Mechanical Ventilation Explained - Ventilator Settings & Modes (Respiratory Failure)

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  • Опубліковано 29 чер 2024
  • Professor Roger Seheult, MD gives a clear illustration of how mechanical ventilation works. Get CME for this video series: www.medcram.com/courses/mecha...
    Learn or review the different modes of ventilation and ventilator settings (based on volume, pressure, rate, flow, O2, CPAP) and other vent basics. This is video 1 of 5 on mechanical ventilation.
    Also, this video has been updated (and sped up) here: • Mechanical Ventilation...
    Speaker: Professor Roger Seheult, MD
    Clinical and Exam Preparation Instructor
    Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine.
    Website - www.medcram.com/?Y...
    MedCram: Medical topics explained clearly including: Asthma, respiratory failure, COPD, Acute Renal Failure, Mechanical Ventilation, Oxygen Hemoglobin Dissociation Curve, Hypertension, Shock, Diabetic Ketoacidosis (DKA), Medical Acid Base, VQ Mismatch, Hyponatremia, Liver Function Tests, Pulmonary Function Tests (PFTs), Adrenal Gland, Pneumonia Treatment, any many others. New topics are often added weekly- please subscribe to help support MedCram and become notified when new videos have been uploaded.
    Subscribe: ua-cam.com/users/subscription_...
    Recommended Audience: Health care professionals and medical students: including physicians, nurse practitioners, physician assistants, nurses, respiratory therapists, EMT and paramedics, and many others. Review for USMLE, MCAT, PANCE, NCLEX, NAPLEX, NDBE, RN, RT, MD, DO, PA, NP school and board examinations.
    More from MedCram:
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    Produced by Kyle Allred PA-C
    Please note: MedCram medical videos, medical lectures, medical illustrations, and medical animations are for medical education and exam preparation purposes, and not intended to replace recommendations by your health care provider.

КОМЕНТАРІ • 504

  • @Medcram
    @Medcram  7 років тому +42

    Thanks for watching. Get CME for this video series,
    AND see Dr. Seheult's updated vent videos at our website:
    www.medcram.com/courses/mechanical-ventilation-explained-clearly

    • @nazikalamin7732
      @nazikalamin7732 5 років тому +2

      MedCram - Medical Lectures
      Explained CLEARLY

  • @mrfrizzle0782
    @mrfrizzle0782 9 років тому +233

    I have used your lectures to help prepare myself for Nurse Anesthesia school interviews, and to obtain a better grasp of certain subjects. I have been accepted into the 2015 class and I want to take this time to thank you for all the great instruction you have given me through your lectures.

    • @CANAYAMD
      @CANAYAMD 7 років тому +1

      mrfrizzle0782 I thought volume control and pressure control are modes of assist control. You are equating assist control to volume control. Know what I mean?

    • @mannyhernandez9991
      @mannyhernandez9991 7 років тому +4

      CANAYAMD VC and PC are two different modes. They do have variations which add assist control for example ACVC+, ACPC, VOL/AF(seen on my anesthesia machine). But strict VC or PC have set values that do not assist a spontaneous breath. There is no pressure support setting on strict VC or PC. However you can assist with modes like SIMV, ACVC+, and of course pressure support. ACVC+ is essentially pressure regulated volume control, so you can deliver a set tidal volume with variable inspiratory pressure to account for changes in lung compliance thus hopefully minimizing your peak inspiratory pressures..hope I answered your question:)

    • @rdseheult
      @rdseheult 7 років тому +1

      That's awesome! Never stop. So great to be part of your education!

    • @bellefeu4933
      @bellefeu4933 4 роки тому +2

      How did it go?

  • @chelseaberry4639
    @chelseaberry4639 8 років тому +37

    Thank you for the videos, they are so helpful in understanding ventilators! It would be great to see a video on SIMV, and VC + (PRVC) in the future!

