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In this episode of the Ventilator Podcast, we discuss different modes of ventilation, including AC (Assisted Controlled), AC Pressure, and SIMV (Synchronized Intermittent Mandatory Ventilation). We explain the key features and settings of each mode and provide insights on how to manage patients in these modes. We also emphasize the importance of understanding the patient's physiological condition and setting goals for ventilation during transport. We share their personal preferences for pressure control ventilation and discuss the advantages and disadvantages of each mode.
AC mode is volume targeted and delivers a preset volume at a set rate, while AC Pressure mode is pressure targeted and delivers a preset pressure at a set rate.SIMV mode combines mandatory ventilation with intermittent ventilation, allowing the patient to take breaths in between the mandatory breaths.Understanding the patient's physiological condition and setting goals for ventilation during transport is crucial.Pressure control ventilation is preferred by the hosts due to its ability to limit pressure and reduce the risk of ventilator-induced lung injury.The hosts discuss the challenges of synchronization in SIMV mode and recommend adjusting sensitivity settings to prevent breath stacking. Understanding the settings and parameters of different ventilation modes is crucial for safe and effective ventilation.Proper coaching and communication with the patient are essential during non-invasive ventilation.Knowing the equipment and the patient's condition is important for tailoring ventilation settings to the patient's needs.Patient comfort and synchronization with the ventilator are key factors to consider in ventilation.Regular training and practice with different ventilation modes can help healthcare professionals become more proficient in their use.
In this conversation, we are discussing different modes of ventilation, including pressure-triggered vent, CPAP, BiLevel, and non-invasive ventilation. We emphasize the importance of understanding the settings and parameters of each mode and tailoring them to the patient's needs. We also highlight the need for proper coaching and communication with the patient during non-invasive ventilation. We as always, stress the importance of knowing the equipment and the patient's condition to ensure safe and effective ventilation.
Keywords: ventilation modes, AC, AC Pressure, SIMV, volume targeted, pressure targeted, mandatory ventilation, intermittent ventilation, synchronization, pressure support, driving pressure, weaning, ventilation modes, pressure-triggered vent, CPAP, BiLevel, non-invasive ventilation, patient comfort, coaching, equipment knowledge
Takeaways[email protected]
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In this episode, we provide an overview of the Zoll EMV+ and Zoll Z-Vent ventilators. We discuss the different modes and preset settings of the ventilators, as well as important considerations such as tubing compliance, leak compensation, and rise time. We emphasize the importance of knowing the equipment and understanding the patient's lung physiology to ensure patient safety and comfort. We also encourage listeners to ask questions and provide feedback for future episodes.
Keywords: ventilators, Zoll EMV+, Zoll Z-Vent, modes, preset settings, tubing compliance, leak compensation, rise time, patient safety, patient comfort
Know your equipment and read the manual to understand its capabilities and limitationsConsider the patient's lung physiology when making adjustments to the ventilator settingsBe aware of the different modes and preset settings available on the Zoll ventilatorsPay attention to factors such as tubing compliance, leak compensation, and rise timeAsk questions and provide feedback to improve future episodes
Takeaways[email protected]
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We're back! In this episode, we discuss ventilator modes, specifically focusing on pressure regulated volume control (PRVC). We explain the basics of PRVC and how it differs from other modes. We also discuss the challenges of classifying ventilator modes and the importance of understanding the patient's needs and disease process when selecting a mode. We provide strategies for managing air hungry patients and offer tips for adjusting settings on different ventilator models. We also want to emphasize the need for individualized care and monitoring of patient response.
