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NPPV and BiPap Changes Per ABG Results

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  • เผยแพร่เมื่อ 19 ม.ค. 2019
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ความคิดเห็น • 400

  • @mohamedalshikh6186
    @mohamedalshikh6186 หลายเดือนก่อน +2

    im not a doctor and even my english not that good i want to tell you this video helps me to much as my father has copd and its very simple to understand, Keep going god bless you.

  • @shanellestone4379
    @shanellestone4379 3 ปีที่แล้ว +11

    Omg. I’m in my second term of RT school and I was just so lost when trying to learn about this portion of noninvasive ventilation. Thank you so much for making your videos!

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว

      You are so welcome! Glad it helped! Thank you for watching and commenting!

  • @andrellaarbeary6151
    @andrellaarbeary6151 28 วันที่ผ่านมา

    You made it so simple to understand. Thank you so much…

  • @nac2016
    @nac2016 4 ปีที่แล้ว +19

    OMG I NEEDED THIS!!! This helped me so much!!!!!

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว

      Fantastic! Thank you for watching and leaving the kind comment!!!! Go be great!

  • @kennethweiss9068
    @kennethweiss9068 3 ปีที่แล้ว +2

    Fantastic videos! As an RT for many years about to re-enter the work force after caring for mom the last couple of years, I find the material and extremely pleasant teaching manner wonderful. Thanks for this!!

  • @marilyntorresrrt6763
    @marilyntorresrrt6763 5 ปีที่แล้ว +9

    every time i have checkoffs, videos like these helps me refresh :)

    • @RespiratoryCoach
      @RespiratoryCoach  5 ปีที่แล้ว +1

      And this is why I created this channel. Thanks for the comment, Marilyn!!!!

  • @silk.spectre6606
    @silk.spectre6606 3 ปีที่แล้ว +6

    This is wonderful! THANK YOU! I was pausing the video after the first example, and I got it right each time. This will be in my lab final, so thank you again for doing this!

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว

      Cool! Hope it helped with your lab final!

  • @lydiac548
    @lydiac548 3 ปีที่แล้ว +4

    Joe, these are so good. So clear. So helpful. Thank you!

  • @Yp_mam
    @Yp_mam 3 ปีที่แล้ว +3

    One of the best videos for Respiratory ICU

  • @Cindyabigail
    @Cindyabigail 3 ปีที่แล้ว +3

    Thank you so much for making it clear and simple! So may videos out there that just over complicate things.

  • @joleenaah
    @joleenaah 3 ปีที่แล้ว +3

    Such a great and easy way to understand NPPV. THANK YOU!
    Im in my second semester of RT school and I feel like i hit a jackpot coming across your videos ✨✨✨✨

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว

      You're very welcome, Joleen! Thank you for watching and kindly commenting!

  • @msalmankhan8339
    @msalmankhan8339 ปีที่แล้ว

    Sir you don't know how much effective your lecture for us
    I don't know before how to set I used to set bipap without making sense

  • @luvinmy3bois
    @luvinmy3bois 4 ปีที่แล้ว +3

    It finally makes sense!! Just in time for summer finals tomorrow. THANK YOU!

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว

      Perfect!! How did finals go, Christina? Thanks for watching and commenting!!!

  • @dr.manzurahmed1652
    @dr.manzurahmed1652 2 ปีที่แล้ว +2

    Excellent explanation& very easy presentation but informative lectures.Thanks a lot.

  • @frankmaggio4328
    @frankmaggio4328 ปีที่แล้ว

    Awesome explanation!!!!!!!!!!!
    When I went over bipap w some of my colleagues (I'm a Travem Nurse who always let RT manage bipap) it wasn't explained to me - the way you're explaining . I couldn't get an explanation of how to fix oxygenation vs. co2 removal. I've watched this video 8 times now. Now I'm getting it and I'm now comfortable knowing how to pick the setting! Thanks for making this video!

