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Welcome to the Mechanical Ventilator Simulation

Welcome to the Mechanical Ventilator Simulation. To continue. NEXT. Please click. Log-In. Please select your name from the list. Jane Smith. Henry Gibbs Bill Clinton Hawkeye Perce BJ Honeycutt Mike Smith Steve Hawking Conrad Black. Password:. Students work independently but are

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Welcome to the Mechanical Ventilator Simulation

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  1. Welcome to the Mechanical Ventilator Simulation To continue NEXT Please click

  2. Log-In Please select your name from the list Jane Smith Henry Gibbs Bill Clinton Hawkeye Perce BJ Honeycutt Mike Smith Steve Hawking Conrad Black Password: Students work independently but are Allowed to consult with each other. This same context as In the clinical area.

  3. Screen Layout This is an example of one screen Layout that the students can choose This layout mimics layout of The Puritan Bennett 840. Students have the option of choosing Layouts for Seimens 300C and the Evita version 5 mechanical Ventilators. These are currently the most commonly Used ventilators in practice. Blood Gas Patient Responses pH RR TVE MVE PCO2 PO2 HCO3 Ventilator Settings SaO2 FiO2 Mode Timer RR Set TV Help Activate Changes PEEP 5

  4. Description of screen elements Blood Gas This Section of the screen has The results of a blood gas. The student will have to interpret the blood gas before making any changes on the mechanical ventilation settings Patient Responses pH RR TVE MVE PCO2 PO2 HCO3 Ventilator Settings SaO2 FiO2 Mode Timer Help Set TV Set RR Activate Changes

  5. This section has the changes the student Can make to the mechanical ventilator Settings. They are a simulation of the Buttons on a Puritan-Bennett 840A. Blood Gas Patient Responses pH RR TVE MVE PCO2 PO2 HCO3 Ventilator Settings SaO2 FiO2 Mode Timer Set TV RR Help Activate Changes PEEP 5

  6. Blood Gas Patient Responses pH RR TVE MVE PCO2 Patients do respond to mechanical ventilation. In this box is how the patient is responding. For instance if the student sets the respiratory Rate at 10, it is conceivable the patient could Breathe above this set rate. The student will have to take into consideration The patient’s efforts to breathe when making Changes. PO2 HCO3 Ventilator Settings SaO2 FiO2 Mode Timer Set TV Help Set TV Activate Changes PEEP 5

  7. Blood Gas Once the student has decided on what Changes to make, they click on This button to activate the changes they Have selected. This mimics closely What occurs in the clinical area. Patient Responses pH RR TVE MVE PCO2 PO2 HCO3 Ventilator Settings SaO2 FiO2 Mode Timer Set TV RR Help Activate Changes PEEP 5

  8. Once the student has activated their change A timer will count down from 20 seconds. Most health care facilities will check A blood gas result 20 minutes after a Ventilator change. For this simulation 1sec = 1 minute. The student will slowly see the blood gas Change as time ticks down. This way they will know they are on the Right track or not. Blood Gas Patient Responses pH RR TVE MVE PCO2 PO2 HCO3 Ventilator Settings SaO2 FiO2 Mode Timer Set TV Set RR Help Activate Changes PEEP 5

  9. Blood Gas At any time the student can push the Help button for assistance The help button will flash to indicate That it has something to contribute Concerning the changes to ventilation. Patient Responses pH RR TVE MVE PCO2 PO2 HCO3 Ventilator Settings SaO2 FiO2 Mode Timer Help Set TV Set RR Activate Changes PEEP 5

  10. Example of setting changes using Rate change Blood Gas Patient Responses pH 7.12 RR 10 TVE 240 MVE2.5 L/m PCO2 75 PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode A/C Timer Set RR 10 Help Set TV 250cc Activate Changes PEEP 5

  11. Student resetting rate Blood Gas Patient Responses pH 7.12 RR 10 TVE 240 MVE2.5 L/m PCO2 75 PO2 89 Student is changing set respiratory rate HCO3 24 Ventilator Settings 16151413121110 SaO2 92% FiO2 .45 Mode A/C Timer Help Set TV 250cc Set RR 10 Activate Changes PEEP 5

