I love all your videos! I just want to point out to those who may not realize that not all ETT have a ballon on the end. Many of the babies have airways too small to accommodate a tube and a cuff so some of the smaller size tubes are not cuffed. Thanks again medcram, and keep up the great videos 👍🏼
Thank you for your videos. Both my parents are in the hospital with COVID-19. One is on a ventilator. I'm trying to understand the stats their Doctors are giving us.
This was very helpful. My dad is in icu and not knowing what everything on the screen means bothers me so much. I’m a CNA but will soon go to school to be a LPN so it’s nice to get a tad bit of knowledge like this before hand.
I am glad to see your channel get more traffic and views during these times. You have been putting up great content for years that has help students around the world.
Thank you for the great lecture! I have one question As far as I know, the machine alone decides whether to put air into the patients lung in CMV mode. A/C mode is slightly different as it picks up +pressure from patient to put air in within set breath time. The mode that you described, that the machine picks up the positive pressure from patients ling, is more like SIMV(synchronized intermittent mansatory ventilation) mode Please correct me if I am wrong, I am still learning
It really depends on the ventilator you will be using. Very old ventilators CMV mode (control mode ventilation) only allowed for the number of set breaths and gave them like a 'clock' regardless if patient was trying to inhale or exhale !, . Newer generation ventilators in A/C provide the set VT breath each time it senses patient inspiration and tries to do so in unison with insp effort (not to be confused with SIMV). Say 1990 or so forward vents are MUCH more forgiving in either mode to allow your patient to receive flow/FIO2 still. You must study the exact vent you work with and learn it's dynamics well. SIMV btw is 2(two) breath types in one mode, a set rate breath (either VOL or PRESS/PCV) and PSV/pressure support breaths, the set rate breaths are (S)Synchronized to the patient insp effort and the PSV breaths are given when the vent senses a patient insp effort in between the set rate breaths... Best in all, hope that helps, enjoy your learning.
I have a CPAP as well but I cant control the pressure as it is done from the doctors office via the internet. However if you just need a bit more air pressure you can use a aquarium air pump. The trick is you just tuck the air line under the Teflon mask. Any extra air pressure just leaks out and cools your face and you have a bit of extra pressure to help breathe. I use this method working around chemicals and it works great but its not a ventilator so its not a cheap replacement.
It can't. A ventilator is a more complex machine. CPAP machine can only keep continuos possitive pressure, You can't set the resp rate and other things, because of how they are Made. If the patient is not breathing, CPAP is not usefull.
I may have asked this question before: how the hell do you regulate so you don't get acidosis or alkalosis if you cannot control your breathing, i.e. pCO2?
The sad thing about this video is that it only has 198,216 views so far and I'm willing to bet that none of the UA-cam experts touting the dangers of ventilators are any of those views.
From what your explanation of AC regarding the "pt. Initiating a breath" sounds like SIMV....I thought with AC, vent breathing 100% for pt.. if pt. Breathing over rate or volume, vent will alarm. SIMV will give pt. Ability to breath on own and if pt. Doesnt take set rate or volume the vent will provide what pt. Isnt doing.... Is this explanation I'm giving correct?
A/C has 1(one) 'breath type'(VOL or PRESS/PCV set) and it's given each time the vent senses patient inspiration with a minimum number guaranteed by set rate if patient doesn't breath . SIMV has 2(two) 'breath types' a VOL or PRESS/PCV like in A/C but ALSO a PSV/Pressure Supported breath, the PSV breath is given when the patient breaths above the set rate breaths, the set rate breaths are designed to be 'synchronized' (S) with a patient's inspiratory effort , if the patient does not breath ,they also get the guaranteed set rate. Each ventilator manufacturer has some variation on this but in general the same, study your vents well RT's nobody else can do that for you.
The guy that invented those baby ventilators I think was a pilot. He saw a need for helping preemie babies to breathe and decide to try to build one. They told him no way can you do that with babies etc. He never listened and cobbled together something from duct tape pumps and hoses. In the end it worked and that is how we got ventilators for babies. An engineer from Quebec Canada had a baby and realized that baby bottles were not the best way to feed them because they let in too much air. He then invented the collapsible baby bottle that takes those little bags. He then went on to invent the machine that lets you skydive inside a tunnel with a giant fan. Another fellow that invented the gas mask for miners went on to invent the stoplight for cars at intersections. It seems if your an inventor type with a good imagination there is no limit to what you can do. cheers
Good timing for this topic. I was taking care of pts on vents all day today as RT student. Thanks!
I’m new to ICU and this was a great explanation! Thank you! Very clear!
I love all your videos! I just want to point out to those who may not realize that not all ETT have a ballon on the end. Many of the babies have airways too small to accommodate a tube and a cuff so some of the smaller size tubes are not cuffed. Thanks again medcram, and keep up the great videos 👍🏼
+Halivan very good point. Thanks for sharing!
Thank you for your videos. Both my parents are in the hospital with COVID-19. One is on a ventilator. I'm trying to understand the stats their Doctors are giving us.
V SIP
Hope they are getting well
@@atharalnemri241 90% of people who go on ventilators DIE.
This video should blow pretty soon.......