  • @minerva944solange
    @minerva944solange 4 ปีที่แล้ว +4

    Omg.....this made so much sense to me.....ugh.....thank you soo much for the service you provide selflessly...studying is hard for some of us without examples. Thank you!!!!!😘😘😘😘😘

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว +1

      Hi Mandy! You're very welcome, and I'm so glad it clarified things for you. Thank you so much for watching and commenting!!!

  • @susiecisner1736
    @susiecisner1736 ปีที่แล้ว +2

    Thank you for helping me understand this so much better!

  • @kulothungans6838
    @kulothungans6838 2 ปีที่แล้ว +2

    This video is a dynamite! Bro this is an epic video. U brought somuch clarity in such a short span of time ... will remember as long as i see am ABG .... thanks bro!

  • @Thetimbercruiser
    @Thetimbercruiser 3 ปีที่แล้ว +3

    New grad RN headed to the ICU. Great videos my dude 🤙🏻

  • @samikshyapokharel2790
    @samikshyapokharel2790 3 ปีที่แล้ว

    In short of words to thank you..Please understand how big help your video was..thank you !!

  • @Vivaz79
    @Vivaz79 4 หลายเดือนก่อน

    Thank you. Explained v well, cleared my doubts and way of dealing with the issues.

  • @lenahkarimi6260
    @lenahkarimi6260 2 ปีที่แล้ว +1

    You explained it in simplicity!! Was way easier for me to understand. Subscribed for more videos. Thank you.

  • @heathercoyle9834
    @heathercoyle9834 3 ปีที่แล้ว +2

    Hello there! Your video is amazing and simplifies it all so it’s much easier to understand. Thank you! My question is on the actual state board tests it asks questions about changing the settings but they give answers like changing minute ventilation and such. It’s never as easy as you explain it. I feel like it goes into way more detail. It’s like they take it a step further in depth. Can you be owing this pretty please!!!

  • @jamlisa4696
    @jamlisa4696 3 ปีที่แล้ว +2

    Where have you been all my life? I am so freaking happy I found your channel😁. You are an amazing teacher sir.

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว +1

      I've been right here! So glad you finally found us!! Welcome to the FRT Community!

    • @jamlisa4696
      @jamlisa4696 3 ปีที่แล้ว +1

      @@RespiratoryCoach Thank you! I am binge watching your videos. So much to learn! You explain eveything so well. It’s just incredible. You are appreciated. Blessings to you and your family.🙏🏾

  • @drshaileshbarphe4717
    @drshaileshbarphe4717 4 ปีที่แล้ว +2

    Sir u hv Explained in a very simplified way. Thank u very much 🙏

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว

      You are most welcome. Thank you for watching!!

  • @samanthafults9202
    @samanthafults9202 4 ปีที่แล้ว +2

    Bless you. This made so much more sense.

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว

      Cool! Thank you for watching and kindly commenting!!!

  • @derickasartblog835
    @derickasartblog835 ปีที่แล้ว

    Thank you 1000x for this. My wheels are starting to turn.

  • @S2SStorytellingtoSucess-yq6xq
    @S2SStorytellingtoSucess-yq6xq 11 หลายเดือนก่อน +1

    hats off to you dear .. very well explained

    • @RespiratoryCoach
      @RespiratoryCoach  11 หลายเดือนก่อน

      Thanks for watching and kindly commenting!

  • @clarishancheta1487
    @clarishancheta1487 ปีที่แล้ว +1

    Wish you are my professor I love the way you teach. Do you have a video on setting up the Mechanical Ventilation Machine (Hamilton G5). ❤❤

  • @ahmadhassan2511
    @ahmadhassan2511 2 ปีที่แล้ว +1

    Perfect
    How simply u explained it.. thanks 👍

  • @starvingsum1
    @starvingsum1 3 ปีที่แล้ว +2

    If I can help you in anyway let me know. This was fantastic! I have my check offs this morning and wow, your a life saver!

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว +1

      Best wishes on your check offs! Go be Great!

    • @starvingsum1
      @starvingsum1 3 ปีที่แล้ว +1

      Thank you very much! I did good. I struggled on names for PFTs.. but nonetheless, I’m officially a senior now! :-). Thank you, I don’t think I’m great yet, but I’m striving for it!

