Ventilator Basics

EM Clerkship

Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD

Education, Science, Life Sciences, Courses, Health & Fitness, Medicine

5 • 795 Ratings

🗓️ 8 July 2018

⏱️ 10 minutes

🔗️ Recording | iTunes | RSS

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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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