  • @raffyibanez9653
    @raffyibanez9653 10 місяців тому +8

    Who is here because they are the new nurse to the ICU unit.. 🥹

  • @amyaksu2137
    @amyaksu2137 4 роки тому +11

    Thank you! I'm an ER nurse turned ICU nurse literally overnight. I know nothing about mechanical ventilation and tomorrow I get to work on the machines for the first time so this is a great series!! I couldn't find something like this in German (I work in Germany as well) but hearing it explained so clearly in my mother tongue helps me feel less nervous.

    • @Medcram
      @Medcram  4 роки тому

      Good to hear, thanks for the comment

  • @darylreece7840
    @darylreece7840 4 роки тому +19

    I’m a mechanical engineer and I love your videos. They are very interesting and informative. Thanks!

  • @betfiendish
    @betfiendish 6 років тому +43

    this was great! I'm a nurse new to critical care and vents have been confusing the hell out of me, this is making it more clear, thank you!

  • @marisapinto249
    @marisapinto249 5 років тому +11

    Thank you very much for all of these videos doctor Roger Scheuld.I am an anesthesiologist and I am working in the Amazon Region (Roraima)..I am very thankful .

  • @irisitah77
    @irisitah77 4 роки тому +14

    Great video, perfect for ICU nurses like me who still struggle with understanding vents. Very easy to understand!

  • @radcow
    @radcow 4 роки тому +221

    Who's betting this video becomes even more popular

  • @jacobtaylor4258
    @jacobtaylor4258 5 років тому +15

    i was a patient on this treatment, i would just like to thank all doctors and nurses, and cleaners, they all do a fantastic job, god bless you all.

  • @RavishingSailor
    @RavishingSailor 6 років тому +8

    Great info. I'm gonna have to use you form of explaining (which is fantastic) when during MICU rounds for my medical students and new interns rotating through our service.

  • @irenetraum6904
    @irenetraum6904 5 років тому +42

    I am leaving a huge "Thank you" here, I am working currently in Germany and this series of videos really help me to understand those differents modes of a ventilator! Congratulations for your nicely done and excellent work!

  • @tgreaux5027
    @tgreaux5027 4 роки тому +7

    MedCram is gonna blow up over the next 3 months.

  • @URCStJamessNewcastlehymns
    @URCStJamessNewcastlehymns 4 роки тому +20

    love the no nonsense terminology - as someone once said - the more you know about a subject the simpler you can make it sound

  • @MsRN75
    @MsRN75 9 років тому +34

    I work in a home care setting and my client is on a ventilator (non-dependent). This series was very helpful to understanding the vent dynamics. Thank you!

    • @Medcram
      @Medcram  9 років тому

      Deena Foote Glad to hear the series helped with your understanding

  • @nicholaswhs0896
    @nicholaswhs0896 5 років тому +6

    This helped a lot. I took CCP in the summer and that was the hardest class I've ever taken so far. I still struggled to understand the basics of the vent and so far your video has helped cleared some cob webs lol.

  • @MrsLWilliams
    @MrsLWilliams 6 років тому +6

    Thank you so much for this lecture. It raised my Competency in Mechanical Ventilation by 40%. In home health it's very important I not only know how but can explain the rationale

  • @annettefordyce875
    @annettefordyce875 4 роки тому +31

    I am an RN who may be called back to the hospital to care for patients...awesome to be able refresh on this while waiting for the call... it has been a lot of years since ICU for me. Thank you

    • @susanwetmore4822
      @susanwetmore4822 4 роки тому

      I'm in the same boat!

    • @jamesbrown-vi6og
      @jamesbrown-vi6og 4 роки тому +2

      Respiratory Therapist Run Ventilators Period. especially in critical care patients.. if you want to start to kill patients a painful death by all means take a 10 minuet video tutorial and have at it ... we have only gone to school for 2-4 years to learn about hemodynamics.. i not deminishing the job of our RN we love and need them.. but we need to stay in our own lane. or we will see masive crashes..

    • @CyclePat
      @CyclePat 4 роки тому

      Just asking... would a CPAP Machine be sufficient ventilation (possibly) duirng this outbreak/pandemic?

