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EM Clerkship

Ventilator Basics

EM Clerkship

Zack Olson, MD and Michael Estephan, MD

Education, Courses, Health & Fitness, Medicine

5795 Ratings

🗓️ 8 July 2018

⏱️ 10 minutes

🧾️ Download transcript

Summary

Step 1: Start Patient on Volume Assist-Control Ventilation The most basic mode of ventilation Provides a FIXED VOLUME at a FIXED RATE If the patient over-breaths… The ventilator will give another FULL breath Can cause breath stacking and be uncomfortable in patients who are poorly sedated This is not a problem in the ED because […]

Transcript

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0:00.8

Hello, med students.

0:02.5

My name is Zach Olson, and thank you for downloading this week's episode of the EM Clerkship Podcast.

0:11.4

Vents are really intimidating, right?

0:14.8

They're all glowy and beepy and buttony, super intimidating.

0:19.4

But they're actually super easy, so, so easy. It's only going to take

0:24.0

a few minutes today, and you're going to understand how to set up a vent. What you need to know today

0:29.3

are five things, only five things. First, intubated patients in the ED are going to be sedated, vast majority of the time.

0:39.5

And this means that you only need to know one mode of ventilation at first.

0:44.5

One mode, assist control volume.

0:49.7

Now, maybe there is some variation on this globally, and I've seen ICUs put patients on other

0:55.8

modes as they are weaning them, especially peds, but assist control volume is the only

1:01.5

mode that you need to know as a student in the emergency department.

1:05.7

Assist control volume.

1:07.5

Know that one.

1:09.2

Assist control volume will give the patient a set volume at a set rate.

1:14.4

It's very simple. If they over-breatheat the vent, which they shouldn't because you're going to keep them sedated on this mode in the ED.

1:22.9

But if they over-breathe, it will give them another full volume, assist control volume. It's the most basic

1:29.7

fundamental mode of ventilation, assist control volume, a set volume at a set rate, and if they

1:38.3

over breathe, they get that volume again. It's very, very basic, assist control volume. The second thing that you need to know,

1:48.0

very easy. Venting a patient is like breathing, pushing oxygen in and letting that lung that CO2

1:56.0

vent out. In and out. In and out. you're trying to get that oxygen in with a goal of

2:04.1

92ish percent pulse ox and you are letting that CO2 vent out with a goal on capnography or your

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