Please be aware that the Tidal Volume displayed on the machine is not exhaled Tidal Volume, but rather the potential inspiratory tidal volume that is delivered based on the settings, and resistance and compliance of the patient. Because this is not a dual limb circuit, and the expiratory valve is an open hole on the circuit near the patient, with no ability to place a spirometer for exhaled tidal volume, there is no exhaled Vt or MV available. Also anything that goes between the end of the ET tube and that open hole exhalation port, ( such as HME's, HEPA filters, or even extra flex tubing so filters are not so close and pulling down ET tube) all become additional dead space resulting in rebreathing and potentially higher CO2's, as well as adding airway resistance to the circuit. We have tried these V-60's as ventilators without added humidity, and have found the required filters get wet very easily from exhaled moisture and secretions, making resistance worse and requiring frequent filter changes.
What are your thoughts on manipulating the settings for recruitment of a post covid pt having an exacerbation and de-sating from shallow rapid inspirations over 40/minute.
I would be glad to assist in the process to get my video translated. I'm not sure who will translate it for me. Let me know if you have a suggestion. Jimmy.mckanna@gmail.com
I want to try this but I know that that means things would be really bad so I also hope to never have to do this haha. My hospital has a ton of GE vents, a decent amount of AVEAs, and a handful of trilogies, eagles, and I think LTVs. We also rented more. So if we ever get to the point that we need to use V60s, V30s, or the damn Bird(IPPB) we would be in very big trouble. We might not even have the staff for that unless we’re working insane overtime.
Some people are practically using accordions as non invasive ventilators at this time. If professional clinicians actually require a video to adopt the idea of using a ventilator as a ventilator, its safe to say we've failed.
In some cases, clinicians are being pulled from their usual duties to work with these devices. This is for staff that have only seen this used as a nippv machine. The frontline RTs and RNs are being used in other areas or are out of work after being exposed. Very good question though!!
@@rtclinic Meh. Some people have only ever used older Visions or other units and now find themselves with unfamiliar BIPAP because that may be the only one available from a rental company. They may not be aware of the flexibility of the V-60. We had a similar situation with vents. No rental company had our vents available so we rented some we'd never touched before and had to learn a new system on the fly.
Thank you so much, 4yr RRT here. So helpful. Subscribed.
Please be aware that the Tidal Volume displayed on the machine is not exhaled Tidal Volume, but rather the potential inspiratory tidal volume that is delivered based on the settings, and resistance and compliance of the patient. Because this is not a dual limb circuit, and the expiratory valve is an open hole on the circuit near the patient, with no ability to place a spirometer for exhaled tidal volume, there is no exhaled Vt or MV available. Also anything that goes between the end of the ET tube and that open hole exhalation port, ( such as HME's, HEPA filters, or even extra flex tubing so filters are not so close and pulling down ET tube) all become additional dead space resulting in rebreathing and potentially higher CO2's, as well as adding airway resistance to the circuit. We have tried these V-60's as ventilators without added humidity, and have found the required filters get wet very easily from exhaled moisture and secretions, making resistance worse and requiring frequent filter changes.
Thanks for your detailed comment Pat!
I appreciate your experience with v60s as vents.
How the NIV can be hooked to a patient is intubated or had tracheotomy ?
A vented circuit is required to allow exhalation. It will attach just like a mechanical ventilator circuit usually though an inline suction.
The pressure difference between the ipap and epap is what increases the tidal volume. The larger the difference, the bigger the volume and vice versa
Pressure Support yess
So....theoretically you can alternate HFNC w/ BiPAP until your COVID pt needs to be intubated & then ventilate pt using the V60?!
Theoretically.. yes but not in an ideal hospital scenario 😀
Hi
I am a Hospitalist and i currently need to learn how to use different vent machines. Do you have similar videos for draeger etc as well?
I have a bunch of adult ventilation videos. Check out my other vids.
Why is it okay to have a IPAP of over 30 in PCV? On a servo ventilator we would not go that how.
That is very high, but some patients require alot of pressure. It would be hard to maintain a seal on the mask at that pressure.
Good afternoon; is best to use two filters or can the filter be moved towards the exhalation port?
What are your thoughts on manipulating the settings for recruitment of a post covid pt having an exacerbation and de-sating from shallow rapid inspirations over 40/minute.
Recruitment of alveoli is aways good post covid. I would recommend changing settings to help with recruitment.
which humidifier model is that?
What is the advantages of using PCV versus the AVAPS mode?
I've always used Avaps as a ventilator with this machine
PCV is more for the acutely hypercarbic or hypoxic patients.
Great in service thank u
Si può avere la traduzione in italiano ?
I would be glad to assist in the process to get my video translated. I'm not sure who will translate it for me. Let me know if you have a suggestion. Jimmy.mckanna@gmail.com
My fav ourite colour at the hospital: red and blue. 🤣🤣🤣🤣🤣
Great information on the V60’s PCV capability. Will your facility be purchasing the new Philips EV300? A review on that would be helpful.
We just increased our fleet of v60s and phased out the visions. If I get my hands on one, I'll do a review.
My favourite button; the ventilator shutdown button. 😂😂😂😂
I want to try this but I know that that means things would be really bad so I also hope to never have to do this haha. My hospital has a ton of GE vents, a decent amount of AVEAs, and a handful of trilogies, eagles, and I think LTVs. We also rented more. So if we ever get to the point that we need to use V60s, V30s, or the damn Bird(IPPB) we would be in very big trouble. We might not even have the staff for that unless we’re working insane overtime.
I agree. They will work in a pinch, but it will not be optimal ventilatory care if we get there.
Some people are practically using accordions as non invasive ventilators at this time. If professional clinicians actually require a video to adopt the idea of using a ventilator as a ventilator, its safe to say we've failed.
In some cases, clinicians are being pulled from their usual duties to work with these devices. This is for staff that have only seen this used as a nippv machine. The frontline RTs and RNs are being used in other areas or are out of work after being exposed. Very good question though!!
@@rtclinic Meh. Some people have only ever used older Visions or other units and now find themselves with unfamiliar BIPAP because that may be the only one available from a rental company. They may not be aware of the flexibility of the V-60. We had a similar situation with vents. No rental company had our vents available so we rented some we'd never touched before and had to learn a new system on the fly.
Good luck! RTs are the best clinicians for learning on the fly!
The V60 out performs the vision hands down!
@@rtclinic We are know as the Macgyvers of the hospital.