    • @Jeremiah2911HOPE
      @Jeremiah2911HOPE 4 роки тому +3

      In Australia, we don't have a lot of respiratory therapists. Critical Care trained nurses are very capable in looking after ventilated patients :)

    • @bernardofitzpatrick5403
      @bernardofitzpatrick5403 4 роки тому +1

      @@CyclePat good question

  • @Grahmahshanz
    @Grahmahshanz 8 років тому +4

    Where have you been all of my nursing life! I work in a pediatric vent facility with amazing RT's who try their best to explain settings/modes/ functions to me, but since I have them, I never found it necessary to 'know it all'. Now that I care for a baby at home on mechanical ventilation, although my education/experience has taught me everything that I need to know care for him, I just want to 'know it all' !! You explained mechanical ventilation in such a way that, now, my RT's smile in amazement when we converse ;-) thank you so much!

    • @Medcram
      @Medcram  8 років тому

      +Linda Ellis Thank you for the great feedback!

  • @jessicatamayo1041
    @jessicatamayo1041 7 років тому +5

    Thank you for sharing your knowlegde in such a simple and concret matter, please continue to add on value on healthcare education. Keep it up !🤗👏👏👏

  • @crazypete614872011
    @crazypete614872011 3 роки тому +6

    I’m a respiratory therapy student so I’m definitely looking forward to this

  • @heikelphoto
    @heikelphoto 5 років тому +3

    I really enjoy your videos, Roger. Thanks for sharing and making so many things easier to understand!

  • @999akva
    @999akva 4 роки тому +20

    Thank you so much! Learned a lot, especially as a student, who is thinking to go to the anesthesiology residency and, at the same time, working in ICU, I understand much more with your help!

    • @Medcram
      @Medcram  4 роки тому +1

      Thanks for your comment! We wish you luck!

  • @Nitinchowdhary211
    @Nitinchowdhary211 4 роки тому

    The concepts are explained so beautifully and in such simple terms! It takes a genius to explain such complex things to a layman so Medcram guys - you are geniuses! Else any medical technician/doctor can pepper the entire talk with jargon and screw up one's interest in learning the concepts.

  • @broganhogan3469
    @broganhogan3469 2 роки тому +1

    Amazing how impactful this is in the wake of Covid19 and seeing comments from practitioners years ago to present. Thank you, Dr !!

  • @jamiebarclay3693
    @jamiebarclay3693 4 роки тому +2

    These are just brilliant. Excellent teacher, great level of detail. Thanks!

  • @johnkahts7698
    @johnkahts7698 4 роки тому

    I am a total layman re ventilators. Your calm and well paced explanation is down to earth and I am sure anyone in the field will understand this. Keep up the good work,

  • @minimedlessons
    @minimedlessons 4 роки тому +1

    Great video! I LOVE MedCram content! I've been making similar videos, inspired by you guys. Keep up the great work, MedCram!

  • @grntara78
    @grntara78 7 років тому +2

    Your videos are always helping me a lot to understand every kind of topic....thank you very much....

  • @Ot-ej5gi
    @Ot-ej5gi 4 роки тому

    Nice and simple; thank you so much for making a difference in our practice and hence, the lives of many grateful patients!

  • @hosam.eldin.bebars
    @hosam.eldin.bebars 9 років тому +5

    very informative, i am starting my IM residency and these lectures made a great difference to my knowledge , thanks

    • @Medcram
      @Medcram  9 років тому

      Hosam Eldin Bebars Good to hear. Hope your residency gets off to a good start

  • @Eugene019
    @Eugene019 4 роки тому

    Clear and simple introduction to mechanical ventilator dynamics. Well done.

  • @deeparaman1
    @deeparaman1 9 років тому +34

    Excellent especially for students and doctors from non English speaking countries. The usual video tutorials given by native English speakers is with heavy accent and difficult to comprehend and causes lots of stress trying to make out what the speaker is trying to say. But your accent is so clear, slow, English is so simple and you have done fantastic service to students from third world countries. Even a layman can understand your lectures. If the patient care improves because of your lectures,(I am sure that it will) the credit actually goes t o you.