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว

      Awesome! Finish strong! 💪

  • @MunecaA87
    @MunecaA87 10 หลายเดือนก่อน

    Omg ! I am half way through this video and you have explained things in a very clear manner.
    My mother has been hospitalized in ICU many times this year for high cO2 levels, after last discharge they gave her a ventilator machine but the problem is that it was set up by equipment company without a proper sleep study, the guy said he was just going to set it up on a level that she’s comfortable, and I don’t think it should be that way, when she wears that ventilator and she’s sleeping o2 sat levels don’t go above 88 and they say there is no available appointments at sleep study centers until December, her c02 levels were over 90 before and last time I took her she was at 60 and they said oh well she is a c02 retainer

  • @stefaniegunter9128
    @stefaniegunter9128 2 ปีที่แล้ว

    This was the best explanation and practice of nppv... thank youuuuuu

  • @JB-cg1rn
    @JB-cg1rn 3 ปีที่แล้ว +1

    Very helpful. Thank you so very much!

  • @quintonwynn6471
    @quintonwynn6471 2 ปีที่แล้ว +1

    Bro you’re the GOAT

    • @RespiratoryCoach
      @RespiratoryCoach  2 ปีที่แล้ว

      Too kind Quinton! I appreciate you watching and commenting!

  • @UMBUBA
    @UMBUBA 4 ปีที่แล้ว +1

    Loved it bro! Helped a lot. I’m a new RRT, just started working at the hospital.

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว

      Awesome!! Welcome to the field! Go be GREAT!

  • @user-mf4wg6rh6v
    @user-mf4wg6rh6v 3 ปีที่แล้ว +2

    This was so helpful! Thank you!

  • @dinapoole9018
    @dinapoole9018 ปีที่แล้ว +1

    good job explaining .

  • @tasiko6236
    @tasiko6236 3 ปีที่แล้ว

    Thank you from UKRAINE 💙💛 you are incredible!! Very grateful neonatologist)

  • @nishadrangana3727
    @nishadrangana3727 3 ปีที่แล้ว

    I gathered more information from u.. thanks a lot sir..

  • @hunterburton82
    @hunterburton82 5 หลายเดือนก่อน +1

    Awesome video buddy

    • @RespiratoryCoach
      @RespiratoryCoach  5 หลายเดือนก่อน

      Thanks buddy! I appreciate you watching it!

  • @msalmankhan8339
    @msalmankhan8339 ปีที่แล้ว

    You are humble at the same time and want to keep learning ❤️

  • @Vanillakd
    @Vanillakd ปีที่แล้ว

    Thank you so much for this video! Definitely had a light bulb moment when I watched it lol :-D

  • @moizshaikh2605
    @moizshaikh2605 3 ปีที่แล้ว

    👌👌👌 really appreciable..

  • @Lungs523
    @Lungs523 ปีที่แล้ว

    I hope you know that you definitely make a difference in our learning for the better!!! Thanks a million😊I truly appreciate the x u take to do these awesome videos that help us so much 🥹🤛🏼

  • @user-ir7zx3nq5r
    @user-ir7zx3nq5r ปีที่แล้ว +1

    Wonderfuly explained ❤

  • @bezaadmassu4922
    @bezaadmassu4922 3 ปีที่แล้ว +1

    Ahh thanks for simplifying this subject! Super helpful

  • @PravinChandran1983
    @PravinChandran1983 ปีที่แล้ว

    Very nice , simple and understandable, thanks for sharing and your efforts , kind of you 👍👏👏🙂

  • @tarikrafiq1846
    @tarikrafiq1846 2 ปีที่แล้ว

    You are a pro . Thank you
    Easy explaining . You need to write a book. How to be a therapist in 5 days .

  • @rajender686
    @rajender686 4 ปีที่แล้ว +1

    Simple and informative....that's all we need....nice

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว

      I agree! Thanks for watching and commenting!

  • @fanyu6529
    @fanyu6529 3 ปีที่แล้ว

    Thank you very much!!! Finally, I can understand this annoying thing!!