Understanding the basics of PRVC and how it differs from other ventilator modesConsidering the patient's needs and disease process when selecting a modeStrategies for managing air hungry patients and adjusting settings on different ventilator modelsThe importance of individualized care and monitoring patient response
Takeaways
Keywords
ventilator modes, pressure regulated volume control, PRVC, air hungry patients, individualized care, monitoring[email protected]
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In this episode, we reflect on our podcast journey over the last year and the global reach of our show. We discuss the importance of training and knowledge in using ventilators effectively. We recap the basic ventilator settings and emphasize the need to monitor and meet the patient's needs as well. We engage in a slight debate about SIMV vs. AC mode and discuss the increasing use of non-invasive ventilation in transports. We also highlight the new definitions in ARDS classification and express our commitment to research and evidence-based practice. We want to conclude this episode by encouraging listeners to engage with them and stay updated on their future episodes.
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In this case study, we delve into the intricate care of a pediatric patient facing the daunting challenge of chest trauma. Through our discussion, we illuminate crucial ventilator strategies, meticulous fluid management, and the nuanced considerations surrounding medication administration.Embedded within our discourse is an unwavering call to arms for unwavering familiarity with equipment and adherence to guidelines. Furthermore, we underscore the indispensable value of ongoing training and education, particularly in the delicate realm of pediatric care.
[email protected]#FlightParamedics#FlightNurses#BestJobEver#CriticalCareTransport
#LifeSavers#FlightMedicine#HighFlyingHeroes#CriticalCareTeam
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Summary
In this episode, we discuss various topics related to ventilator management. They answer mailbag questions and provide insights on transporting and transitioning LTAC patients. They also explain how to measure plateau pressure on a Hamilton T1 ventilator and discuss the importance of understanding different ventilator modes. Additionally, they address the issue of low-pressure oxygen on noninvasive ventilation. The episode concludes with closing remarks and a call for listener engagement.
Takeaways
Proper communication with caregivers and patients is crucial when dealing with LTAC patients.Understanding different ventilator modes is essential for effective ventilator management.Measuring plateau pressure on a Hamilton T1 ventilator requires using the delta pressure and adding the PEEP setting.Low-pressure oxygen on noninvasive ventilation should be used cautiously and with proper training.Email us at: [email protected]
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Summary – Part 1 & Part 2
In this episode, we would like to introduce Jesse Carroll, the EMS accounts manager for Hamilton Medical. We discuss ASV (Adaptive Support Ventilation) on the Hamilton T1 ventilator and address misconceptions and myths about the mode. We want to highlight the benefits of ASV in reducing cognitive load for clinicians and promoting lung protective strategies. The limitations and contraindications of ASV are also discussed. This conversation explores the training methods and approaches for ventilator management. The discussion emphasizes the importance of waveform management and understanding pressure, flow, and volume. The dynamic lung graphic is introduced as a valuable tool for identifying disease processes. The conversation highlights the significance of practical training and the use of the dynamic lung in both ASV and conventional ventilation modes. The importance of time on target and the challenges of implementing complex formulas like the Otis and Meads equations are discussed. The conversation concludes with a focus on reducing cognitive load and engaging learners with practical applications.
These episodes (Part 1 & 2) conclude with a focus on educating and building trust in ASV.
Contact us at: [email protected]
Key Takeaways for Part 1 & Part 2
ASV on the Hamilton T1 ventilator leverages the power of the proximal flow sensor to measure and manipulate a patient's ventilation status.ASV is an advanced monitoring device that reduces cognitive load for clinicians and allows for optimal patient care.ASV provides lung protective strategies by monitoring static lung compliance, airway resistance, and expiratory time constant.ASV is not a set it and forget it mode, but rather a tool to optimize patient care and engage clinicians in the ventilation process.Education and trust-building are essential in promoting the use of ASV and transitioning from ASV to conventional ventilation. Understanding waveforms is crucial for effective ventilator training.The dynamic lung graphic is a valuable tool for identifying disease processes.Practical training and hands-on experience are essential for mastering ventilator management.Reducing cognitive load and engaging learners with practical applications can enhance understanding and retention.[email protected]
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Summary – Part 1 & Part 2
In this episode, we would like to introduce Jesse Carroll, the EMS accounts manager for Hamilton Medical. We discuss ASV (Adaptive Support Ventilation) on the Hamilton T1 ventilator and address misconceptions and myths about the mode. We want to highlight the benefits of ASV in reducing cognitive load for clinicians and promoting lung protective strategies. The limitations and contraindications of ASV are also discussed. This conversation explores the training methods and approaches for ventilator management. The discussion emphasizes the importance of waveform management and understanding pressure, flow, and volume. The dynamic lung graphic is introduced as a valuable tool for identifying disease processes. The conversation highlights the significance of practical training and the use of the dynamic lung in both ASV and conventional ventilation modes. The importance of time on target and the challenges of implementing complex formulas like the Otis and Meads equations are discussed. The conversation concludes with a focus on reducing cognitive load and engaging learners with practical applications.
