Been through many ventilator lectures. This is toward the top of the list. Transitioned a VC patient to PC one day just to see the difference in volumes generated by transitioning. Used the same PIP(generated in VC) to set the pressure control. It was amazing the increase in Vte generated in PC. Thanks so much for the great video.
Hi, just as a heads up. A week ago, I was asked to take over anaesthetics in a theatre list. I noticed a bottle of Sevo by the side of the machine and the anaesthetist struggling to solve a leak problem along with the smell of Sevo. We changed the tube in the patient using a Bougie however a small leak was still present. On the monitor the Sevo inspired was reading 2-3 litres however the Sevo vaporizer itself was set on full. We found that the twist on top for the vaporizer was cross threaded setting the whole machine of on a tangent. It was an important lesson on locating and solving a problem.
Cool. With the situation where you are locating a potential airway ventilation problem you also could also have potential anaesthetic awareness going on with the patient and needing to think about keeping the patient asleep during the intervention. As an ODP of decades I guessed around when you said 'the smell of sevo' (nuff said) but very well worked out by your team under pressure and a lesson you will pass on, one thing more to relax about in the future.
Do you have a video of a full check of this machine? I am not familiar with the GE machine as I regularly use the Drager ZUes and Tiro. I need to learn how to use this one for work as agency nursing . most other hospitals use this machine. I love your videos . really informative and clear.
Great video doc! I love watching your videos. Super engaging and informative. Best part is your way to educate by giving examples and circumstances. Tnx!
Great content there, but please, always point to the exact thing on the monitor as you talk about it for fresh respiratory therapist to catch up quick, thank you
Thanks, great lecture, as always! The "you get more ventilation when using PC on same Pinsp" was new to me - but that also poses the question, why use VC when you can ventilate the patient with the same tidal volume but at lower driving pressures (= Pinsp-PEEP, minimizing driving pressure is important to reduce pulmonary trauma when reaching the upper deflection point in the p/V-curve - see ARDSNET-studies)? My practice is to use PC for nearly all cases, and I use VC only in laparoscopic surgery cases (with tightly set Pmax) because I don´t want to change Pinsp every minute when the surgeon de- or inflates the abdomen. With PC I can see if the patient has more pain (decreasing Vt), which sometimes precedes rise in HR/BP. Also as mentioned PC is useful in SGA, not because it can obtain sufficient ventilation when having larger leaks (it doesn´t!) but because it prevents the respirator reaching Pinsp larger than the esophageal sphincter occlusion pressure (LES: 14mmHg, UES 7mmHg), thereby inflating the stomach.
There is almost no reason to use VC. Even in laparoscopic surgery you can use Volume guided PC and let the ventilator change the Pinsp for you to achieve a target volume but with a PC pressuyre waveform.
@@joestevenson5568 Thanks for your reply! Not all respirators offer the PC/VG-option. Also I´m not aware of any studies that show PC/VG is better than VC - or do you have any references?
Thank you so much, I really got to learn couple new things but I’m just wondering how do we know the ideal pressure for a patient ¿ for volume we got the 6l/kg is there anything like that for pressure
Odd numbers for resp rate? Are you sure you're an anaesthetist 😂 Seriously though, thanks for your content. Using it to learn skills to improve my own teaching as I find educating registrars and junior doctors a pretty challenging part of the job. Love your podcasts too. Very inspirational.
Amazing! I think having that fake lung 🫁 for some reason made the explanation more clear . Thank you so much ! I hope you continue to make more in-depth ventilator videos
Been through many ventilator lectures. This is toward the top of the list. Transitioned a VC patient to PC one day just to see the difference in volumes generated by transitioning. Used the same PIP(generated in VC) to set the pressure control. It was amazing the increase in Vte generated in PC. Thanks so much for the great video.
Thanks so much!
Hi, as a first year resident, your video is just fantastic that fully help me understand the mechanism! Awesome job, sincerely!!
I'm on an anesthesia rotation and this is so helpful, now I get it! Thank you!!!
Hi, just as a heads up. A week ago, I was asked to take over anaesthetics in a theatre list. I noticed a bottle of Sevo by the side of the machine and the anaesthetist struggling to solve a leak problem along with the smell of Sevo. We changed the tube in the patient using a Bougie however a small leak was still present. On the monitor the Sevo inspired was reading 2-3 litres however the Sevo vaporizer itself was set on full. We found that the twist on top for the vaporizer was cross threaded setting the whole machine of on a tangent. It was an important lesson on locating and solving a problem.
Cool.