  • @bayanalkhalifa1853
    @bayanalkhalifa1853 4 ปีที่แล้ว +2

    Thank you so much!!! This is soooooooo helpful.

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว

      Glad it was helpful, Bayan! Thank you so much for watching!!!

  • @carissababyy12
    @carissababyy12 3 ปีที่แล้ว

    Awesome video. Thank you for this, it helped sooo much!!

  • @kimms8610
    @kimms8610 4 ปีที่แล้ว +1

    Thank you I was struggling to under stand this concept. Amazing explanation..thank you so much.

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว +1

      You're very welcome, Kim. Glad it helped, and I appreciate you watching!

    • @user-mf4wg6rh6v
      @user-mf4wg6rh6v 3 ปีที่แล้ว

      Thank you I was struggling to under stand this concept. Amazing explanation..thank you so much.

  • @zakilivoali2504
    @zakilivoali2504 ปีที่แล้ว +1

    Great work man. Can you do a video on CPAP

  • @dr.tabassum2859
    @dr.tabassum2859 2 ปีที่แล้ว +1

    Thank you sooo much!! It helped a lot! Thanks a lot!

  • @jeckellstallworth
    @jeckellstallworth 4 ปีที่แล้ว +1

    Excellent video as always! Thank you

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว +1

      Hey, Jay! Thanks man. I always appreciate your presence on the channel.

  • @rickpelow1861
    @rickpelow1861 3 ปีที่แล้ว +1

    These are best RRT info on youtube. Can you explain when you have settings of epap min and epap max how to increase oxygenation

    • @stryderhiryu8
      @stryderhiryu8 2 ปีที่แล้ว

      It expands the alveoli.. thus the very essential part of lungs are well suffice with oxygen.

  • @joshuacastruita8052
    @joshuacastruita8052 3 ปีที่แล้ว +1

    Great video bro, thank you.

  • @the_resilient1977
    @the_resilient1977 5 ปีที่แล้ว +1

    Thank you soooo much! This video was very helpful 🙌🏾

    • @RespiratoryCoach
      @RespiratoryCoach  5 ปีที่แล้ว

      Glad it helped. Let me know whenever I can help with whatever.

  • @griseldagonzalez5121
    @griseldagonzalez5121 5 ปีที่แล้ว +1

    Great explanation. Love all your videos.

    • @RespiratoryCoach
      @RespiratoryCoach  5 ปีที่แล้ว

      Well thanks for watching, and thanks for the kind comment!

  • @policegadi
    @policegadi 3 ปีที่แล้ว +1

    Such a clear explanation.. wonderful

  • @mohamedhabibberhanu6553
    @mohamedhabibberhanu6553 4 ปีที่แล้ว +1

    Awesome job coach I really enjoyed it

  • @jubaida4alam
    @jubaida4alam ปีที่แล้ว

    You are the best

  • @traceylomax2156
    @traceylomax2156 4 ปีที่แล้ว +2

    Second week of orientation, listening to your videos again. Listening to u before RRT and after RRT

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว

      Awesome, Tracey. How's orientation going?

  • @martiniasmith1446
    @martiniasmith1446 3 ปีที่แล้ว +1

    Even if the bicarb is out of normal range, we shouldn't worry about that

  • @timbailey6548
    @timbailey6548 2 ปีที่แล้ว +1

    Okay got it oxygenation problem increase epap and keep the pressure support so increase IPap as well. If the problem is ventilation then increase IPAP alone.

    • @RespiratoryCoach
      @RespiratoryCoach  2 ปีที่แล้ว

      Hey, Tim! Essentially yes, but there is one potential scenario to consider. Let's say a patient is placed on 15/10, but has no oxygenation issues. In this case, we could leave IPAP at 15 and decrease EPAP to 5, and that would increase PS without having to increase IPAP. Just wanted to throw that out there. Thanks for commenting and watching. Good luck on your upcoming CSE!!!

  • @dhandapani9870
    @dhandapani9870 3 ปีที่แล้ว

    Thanking GOD for you🥳

  • @wasimraja301
    @wasimraja301 3 ปีที่แล้ว +1

    Very good appreciate ur work, can u pls make video on oxygen therapy, which mode of oxygenation should be used in which setting,when to use high flow system when to use low flow system, when to use Nasal canula,face mask,high flow nasal canula,NRBM etc.

