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Ventilators. How to understand them. Ventilator. A device for getting air in and out of a patients lungs. Ventilator. Negative pressure positive pressure. Cuirasse Iron lung. ITU ventilators. NIPP ventilators. Domicilliary ventilators. Negative pressure. Advantages
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Ventilators How to understand them
Ventilator A device for getting air in and out of a patients lungs
Ventilator Negative pressure positive pressure Cuirasse Iron lung ITU ventilators NIPP ventilators Domicilliary ventilators
Negative pressure Advantages No need for tracheostomy more physiological Disadvantages Bulky Restrictive
ITU Ventilators Complex Need piped gasses Expensive Fragile
NIPP Ventilators Used to assist breathing eg COPD, scoliosis, muscular dystrophies sleep apnoea
Domicilliary ventilators Rugged Reliable Simple Variety of power sources (must have internal battery to be classed as life support device)
What do ventilators do ? Ensure gas exchange Enhance oxygenation Eliminate carbon dioxide
CO2 removal Depends on quantity of air moved in and out of lungs = minute volume = tidal volume X respiratory rate Tidal volume = 10 ml/Kg Resp rate 10/min Minute volume 100 ml/Kg Rough guides Measure PCO2 or ETCO2 (end tidal)
What if you get it wrong ? Hypoventilation Raised PCO2, low pH tachycardia, hypertension breathlessness, accesory muscle use tiredness, confusion, headache, nausea coma, death. Hyperventilation Low PCO2, raised pH vasoconstriction dizzyness, confusion, parasthesia
What do all the knobs do ? 1. Basic ventilator settings 2. Alarm settings 3. Optional extras
How to achieve the minute volume of your dreams Basic settings Volume ventilators Set tidal volume and respiratory rate Pressure ventilators Set desired pressure and respiratory rate
Optional extras basic settings I:E Ratio Flow rate Sigh Oxygen PEEP
Alarm settings High airway pressure Low airway pressure Optional extras Low minute volume Low Oxygen
Optional extras Trigger Alarm volume FiO2 High airway pressure delay Low airway pressure delay