support after any period of weaning. For tracheostomy patients, the tracheal tube may not be withdrawn for days after discontinuation of continuous ventilatory support. Therefore, the duration would end with the cessation of continuous ventilatory support. For weaning, using methods such as positive pressure ventilation or oxygen delivery via a tracheostomy collar, include the weaning in the duration of continuous ventilatory support up to a maximum of 24 hours following cessation, or the removal of the tracheostomy. Where continuous ventilatory support via the tracheostomy recommences > 24 hours following cessation a new period of ventilation commences;
  • Discharge, death or transfer of a patient on continuous ventilatory support; or
  • Change of episode type.

Subsequent periods of continuous ventilatory support should be added together. For example, if a patient is on continuous ventilatory support on the first day of their admission, then again on the fourth day of their admission, the hours should be added together.

If there is a period of less than 1 hour between cessation and then restarting of ventilatory support, continue counting the duration. If there is removal and immediate replacement of airway devices, continue counting the duration.

Ventilatory support which is provided to a patient during surgery is associated with anaesthesia and is considered an integral part of the surgical procedure. Duration of continuous ventilatory support should not be counted if it is part of a surgical procedure, except in the following circumstances:

  • Ventilatory support was performed for respiratory support prior to surgery and then continued during surgery and post surgery; or
  • Ventilatory support was initiated during surgery, continues after surgery and for more than 24 hours post surgery. Where a patient has multiple visits to theatre requiring ventilation, each period of ventilation should be considered individually. If the period of ventilation post surgery is ≤ 24 hours it is not considered or used cumulatively with other periods of ventilation in the episode of care.

Hours of ventilatory support should be reported as completed cumulative hours. For example, if the total duration of ventilatory support was 98 hours 45 minutes, report 98 hours. If a patient is intubated and ventilated for < 1 hour the intubation and ventilation are not reported. This includes patients who die or are discharged or transferred.

Source and reference attributes

Submitting organisation:Help on this term

Independent Hospital Pricing Authority

Reference documents:Help on this term

Australian Consortium for Classification Development 2016. Australian Coding Standards for ICD-10-AM (The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification) and ACHI (The Australian Classification of Health Interventions) (10th edition). Sydney: Independent Hospital Pricing Authority.

Relational attributes

Related metadata references:Help on this term

Has been superseded by Episode of admitted patient care—duration of continuous ventilatory support, total hours NNNN Health, Standard 12/12/2018

Supersedes Episode of admitted patient care—duration of continuous ventilatory support, total hours NNNN Health, Superseded 25/01/2018, Independent Hospital Pricing Authority, Standard 31/10/2012

Implementation in Data Set Specifications:Help on this term
All attributes +

Admitted patient care NMDS 2017-18 Health, Superseded 25/01/2018

DSS specific attributes +

Admitted patient care NMDS 2018-19 Health, Superseded 12/12/2018
ACT Health, Final 09/08/2018

DSS specific attributes +

Tasmanian Admitted Patient Data Set - 2018 Tasmanian Health, Archived 12/04/2019

DSS specific attributes +

Tasmanian Admitted Patient Data Set - 2019 Tasmanian Health, Endorsed 12/04/2019

DSS specific attributes +
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