I appreciate this video thank you for clearing up I-time in noninvasive ventilation. However, I observe that your volume curve fell off a lot quicker when you reduced the I-time. I was wondering, wouldn’t it be good to leave the I-time at .8 sec. or higher since the little delay in time, which you called breath holding, allows for better alveolar/capillary gas exchange?
Something to mention is that I-Time only comes into affect during mandatory breaths (this excludes P/C mode). If a patient is breathing over set rate they will determine their own I-Time
I personally think that ventilators set to NIV are more effective than NIV ventilators, as NIV vents like the V60, and the old Vision, ALWAYS tend to autocycle, even when there's No UNINTENTIONAL lead. The Vision was HORRIBLE about that. For example, a Servo I set to NIV, and used via a full face mask worked WONDERFUL vs the same mask on the V60, and Vision. And this was both with NO unintentional leads. But then a Servo would be used with a Non-Vented mask, and the vision or V60 with a vented mask, or an exhalational valve with a Non-Vented mask, such as would be the case with a whisper swivel.
That is correct and the Servo i also has flow trigger. Remember that many hospitals would rather spend $20K on a V60 than $50K on a vent for non-invasive vent.
Rise time was invented for further manipulation of the I Time due to abnormal lung anatomy like severe COPD, or RLD. or someone with Keto acidosis/airhunger. To meet the inspiration deman and to ventilate to have good IE ratios.
The IPAP is the max pressure. If the pt is breathing, the machine will provide less support (flow/pressure). Basically, the set IPAP is the max pressure in the airway. If the pt coughs, forcefully breathes out, etc, then the P could go higher than IPAP but those are exceptions and not the norm. Hope this helps
Jen, I am not sure if I fully understand your question. There are 2 methods to make a change and have the V60 implement (accept) the change. One way is to make your setting change and then press the green check button on the far upper right hand side. This is also where the pressure dial is located where you can change the setting values. The other way is by tapping accept on the screen when you make the change. You will have an accept button and a cancel button that appear when you tap a setting to make a change. As to actual acknowledgement, you will need to perform an assessment of the V60 after the change. I hope this helps and please let me know if it was not what you were wanting.
@@resptherapyedresources1997 thank you for your reply. This question had me scratching my head too at first but the more I think, it makes sense. Great video, clear sound and picture perfect! Thanks a bunch!
Yes you are correct. I have had many therapists with many years of experience not look at the flow scalar when setting the I-time. If there is no flow going in, there is not any more volume going in. Basically, look at the expiratory flow scalar to set the correct I-time so there is not a breath hold.
2:42 can someone clarify to me what is it really the cycle on S/T mode. Sometimes I see time cycle, sometimes flow cycle, and this video says it is pressure cycle
yugioh2463 Thank you for your question. I can see where the confusion comes in. I was speaking of pressure as in a pressure control breath and the Vt will vary with each breath. So all breaths on the V60 are pressure limited not pressure cycled. I apologize for the misspeak. The back up rate or set rate is time cycled. At the end of the Ti, exhalation begins. The spontaneous breaths or synchronized breaths are flow cycled. When the flow hits zero, exhalation begins. I hope this clears up any misunderstanding and thank you for bringing this to my attention.
As it was explained to me by the clinical Educator for Respironics, there is not an unintentional leak. Remember that the machine is set up to operate with Respironics masks. You must go into the menu and choose the "Leak" Number that is on the mask (this is the 1, 2, 3, etc printed on the packaging and also on the mask). In addition, you must choose the correct exhalation valve. I have found that most therapists do not know how to do this. If you are not using Respironics equipment, then you should choose other. By doing this, the machine can calculate how much leak is already occurring by using Respionics equipment. Now as to the leak, I was told and teach my students that as long as the patient is getting their pressure AND there are not any alarms (properly set of course) then the leak is fine. The old Visions had a Max leak. If the leak is too high the V60 will alarm or not achieve pressure. Does this answer your question?
Okay thank you for your respond, appreciate alot🙏. Btw, is V60 can able to ventilate a size 4, fenestrated, with cuff Tracheostomy tube? Will there be issue with leak or resistance? Thank you
@@miracleisreal1518 I personally have not used the V60 for invasive ventilation. I know that it is capable of it. Make sure you place the machine in the invasive modality. As to your question, I am not sure. I know there must be a large leak to cause an alarm and since it is a 4 Fenestrated, it may no leak enough to cause an alarm. You can also try it in with just the Trach and also try it in an artificial lung or in a glove. Just a trial and error thought.
@@miracleisreal1518 I hope by now, you've found the answer to your question. Ive used the v60 for nocturnal trach patients for years. Whisper swivel in place, set to trach interface, leak is compensated fine in most cases.
![Non-Invasive Ventilation [NIV] - Basics](http://i.ytimg.com/vi/VLzHaQ2d9gs/mqdefault.jpg)
![Non-Invasive Ventilation [NIV] - Basics](/img/tr.png)
Thanks for this video, very clear and instructional!
Thank you
Thanks for this video, it's very helpful for me,thanks!!!!
Thank u for the video. Excellent job in explaining. I appreciate it.
You are welcome!
THANK YOU! This was a helpful video.
Thank you
I appreciate this video thank you for clearing up I-time in noninvasive ventilation. However, I observe that your volume curve fell off a lot quicker when you reduced the I-time. I was wondering, wouldn’t it be good to leave the I-time at .8 sec. or higher since the little delay in time, which you called breath holding, allows for better alveolar/capillary gas exchange?
Great tutorial, thank you very much!!!!