  12. Timer activated after change Blood Gas Patient Responses pH 7.12 RR 16 TVE 240 MVE4.0 L/m PCO2 75 PO2 89 Student has activated the changes And the timer has started the count down HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode A/C 19 sec Help Set TV 250cc Set RR 16 Activate Changes PEEP 5

  13. 10 secs after changes. Blood Gas Patient Responses pH 7.32 RR 16 TVE 340 MVE4.0 L/m PCO2 50 10 secs have passed since change, some changes Are apparent on the blood gas PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode A/C 10 secs Help Set TV 250cc Set RR 16 Activate Changes PEEP 5

  14. Congratulations; can you solve it another way Blood Gas Patient Responses Excellent. You have correctly Resolved the respiratory Acidosis by adjusting the Respiratory rate. Can you think of another way To solve the acidosis? Let’s go back to the start and See if you can solve it without Adjusting the rate. I am here if you need help. Just click on “Help”. pH 7.38 RR 16 TVE 240 MVE4.0 L/m PCO2 41 PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode A/C 00 secs Help Set TV 250cc Set RR 16 Activate Changes PEEP 5

  15. Re-setting TV Returned to the same situation Blood Gas Patient Responses pH 7.12 RR 10 TVE 240 MVE2.5 L/m PCO2 75 Student has determined they can change TV PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode A/C 350325300275250 Timer Help Set TV 250cc Set RR 10 Activate Changes PEEP 5

  16. Changes activated Blood Gas Patient Responses pH 7.12 RR 10 TVE 340 MVE4.0 L/m PCO2 75 PO2 89 Student has activated the changes And the timer has started the count down HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode A/C 19 sec Help Set TV 350cc Set RR 10 Activate Changes PEEP 5

  17. 10 secs after changes. Blood Gas Patient Responses pH 7.32 RR 10 TVE 340 MVE4.0 L/m PCO2 50 10 secs have passed since change, some changes Are apparent on the blood gas PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode A/C 10 secs Help Set TV 350cc Set RR 10 Activate Changes PEEP 5

  18. Congratulations; solved both ways Blood Gas Patient Responses Excellent. You have correctly Resolved the respiratory Acidosis by adjusting the Respiratory rate and TV. By adjusting the rate and/ or TV you can blow Off CO2. Knowing this what settings would you manipulate For respiratory alkalosis?? pH 7.38 RR 16 TVE 240 MVE4.0 L/m PCO2 41 PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode A/C 00 secs Help Set TV 250cc Set RR 16 Activate Changes PEEP 5

  19. Example of setting changes using mode change(PC) Blood Gas Patient Responses pH 7.12 RR 10 TVE 240 MVE2.5 L/m PCO2 75 Note same blood gas but different Ventilator settings PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode PC Timer Help Set Pressure 22 Set RR 10 Activate Changes PEEP 5

  20. Student resetting rate Blood Gas Patient Responses pH 7.12 RR 10 TVE 240 MVE2.5 L/m PCO2 75 PO2 89 Student is changing set respiratory rate HCO3 24 Ventilator Settings 16151413121110 SaO2 92% FiO2 .45 Mode PC Timer Help Set Pressure 22 Set RR 10 Activate Changes PEEP 5

  21. Timer activated after change Blood Gas Patient Responses pH 7.12 RR 16 TVE 240 MVE4.0 L/m PCO2 75 PO2 89 Student has activated the changes And the timer has started the count down HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode PC 19 sec Help Set Pressure 22 Set RR 16 Activate Changes PEEP 5

  22. 10 seconds after changes Blood Gas Patient Responses pH 7.32 RR 16 TVE 240 MVE4.0 L/m PCO2 50 10 secs have passed since change, some changes Are apparent on the blood gas PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode PC 10 secs Help Set Pressure 22 Set RR 16 Activate Changes PEEP 5

  23. Congratulations; can you solve it another way Blood Gas Patient Responses Excellent. You have correctly Resolved the respiratory Acidosis by adjusting the Respiratory rate. Can you think of another way To solve the acidosis? Let’s go back to the start and See if you can solve it without Adjusting the rate. I am here if you need help. Just click on “Help”. pH 7.38 RR 16 TVE 240 MVE4.0 L/m PCO2 41 PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode A/C 00 secs Help Set TV 250cc Set RR 16 Activate Changes PEEP 5