    • @edwigcarol4888
      @edwigcarol4888 3 роки тому

      Of course laypeople might understand. The child blowing up a balloon, how much pressure does it need to get it big, depending of the material the balloon is made of. No equation necessary.. in fact..

  • @matthewjkele
    @matthewjkele 8 років тому +12

    even after you helped me through PA school, I still watch videos like this as I practice.

    • @Medcram
      @Medcram  8 років тому

      +Matthew Kele Good to hear, glad the videos remain helpful

  • @ghadatawfiq8200
    @ghadatawfiq8200 8 років тому +6

    thank you, your videos are really helpful

  • @limeykl
    @limeykl 6 років тому +1

    Great presentation! Simple explanation of a serious situation

  • @jim2980
    @jim2980 8 років тому +1

    Strong work guys! Love you lectures. Trying to get through them all!

    • @Medcram
      @Medcram  8 років тому

      +Jim Mathey Thanks Jim! Hope you're doing well

  • @davidwalker8124
    @davidwalker8124 4 роки тому +11

    Excellent - just learning about ventilators as we are working on a new lower cost design for hospital / home use for patients just needing a little assist - physicist Dave

    • @kaankalem2666
      @kaankalem2666 4 роки тому +2

      Are you planning to do it amateurly and how many people are there working with you ? I am also interested.

    • @jazzbluesify
      @jazzbluesify 4 роки тому +1

      Im in wt you frm winnipeg

  • @LilCraftyNook
    @LilCraftyNook 5 років тому

    This is really good!! Thank you!! Great teach for ventilator nurses!

  • @nargiznargiz4907
    @nargiznargiz4907 4 роки тому

    as always your lectures makes the subjects easy to understand and of course to remember.

  • @neil17z
    @neil17z 8 років тому +9

    You guys are awesome! I'm so glad I found this channel! Cheers from Israel

  • @hananalshubbar2376
    @hananalshubbar2376 6 років тому +4

    That was really helpful, Thank you so much!

  • @bing259
    @bing259 Рік тому

    This is the exact explanation and step by steps instructions I was looking for. Please continued to do more blogs. Thank you

    • @Medcram
      @Medcram  Рік тому

      Thank you for your feedback

  • @BB-sm8ey
    @BB-sm8ey 4 роки тому +2

    Thank you for these excellent and informative videos.

  • @tvphealth9889
    @tvphealth9889 4 роки тому +3

    Thank you for sharing this educational resource! The creation of low-cost ventilators is incredibly crucial, now more than ever. Understanding how a ventilator works and why it is needed is a necessary step towards solving the global ventilator shortage.

  • @Nathalia-uz5nq
    @Nathalia-uz5nq 6 років тому +2

    Nice video. Thank you for the good explanation!

  • @pankajgoyal6747
    @pankajgoyal6747 9 років тому +2

    Thank you! It's very helpful.

  • @meloyellow6488
    @meloyellow6488 8 років тому +2

    Best video on UA-cam !!! Very informative

    • @Medcram
      @Medcram  8 років тому

      +Melody Aribuabo Good to hear- thank you

  • @ahmadshokry5945
    @ahmadshokry5945 8 років тому

    Thank you very much for this wonderful illustration of such a complicated topic

    • @Medcram
      @Medcram  8 років тому

      +Ahmad Shokry Thank you for the comment

  • @GREENPOWERSCIENCE
    @GREENPOWERSCIENCE 4 роки тому +8

    Good info to learn… Thank you….

  • @akhilanslectures3748
    @akhilanslectures3748 7 років тому +4

    As good and as simple as it gets!!

  • @croaker260
    @croaker260 7 років тому +1

    Excellent series!

  • @anncarter9291
    @anncarter9291 8 років тому +2

    Thanks! Clear and concise.