With the situation where you are locating a potential airway ventilation problem you also could also have potential anaesthetic awareness going on with the patient and needing to think about keeping the patient asleep during the intervention. As an ODP of decades I guessed around when you said 'the smell of sevo' (nuff said) but very well worked out by your team under pressure and a lesson you will pass on, one thing more to relax about in the future.
Do you have a video of a full check of this machine? I am not familiar with the GE machine as I regularly use the Drager ZUes and Tiro. I need to learn how to use this one for work as agency nursing . most other hospitals use this machine. I love your videos . really informative and clear.
This is truly a top-tier lecture. Kudos!! Thanks so much for this great video!
Great video doc! I love watching your videos. Super engaging and informative. Best part is your way to educate by giving examples and circumstances. Tnx!
Glad you like them!
Well Explained... Thank you for sharing the knowledge
Great content there, but please, always point to the exact thing on the monitor as you talk about it for fresh respiratory therapist to catch up quick, thank you
Tons of thanks 🙏🏻🙏🏻 Super helpful 🙏🏻🙏🏻
Thanks so much for this. Helped me a lot with Anaesthetics
You, good sir, are a legend.
Too kind
Thanks, great lecture, as always! The "you get more ventilation when using PC on same Pinsp" was new to me - but that also poses the question, why use VC when you can ventilate the patient with the same tidal volume but at lower driving pressures (= Pinsp-PEEP, minimizing driving pressure is important to reduce pulmonary trauma when reaching the upper deflection point in the p/V-curve - see ARDSNET-studies)?
My practice is to use PC for nearly all cases, and I use VC only in laparoscopic surgery cases (with tightly set Pmax) because I don´t want to change Pinsp every minute when the surgeon de- or inflates the abdomen. With PC I can see if the patient has more pain (decreasing Vt), which sometimes precedes rise in HR/BP.
Also as mentioned PC is useful in SGA, not because it can obtain sufficient ventilation when having larger leaks (it doesn´t!) but because it prevents the respirator reaching Pinsp larger than the esophageal sphincter occlusion pressure (LES: 14mmHg, UES 7mmHg), thereby inflating the stomach.
There is almost no reason to use VC. Even in laparoscopic surgery you can use Volume guided PC and let the ventilator change the Pinsp for you to achieve a target volume but with a PC pressuyre waveform.
@@joestevenson5568 Thanks for your reply! Not all respirators offer the PC/VG-option. Also I´m not aware of any studies that show PC/VG is better than VC - or do you have any references?
Thank you for the wonderful simplification!
My pleasure!
Excellent explanation 🎉, many thanks for your efforts to teach and congratulations in reaching 120000 subscribers 🙂
Thanks so much! Its a nice milestone :)
You are literally a living legend 🤩
😂
Wonderful explanation.. Thanks a lot
My name is rachel I get very nervous around anesthesia going under I get very upset due to nerves what advice do you have
Excellent job
Thank you very much!
Excellent info ❤
Thank you so much, I really got to learn couple new things but I’m just wondering how do we know the ideal pressure for a patient ¿ for volume we got the 6l/kg is there anything like that for pressure
Id say just use volume control mode :) 6ml x weight….
If you really wanna use PCV… start at 10cmH2O and increase/decrease from there
@@ABCsofAnaesthesia thank you so much for answering
Whick control mode is used for adults and pediatric patients?
thank you for making this video
Thank youuu SO much this is very helpful 🙏appreciate it
Glad it was helpful!
Odd numbers for resp rate? Are you sure you're an anaesthetist 😂 Seriously though, thanks for your content. Using it to learn skills to improve my own teaching as I find educating registrars and junior doctors a pretty challenging part of the job. Love your podcasts too. Very inspirational.
Haha love using 13 of pressure and 13 RR just to really jinx it 😂
Amazing ❤
👏👏👏 Very helpfull !!! Thank you! 🙏
Thanks Jelena :) Glad it was helpful!
Bro very good
thank you for sharing
Thank you
Thank you a lot i like your videos
Thanks you very much 💕
Thank you!
You're welcome!
7:53 restaurant per minute 😂, ok why not 😅. I guess it's a kind of a automatic translation
for JR 1 who have just joined....this should NOT be your first video
Thank you 😊
You're welcome 😊
suction machine
Don't use background music because it's disturbing for non-English speaker.
True..
Or English speakers lol
Agreed ... This background music makes my focus hazy
Amazing! I think having that fake lung 🫁 for some reason made the explanation more clear . Thank you so much ! I hope you continue to make more in-depth ventilator videos
Yeah so much easier to see with a fake lung! :)