These episodes (Part 1 & 2) conclude with a focus on educating and building trust in ASV.
Contact us at: [email protected]
Key Takeaways for Part 1 & Part 2
ASV on the Hamilton T1 ventilator leverages the power of the proximal flow sensor to measure and manipulate a patient's ventilation status.ASV is an advanced monitoring device that reduces cognitive load for clinicians and allows for optimal patient care.ASV provides lung protective strategies by monitoring static lung compliance, airway resistance, and expiratory time constant.ASV is not a set it and forget it mode, but rather a tool to optimize patient care and engage clinicians in the ventilation process.Education and trust-building are essential in promoting the use of ASV and transitioning from ASV to conventional ventilation. Understanding waveforms is crucial for effective ventilator training.The dynamic lung graphic is a valuable tool for identifying disease processes.Practical training and hands-on experience are essential for mastering ventilator management.Reducing cognitive load and engaging learners with practical applications can enhance understanding and retention.[email protected]
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Summary
In this episode, we discuss the challenges of neonatal and pediatric ventilation. We also want to emphasize the importance of experience and knowledge in handling ventilators for these patients. We’re covering topics such as ventilator settings for neonates, the significance of inspiratory time, ventilation strategies for different lung diseases, and the use of high-frequency oscillation and high-frequency jet ventilation. We’re also discuss the two-piece resuscitator and the concept of minute ventilation. We stress the importance of consulting with medical direction and following their guidance.
Takeaways
Neonatal and pediatric ventilation requires experience and knowledge of ventilator settings specific to these patients.The inspiratory time is a crucial setting that needs to be adjusted based on the patient's size and condition.Different lung diseases require different ventilation strategies, such as higher pressures for respiratory distress syndrome (RDS) and careful flow management for bronchopulmonary dysplasia (BPD).Mean airway pressure is a key factor in oxygenation, and adjustments may be necessary to achieve optimal oxygen levels.High-frequency oscillation and high-frequency jet ventilation are alternative ventilation methods for patients with high mean airway pressures.Consulting with medical professionals and following their guidance is essential in providing appropriate ventilation for neonatal and pediatric patients.email us at: [email protected]
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Summary
In this episode, we discuss the challenges and considerations for neonatal and pediatric intubation. We emphasize the need for proper training and reference materials for healthcare professionals who may be called upon to transport neonates and pediatric patients. The discussion covers topics such as ET tube sizes and placement, securing the ET tube, choosing the right laryngoscope, and pharmacological considerations. We also highlight the importance of pre-oxygenation and bag-mask ventilation, as well as the use of backup airway devices. The episode concludes with a call for listener questions and feedback.