  • @patelyasin9831
    @patelyasin9831 5 років тому

    Very simple & nicely explained. Thank you.

  • @yustinaaron
    @yustinaaron 6 років тому +1

    Nice breakdown/intro to vents

  • @Paracutie
    @Paracutie 9 років тому +1

    Thank you for the easy-down to basics demo!

    • @Medcram
      @Medcram  9 років тому

      Paracutie thank you for the comment

  • @Medicknowhow
    @Medicknowhow 9 років тому

    Awesome buddy...liked the simple methodology of teaching ..didn't cram it up like the docs do it while explaining the paramedics..thanx again...concept is crystal clear

    • @Medcram
      @Medcram  9 років тому

      Johnson Irudayasamy Thanks for the feedback. Glad to hear it helped

  • @dorao.a3698
    @dorao.a3698 5 років тому +1

    Great teaching. Very simple to understand. Thank you.

    • @Medcram
      @Medcram  5 років тому

      Thank you for the feedback!

  • @rodhoover9158
    @rodhoover9158 3 роки тому

    Another outstanding period of instruction.

  • @glaizaneuhaus6600
    @glaizaneuhaus6600 9 років тому +3

    very helpful, thank you!

  • @abar7178
    @abar7178 3 роки тому +7

    This was great. I wish I had this available back in the day. Thank you for your time. I started out as an Oxygen orderly back in 1973 after I was discharged from The Marine Corps in New York City. Wheeling H tanks on a dolly with an adjustable wrench to the patients bedside and changing them out when they reached 500 PSI. No piped in Oxygen back then and only open patient Wards. with 10 to 15 patients in a room separated by a draw curtain.Part of my arsenal was a No smoking sign. It was not uncommon. to see patients smoking while lying in their beds as well as a doctor examining a patient with a cigarette dangling from the sides of his mouth. Oh how we long for the good old days LOL. I eventually became a certified inhalation therapy tech. Via The AARC later it became the NBRC or vice Versa. I stopped practicing in 1999 when I came to Massachusetts only to discover Massachusetts was a commonwealth and reciprocity of my licenses were never granted. I like to believe, I was a respiratory therapist and have been around since the Infancy of our profession. That makes me the original OG of respiratory therapy. Back in the days. We ran to codes with a Bird Mark 5 or mark 8 pressure ventilators
    ( the little green Box ) attached to an E-cylinder of Oxygen. The ideal settings on the Bird were 15, 15, 15. It was actually a great little machine to run to codes with. Easy to maneuver through patients wards and great during transports. Back then the big fear with the Bird was the infrequent incidence of Barotrauma as well as all the negatives associated with Positive pressure ventilators. However, if you knew what you were doing, You were golden.
    later in my career I became a clinical instructor and that became part of my introduction to my students. I would introduce myself and begin with these words
    ( Keep in mind. I am a United States Marine ) I would begin, If you are here to press buttons and turn Knobs. This is not a class for you. I can teach a Monkey to do that.
    However, if you want to know what happens mechanically and physiologically after you have pressed that button and turned that knob. Please have a seat.
    ( By the way, my students had the highest passing rate on certs and registry ) Back to the past.
    Back then, we had Engstrom and Emerson Volume ventilators with a heating plate at the bottom and a steel pot similar to a pressure cooker that sat on atop of the heating plate. The tubing ( AKA Manifold) contained steel wool lining the inside of the tubing to increase and help maintain the humidity of a dry gas. It had a huge mechanical spirometer. It sat on top with a large needle that move per cycle of respiration .
    One day, the workhorse came onto the scene. We all gathered around and received an Inservice on the latest and the greatest. The Puritan Bennet MA-1. followed by the 7200, the bear respirator, Etc. I could go on forever, so I will end here with these two memories. When PEEP was in its Infancy. Hell, it felt like we invented it. We would take a large bottle filled with water, placed alongside the respirator on the floor. We would submerge the tubings of the manifold into the bottle below the water level we would adjust the amount of PEEP by adding more water to the bottle or elevating or decreasing the height of the submerged tubing into the water. This is how PEEP. started out. ( Positive End Expiratory Pressure. prolongs exhalation. Thereby allowing the Alveoli to remain open longer and allowing for a prolonged period of Diffusion along the Alveolar Capillary membrane ) Somethings you never forget LOL
    If you took the time to read this. Thank you for allowing me to share with you a trip down memory lane. Trust me there is a lot more to share as my career span was well over 35 years working in diverse clinical settings and adult critical care. To include having the honor of being part of Mount Sinai's School of medicine and working as a pulmonary research technician alongside Dr. Irving Sellikoff ( asbestosis and Sarcoidosis studies) Dr.Alvin Tierstien and Dr. L.K Brown. Traveling the country back in the 80's as part of a research team to predominately gay communities and seeing well over 100 patients a day and performing PFT's and Perfusion studies when patients at that time were expiring in NYC and the diagnosis at that time was " Fever Of Unknown Origin " ( AIDS) Going into the Tunnels of the NYC Subway system with a team to locate and perform sputum inductions on the homeless. At that time, we had a strain of drug resistant TB.
    Then I moved to Mass and my carrier came to an abrupt halt because of Bureaucracy. "Sie La Vie" . I am a U.S. Marine. We are trained to adapt and overcome.
    I fell back on the trades. In the Marine Corps, I was formally trained as a Lineman and electrician as well as an Avionics tech.( Aircraft electrician ) At Marine Corps engineer school. Courthouse Bay N.C.
    My mechanical aptitude I believe was why I was able to teach my students and reach them in a mechanical way. I would equate the human body in its purist form. A machine and in a mechanical way. The neuron pathways are no more than a glorified electrical conductor ( wire ) picture the wiring in your home. It has copper and the insulation that surrounds the copper coil is made of a rubber non conductive material.
    A neuron for all intents and purposes is a wire and it's insulation it is the Myelin sheath. The heart, a four chamber pump. Positive and negative pressure outputs with valves that open and close and seal etc.
    I miss my career, I miss my patients, I miss being able to have that feeling after all is said and done. Watching that patient and his family go home together.
    However, I was able to vicariously share with you a very small part of the evolution of Respiratory Therapy from a first hand eye witness.
    This is the OG of Respiratory therapy saying Thank you again and Semper Fi.