Thank you
Very informative. Thanks
Something to mention is that I-Time only comes into affect during mandatory breaths (this excludes P/C mode). If a patient is breathing over set rate they will determine their own I-Time
You are correct, I typically cover that in lecture.
Thank you!
Very helpful!
Thank you
Very helpful and detailed.
Thank you
I learnt a lot.
Thank you
thankyou! very helpful
Thank you
Thank you so much
I personally think that ventilators set to NIV are more effective than NIV ventilators, as NIV vents like the V60, and the old Vision, ALWAYS tend to autocycle, even when there's No UNINTENTIONAL lead. The Vision was HORRIBLE about that. For example, a Servo I set to NIV, and used via a full face mask worked WONDERFUL vs the same mask on the V60, and Vision. And this was both with NO unintentional leads. But then a Servo would be used with a Non-Vented mask, and the vision or V60 with a vented mask, or an exhalational valve with a Non-Vented mask, such as would be the case with a whisper swivel.
That is correct and the Servo i also has flow trigger. Remember that many hospitals would rather spend $20K on a V60 than $50K on a vent for non-invasive vent.
Is your LIP not supposed to be higher than your EPAP?
How do I get into diagnostics mode to calibrate the touchscreen?
Can we serve nebulizer via this machine? Any setting there
thanks you
Your Welcome
how to clear the low rate alarm?
Rise time was invented for further manipulation of the I Time due to abnormal lung anatomy like severe COPD, or RLD. or someone with Keto acidosis/airhunger. To meet the inspiration deman and to ventilate to have good IE ratios.
So if the patient is breathing with this, the PIP would be greater than the set IPAP since this is on a test lung?
The IPAP is the max pressure. If the pt is breathing, the machine will provide less support (flow/pressure). Basically, the set IPAP is the max pressure in the airway. If the pt coughs, forcefully breathes out, etc, then the P could go higher than IPAP but those are exceptions and not the norm.
Hope this helps
Can you tell me in what 2 ways the ventilator acknowledge a parameter change?
Jen, I am not sure if I fully understand your question. There are 2 methods to make a change and have the V60 implement (accept) the change. One way is to make your setting change and then press the green check button on the far upper right hand side. This is also where the pressure dial is located where you can change the setting values. The other way is by tapping accept on the screen when you make the change. You will have an accept button and a cancel button that appear when you tap a setting to make a change. As to actual acknowledgement, you will need to perform an assessment of the V60 after the change. I hope this helps and please let me know if it was not what you were wanting.
@@resptherapyedresources1997 thank you for your reply. This question had me scratching my head too at first but the more I think, it makes sense. Great video, clear sound and picture perfect! Thanks a bunch!
Why do you say I-time for exhale? I stands for inspiratory
Yes you are correct. I have had many therapists with many years of experience not look at the flow scalar when setting the I-time. If there is no flow going in, there is not any more volume going in. Basically, look at the expiratory flow scalar to set the correct I-time so there is not a breath hold.
it's a pity there's no translation into spanish.It's very interesting.THANK YOU!!!!
2:42 can someone clarify to me what is it really the cycle on S/T mode. Sometimes I see time cycle, sometimes flow cycle, and this video says it is pressure cycle
yugioh2463 Thank you for your question. I can see where the confusion comes in. I was speaking of pressure as in a pressure control breath and the Vt will vary with each breath. So all breaths on the V60 are pressure limited not pressure cycled. I apologize for the misspeak.
The back up rate or set rate is time cycled. At the end of the Ti, exhalation begins.
The spontaneous breaths or synchronized breaths are flow cycled. When the flow hits zero, exhalation begins.
I hope this clears up any misunderstanding and thank you for bringing this to my attention.
@@resptherapyedresources1997 thanks, and thank u so much for the video you posted. It is really helpful to us students..
How do you define or described unintentional leàk on V60?
As it was explained to me by the clinical Educator for Respironics, there is not an unintentional leak. Remember that the machine is set up to operate with Respironics masks. You must go into the menu and choose the "Leak" Number that is on the mask (this is the 1, 2, 3, etc printed on the packaging and also on the mask). In addition, you must choose the correct exhalation valve. I have found that most therapists do not know how to do this. If you are not using Respironics equipment, then you should choose other. By doing this, the machine can calculate how much leak is already occurring by using Respionics equipment.
Now as to the leak, I was told and teach my students that as long as the patient is getting their pressure AND there are not any alarms (properly set of course) then the leak is fine.
The old Visions had a Max leak. If the leak is too high the V60 will alarm or not achieve pressure.
Does this answer your question?
Okay thank you for your respond, appreciate alot🙏. Btw, is V60 can able to ventilate a size 4, fenestrated, with cuff Tracheostomy tube? Will there be issue with leak or resistance? Thank you
@@miracleisreal1518 I personally have not used the V60 for invasive ventilation. I know that it is capable of it. Make sure you place the machine in the invasive modality.
As to your question, I am not sure. I know there must be a large leak to cause an alarm and since it is a 4 Fenestrated, it may no leak enough to cause an alarm.
You can also try it in with just the Trach and also try it in an artificial lung or in a glove.
Just a trial and error thought.
@@miracleisreal1518 I hope by now, you've found the answer to your question. Ive used the v60 for nocturnal trach patients for years. Whisper swivel in place, set to trach interface, leak is compensated fine in most cases.
Why your low rr alarm set at 7 and low inspiratoy alarm set at 5? This is not right
This video was not designed to be on where to set the alarms, but instructional on the individual settings and what they monitor.
Not so much information and tutorial .. ur just teaching how to press and touch and bom the buttons .. bad teaching