  24. Adjusting set pressure Returned to the same situation Blood Gas Patient Responses pH 7.12 RR 10 TVE 240 MVE2.5 L/m PCO2 75 Student has determined they can set pressure As this will change TV PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode PC 282624222018 Timer Help Set Pressure 22 Set RR 10 Activate Changes PEEP 5

  25. Timer activated after change Blood Gas Patient Responses pH 7.12 RR 10 TVE 405 MVE4.0 L/m PCO2 75 PO2 89 Student has activated the changes And the timer has started the count down HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode PC 19 sec Help Set Pressure 28 Set RR 10 Activate Changes PEEP 5

  26. 10 seconds after changes Blood Gas Patient Responses pH 7.32 RR 10 TVE 405 MVE4.0 L/m PCO2 50 10 secs have passed since change, some changes Are apparent on the blood gas PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode PC 10 secs Help Set Pressure 28 Set RR 10 Activate Changes PEEP 5

  27. Congratulations; can you solve it another way Blood Gas Patient Responses Excellent. You have correctly Resolved the respiratory Acidosis by adjusting the Set pressure. To resolve respiratory acidosis in PC ventilation Adjusting either the rate or the set pressure Allows for more CO2 to be blown off. pH 7.38 RR 16 TVE 240 MVE4.0 L/m PCO2 41 PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode A/C 00 secs Help Set Pressure 28 Set RR 10 Activate Changes PEEP 5

  28. Example of choosing the wrong settings Blood Gas Patient Responses pH 7.12 RR TVE MVE PCO2 75 PO2 89 HCO3 24 Ventilator Settings SaO2 92% PC .45 FiO2 Mode Timer Help 10 Set Pressure 22 Set RR Activate Changes PEEP 5

  29. Student selecting PEEP- wrong choice Blood Gas Patient Responses pH 7.12 RR 10 TVE 240 MVE2.5 L/m PCO2 75 Student is changing the PEEP in this case Which is not the correct choice PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode PC Timer 98765 Help Set Pressure 22 Set RR 10 Activate Changes PEEP 5

  30. Timer activated after change Blood Gas Patient Responses pH 7.12 RR 10 TVE 405 MVE4.0 L/m PCO2 75 PO2 89 Student has activated the changes And the timer has started the count down HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode PC 19 sec Help Set Pressure 28 Set RR 10 Activate Changes PEEP 10

  31. No change after PEEP adjusted Blood Gas Patient Responses pH 7.12 RR 10 TVE 405 MVE4.0 L/m PCO2 75 Student has activated the changes, time has Expired and no changes have occurred to Blood gas. Help button flashes indicating the tutor can help PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode PC 0 sec Help Set Pressure 28 Set RR 10 Activate Changes PEEP 10

  32. Tutor gives first level of advice Blood Gas Patient Responses pH 7.12 RR 10 TVE 405 MVE4.0 L/m PCO2 75 The change you have selected will not work. Look again at the blood gas and determine the correct interpretation PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode PC 0 sec Help Set Pressure 28 Set RR 10 Activate Changes PEEP 10

  33. Tutor gives second level of advice Blood Gas Patient Responses pH 7.12 RR 10 TVE 405 MVE4.0 L/m PCO2 75 The change you have selected will not work. The blood gas is a respiratory acidosis indicating Inadequate ventilation PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode PC 0 sec Help Set Pressure 28 Set RR 10 Activate Changes PEEP 10

  34. Tutor gives Third level of advice Blood Gas Patient Responses pH 7.12 RR 10 TVE 405 MVE4.0 L/m PCO2 75 The change you have selected will not work. The blood gas is a respiratory acidosis indicating Inadequate ventilation. You need to make changes To either the rate or the set pressure. PO2 89 HCO3 24 Ventilator Settings SaO2 92% FiO2 .45 Mode PC 0 sec Help Set Pressure 28 Set RR 10 Activate Changes PEEP 10

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