  • @vernareeder316
    @vernareeder316 3 роки тому

    Tell me you made it through covid.I have followed you for awhile now and I have found comfort in your courage and faith.God bless and keep you.

  • @luzestrada9536
    @luzestrada9536 Рік тому

    Thank you so mucho for this information. It was explained really good, and you made it seems easy to understand!

  • @stephgami
    @stephgami 4 роки тому +1

    Very helpful as I am currently rotating in ICU.Thanks

  • @geoindian5467
    @geoindian5467 4 роки тому +2

    I am here becoz of covid 19. Thank you doctor , immensely for the valuable video.

  • @shadiahniaz2954
    @shadiahniaz2954 4 роки тому +1

    wonderful.Simple and easy to understand.God Bless

  • @mustafaalzobaidy3308
    @mustafaalzobaidy3308 6 років тому +1

    thank you, very useful and easy to understand video, I came here looking for a video to explain to me CPAP PPV PEEP PIP and i hope i find it in the next parts or in other videos on this channel

  • @enckidoofalling4519
    @enckidoofalling4519 2 роки тому +1

    Thanks for the review! Just picked up a home vent patient. 🤙

  • @mohd.shabbir6510
    @mohd.shabbir6510 4 роки тому +1

    thanku sir....a lot of help...we ll remember u till life...

  • @minhui9665
    @minhui9665 5 років тому

    thank you for your detailed explanation!

  • @adimi1962
    @adimi1962 5 років тому +1

    thanks a lot for these clear explanations

  • @haloan1258
    @haloan1258 7 років тому +1

    it is very helpfful for me.thank you!

