Is that a VAP?

You are informed by the nurse that your ventilated patient has a fever, and the lab tells you that there are Gram - rods in his sputum culture.

Is is a Ventilator Associated Pneumonia?

It may be, after all, VAP is the most frequent nosocomial infection in the ICU.  You still need more information...

First, what does today's chest x-ray show?   If there is a new or worsening infiltrate, you have met the first requirement to diagnose a VAP.
If the x-ray is normal or unchanged, it is not a VAP.

But the x-ray isn't the only thing you need to know.  What about:
1.What are the patient's tracheal secretions like?
2. Is the patient febrile?
3. Does the patient have a rising WBC?

To make the diagnosis of VAP you must have:
*** A new or progressive pulmonary infiltrate on CXR***
plus at least 2 of the following:
1. Fever
2. Leukocytosis or leukopenia
3. Purulent secretions

Once you make the diagnosis, how do you treat it?
Start broad-spectrum empiric antibiotics - to treat Gram negative and Gram positive organisms.
Once you have your culture results, you can tailor your antibiotics.

Treat for a total of 8 days.