Thanks. Needed this for the corona virus pandemic
This was very helpful. My dad is in icu and not knowing what everything on the screen means bothers me so much. I’m a CNA but will soon go to school to be a LPN so it’s nice to get a tad bit of knowledge like this before hand.
This video is such a nice simple explanation that makes it so much clearer. Thankyou!
I am glad to see your channel get more traffic and views during these times. You have been putting up great content for years that has help students around the world.
Nice explanation!
But if you cover the cases or indications of each mode of mechanical ventilation would be great as well..
So easily explained. Thanks
Thanks for a clear explanation!
You're welcome
Great series
Thank you docter
Brilliant thanks. Very educational.
Well done .❤
Awesome.. thanks a lot..
Great explanation! Thanks so much!
Such a great help esp during my shifts in ITU recently
Yea!! So helpful thanks
Thank you for the great lecture!
I have one question
As far as I know, the machine alone decides whether to put air into the patients lung in CMV mode.
A/C mode is slightly different as it picks up +pressure from patient to put air in within set breath time.
The mode that you described, that the machine picks up the positive pressure from patients ling, is more like SIMV(synchronized intermittent mansatory ventilation) mode
Please correct me if I am wrong, I am still learning
It really depends on the ventilator you will be using. Very old ventilators CMV mode (control mode ventilation) only allowed for the number of set breaths and gave them like a 'clock' regardless if patient was trying to inhale or exhale !, . Newer generation ventilators in A/C provide the set VT breath each time it senses patient inspiration and tries to do so in unison with insp effort (not to be confused with SIMV). Say 1990 or so forward vents are MUCH more forgiving in either mode to allow your patient to receive flow/FIO2 still. You must study the exact vent you work with and learn it's dynamics well. SIMV btw is 2(two) breath types in one mode, a set rate breath (either VOL or PRESS/PCV) and PSV/pressure support breaths, the set rate breaths are (S)Synchronized to the patient insp effort and the PSV breaths are given when the vent senses a patient insp effort in between the set rate breaths... Best in all, hope that helps, enjoy your learning.
rockymnt hodad doesnt CMV stands for Continuous Mandatory Ventilation? He/she (whoever made the question) is making sense, i also cot confused.
Thank you! This is great. Is it ok to share with some of my staff?
So what would be a reason that a clinician would choose Volume control over pressure control?? Is it arbitraily/subjective?
I was wondering if A CPAP can be used as a ventilator with a change in settings?
I have a CPAP as well but I cant control the pressure as it is done from the doctors office via the internet. However if you just need a bit more air pressure you can use a aquarium air pump. The trick is you just tuck the air line under the Teflon mask. Any extra air pressure just leaks out and cools your face and you have a bit of extra pressure to help breathe. I use this method working around chemicals and it works great but its not a ventilator so its not a cheap replacement.
It can't. A ventilator is a more complex machine. CPAP machine can only keep continuos possitive pressure, You can't set the resp rate and other things, because of how they are Made. If the patient is not breathing, CPAP is not usefull.
great؛!
I may have asked this question before: how the hell do you regulate so you don't get acidosis or alkalosis if you cannot control your breathing, i.e. pCO2?
Examples of disease processes would have helped.
4:18
The sad thing about this video is that it only has 198,216 views so far and I'm willing to bet that none of the UA-cam experts touting the dangers of ventilators are any of those views.
From what your explanation of AC regarding the "pt. Initiating a breath" sounds like SIMV....I thought with AC, vent breathing 100% for pt.. if pt. Breathing over rate or volume, vent will alarm. SIMV will give pt. Ability to breath on own and if pt. Doesnt take set rate or volume the vent will provide what pt. Isnt doing....
Is this explanation I'm giving correct?
In AC the patient can breathe over the rate.
A/C has 1(one) 'breath type'(VOL or PRESS/PCV set) and it's given each time the vent senses patient inspiration with a minimum number guaranteed by set rate if patient doesn't breath . SIMV has 2(two) 'breath types' a VOL or PRESS/PCV like in A/C but ALSO a PSV/Pressure Supported breath, the PSV breath is given when the patient breaths above the set rate breaths, the set rate breaths are designed to be 'synchronized' (S) with a patient's inspiratory effort , if the patient does not breath ,they also get the guaranteed set rate. Each ventilator manufacturer has some variation on this but in general the same, study your vents well RT's nobody else can do that for you.
Get CME / CE for this video series at our website: www.medcram.com/courses/mechanical-ventilation-explained-clearly
Explanation for 3rd graders?
hi
Waking after being on vent
When I was a kid all this didn't exist. What did exist was a contraption called an "oxygen tent". In other words you were basically on your own.
The guy that invented those baby ventilators I think was a pilot. He saw a need for helping preemie babies to breathe and decide to try to build one. They told him no way can you do that with babies etc. He never listened and cobbled together something from duct tape pumps and hoses. In the end it worked and that is how we got ventilators for babies. An engineer from Quebec Canada had a baby and realized that baby bottles were not the best way to feed them because they let in too much air. He then invented the collapsible baby bottle that takes those little bags. He then went on to invent the machine that lets you skydive inside a tunnel with a giant fan.
Another fellow that invented the gas mask for miners went on to invent the stoplight for cars at intersections.
It seems if your an inventor type with a good imagination there is no limit to what you can do. cheers