  • @workinehtarekegn8150
    @workinehtarekegn8150 4 роки тому +2

    wow it is very fantastic and i hvae got alot of knowledges from this lectur video

  • @genhuang1219
    @genhuang1219 8 років тому +1

    Wonderful video
    Thank you!!

  • @robertberthiaume7301
    @robertberthiaume7301 4 роки тому +1

    Great explanation dr. Thanks

  • @GrizzleyBruin
    @GrizzleyBruin 9 років тому +1

    You guys are awesome! Very informative!

    • @Medcram
      @Medcram  9 років тому

      GrizzleyBruin Thanks for the feedback- glad the video helped.

  • @maheshjhunjhunwala44
    @maheshjhunjhunwala44 3 роки тому

    Explained in a very simple comprehensible way to any beginner

  • @marcoantoniogongoleski196
    @marcoantoniogongoleski196 4 роки тому

    Thanks, very nice explanaition.
    - Learning from Brazil !!

  • @parthasarathidas7279
    @parthasarathidas7279 9 років тому +1

    awesome sir. really great video

  • @granitabirg7950
    @granitabirg7950 4 роки тому

    Thanks for the lecture. very detailed explained.💖

  • @grethelbayro5710
    @grethelbayro5710 10 місяців тому

    Thanks for the very clear, didactic presentation!

  • @tovahromanov7414
    @tovahromanov7414 4 роки тому +1

    An Ontario🇨🇦Canada🇨🇦 Doc has figured out a way to DOUBLE ventilator capacity!
    There’s a catch......the patients need to be of similar size and lung capacity.
    It’s still fantastic and if one vent can help two people, less horribly difficult decisions will have to be made by Docs like what has/is taking place in Italy......who gets a ventilator?
    Small miracle but still a miracle and heck yeah, any miracle right now is welcome! Way to go Dr. Gauthier!!!

  • @1412Z
    @1412Z 2 роки тому

    Thank you, great introduction.

  • @amrojamil7061
    @amrojamil7061 7 років тому +3

    Good job 👍🏻

  • @gunncessna9359
    @gunncessna9359 4 роки тому +1

    excellent presentation Doctor.

  • @muhannadbahrami9230
    @muhannadbahrami9230 7 років тому

    thank you, it was very clever and simple

  • @sunnytraveler290
    @sunnytraveler290 2 роки тому

    Excellent presentation.

  • @washimakram141
    @washimakram141 6 років тому +1

    doc..ur understanding of the science and the way u made me understand it.. is marvellous..bow down to u sir...

  • @loveovercomeshate
    @loveovercomeshate 9 років тому +1

    Great Vid!

  • @dangcao8341
    @dangcao8341 3 роки тому

    Thank you for sharing your knowledge!

  • @zahratmtm1993
    @zahratmtm1993 8 років тому +1

    simply you are awsome, I am really thankful for your helpful vedioes

    • @Medcram
      @Medcram  8 років тому

      +zahra tmtm Thank you for the comment and feedback

  • @dayanandav.k.3499
    @dayanandav.k.3499 4 роки тому +1

    Awesome explanation.Thanks a lot.

  • @cherlynsalang3561
    @cherlynsalang3561 7 років тому +1

    such a great help

  • @gardeniabee
    @gardeniabee 4 роки тому +24

    My cat loves the doctor's voice, and though usually very active, is sleeping nearby.

  • @elhammohamed463
    @elhammohamed463 9 років тому +1

    thanxxx for this informative video

  • @katemasel6703
    @katemasel6703 7 років тому +3

    Vents made understandable. Thank you!

  • @briannaaa____1
    @briannaaa____1 3 роки тому

    God bless science ❤️ this is saving my dads life right now recovering from covid on the path to a healthy recovery

  • @gloriaredmon-booth6572
    @gloriaredmon-booth6572 4 роки тому

    Great refresher course.

  • @lefuturiste27
    @lefuturiste27 4 роки тому

    this is really well explained