Mailbag: [email protected]
Takeaways
Proper training and reference materials are essential for healthcare professionals who may be called upon to transport neonates and pediatric patients.When intubating neonates, it is important to consider the appropriate ET tube size based on weight and gestational age.Securing the ET tube is crucial, and healthcare professionals should be skilled in proper taping techniques.Neonates should not be treated as "little adults"; they have unique physiological responses and considerations.Pre-oxygenation and bag-mask ventilation are critical in neonatal intubation to ensure adequate oxygenation and ventilation.Backup airway devices, such as LMAs and iGels, should be available in case intubation is unsuccessful.[email protected]
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In this episode, the hosts tackle questions from listeners. They discuss the differences between ABGs and VBGs, the applications of dead space in ventilating patients, and how to calculate ideal body weight and tidal volume for patients with congenital deformities. The hosts emphasize the importance of individualized approaches in medicine and patient safety. They also express their gratitude for the questions and wish listeners happy holidays.
Takeaways
ABGs and VBGs have different applications and should be chosen based on the specific needs of the patient.Dead space can be introduced through various applications in ventilation and should be carefully managed to prevent complications.Calculating ideal body weight and tidal volume for patients with congenital deformities can be challenging, and individualized approaches are necessary.Patient safety and comfort should always be prioritized in medical practice.
Special thanks to our listeners that send in questions.
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Part 2 continuation...
Case Study Description:10-month-old infant who was born prematurely at 30 weeks’ gestation. She has a history of chronic lung disease. Over the past few days, her parents have noticed increased respiratory distress with coughing, wheezing, and nasal flaring. They also report decreased oral intake and increased irritability.
We are getting ready to transport.[email protected]
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RSV is usually a seasonal disease, the CDC says, causing illnesses in the US between October and April, with the largest wave coming in December or January. RSV is the most common cause of hospitalization in children under age 1 year. Two to three out of every 100 infants with RSV infection may require a hospital stay. Those babies may need oxygen to help with breathing or IV fluids if they are not eating or drinking. Most of these children get better and can go home after a few days but some do not…
Case Study Description:10-month-old infant who was born prematurely at 30 weeks’ gestation. She has a history of chronic lung disease. Over the past few days, her parents have noticed increased respiratory distress with coughing, wheezing, and nasal flaring. They also report decreased oral intake and increased irritability. You are being called to transport to Children’s Hospital.
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In this episode we discuss a case scenario of Asthma exacerbation. This can be one of the most challenging patients to manage on the ventilator. If at all possible we try not to intubate these patients, however there are times when this happens. We will discuss clinical treatment, ventilator management, and what our rolls are as transport clinicians in the transport of these patients.
References:
1) National Asthma Education and Prevention Program: Expert Panel Report III: Guidelines for the diagnosis and management of asthma. Bethesda, MD. National Heart, Lung, and Blood Institute, 2007. (NIH publication no. 08-4051) www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm (Accessed on September 19, 2018).
2) McFadden ER Jr, Lyons HA. Arterial-blood gas tension in asthma. N Engl J Med. 1968 May 9;278(19):1027-32. doi: 10.1056/NEJM196805092781901. PMID: 5644962.
3) Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention. www.ginasthma.org (Accessed on February 13, 2022)
4) National Asthma Education and Prevention Program: Expert Panel Report III: Guidelines for the diagnosis and management of asthma. Bethesda, MD. National Heart, Lung, and Blood Institute, 2007. (NIH publication no. 08-4051) www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm (Accessed on September 19, 2018).
5) Rowe BH, Spooner C, Ducharme FM, Bretzlaff JA, Bota GW. Early emergency department treatment of acute asthma with systemic corticosteroids. Cochrane Database Syst Rev. 2001;(1):CD002178. doi: 10.1002/14651858.CD002178. PMID: 11279756.
6) Menzies-Gow A, Busse WW, Castro M, Jackson DJ. Prevention and Treatment of Asthma Exacerbations in Adults. J Allergy Clin Immunol Pract. 2021 Jul;9(7):2578-2586. doi: 10.1016/j.jaip.2021.05.016. PMID: 34246434.
7) Nanchal R, Kumar G, Majumdar T, et al. Utilization of mechanical ventilation for asthma exacerbations: analysis of a national database. Respir Care 2014; 59:644.[email protected]
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