  • @tulip-vf3iz
    @tulip-vf3iz 4 ปีที่แล้ว +1

    God bless you for this amazing video

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว

      Hi, Tulip. God bless you for watching and leaving this kind comment!

  • @helenosawe6327
    @helenosawe6327 2 ปีที่แล้ว

    please do teaching on how to do vent check, the most important parameters to monitor and how to make adjustments. Thanks

  • @pratikshasutar4328
    @pratikshasutar4328 3 ปีที่แล้ว

    Well explained thanks a lot !
    Ur channel is a blessing 🙏

  • @brianwestgate7055
    @brianwestgate7055 ปีที่แล้ว

    I feel like we kept FiO2 out of the conversation, in regards to oxygenation. If the patient feels comfortable with the support settings, yet values show oxygenation issues, you can keep the support settings while supplementing oxygen by way of FiO2.

  • @nithinkrishna9861
    @nithinkrishna9861 3 ปีที่แล้ว +1

    THANKS BUDDY

  • @marwakassem5780
    @marwakassem5780 2 ปีที่แล้ว

    Good and nice explanation👍

  • @Marzyattakz
    @Marzyattakz 5 ปีที่แล้ว +2

    Yasssss!!! So good !!!!!

    • @RespiratoryCoach
      @RespiratoryCoach  5 ปีที่แล้ว +1

      Here to help, so just let me know what you need.

  • @gracedodd2191
    @gracedodd2191 3 ปีที่แล้ว +1

    most helpful channel on youtube

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว

      Wow, thanks! I appreciate you watching and kindly commenting!!!

  • @desimotto9725
    @desimotto9725 3 ปีที่แล้ว +1

    Great review. You connected the dots for me

  • @naazbano4490
    @naazbano4490 3 ปีที่แล้ว

    Awesome...I just needed this

  • @vangtran2055
    @vangtran2055 3 ปีที่แล้ว +1

    Do we need to take FiO2 into consideration? Will high IPAP (20) cause any harm to the patient?

  • @Tenzinla_
    @Tenzinla_ 2 ปีที่แล้ว

    Great explained thanks

  • @drabdulsamadpulmonologist7113
    @drabdulsamadpulmonologist7113 3 ปีที่แล้ว

    The only conceptual lecture on NIV I found on TH-cam is your's

  • @ngee9701
    @ngee9701 2 ปีที่แล้ว

    bloody awesome. thank you

  • @joannefurman2196
    @joannefurman2196 4 ปีที่แล้ว +2

    Your explanations are very clear. Can you provide an example of a ventilation and oxygenation problem?

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว +2

      Hi Joanne. First, thanks for watching and posting your question. An oxygenation problem would be a patient who's PaO2 is below normal, say 54. Or might be indicated by a low saturation, say 84%. You might also say a patient had an oxygenation problem if their PaO2 was 80, but they were requiring 80% oxygen to achieve that. A ventilation problem would best be illustrated by a patient with a high CO2 (65) and a low pH (7.15), or a patient with a normal CO2 and pH, but is requiring 12lpm of minute volume to achieve that normal gas. Does that help clarify? Let me know if not.

    • @joannefurman2196
      @joannefurman2196 4 ปีที่แล้ว +1

      @@RespiratoryCoach Yes, but I was wondering how you would adjust the settings for the IPAP & EPAP if there was an oxygenation and ventilation problem. Let say a patient who has a CO2 rate of 31 and is moderately hypoxemic?

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว +2

      I see, Joanne. So if your CO2 is 31, which means it's low, then you need to decrease the difference between IPAP and EPAP, which you could easily do by increasing EPAP to address the moderate hypoxemia. So if the patient was on 12/5, then increasing the EPAP to 8, would now put them on 12/8. Your pressure support is lower thus your CO2 should return to normal, and with the added EPAP hopefully your hypoxemia will correct. Let's say your patient was on 10/5 and their ABG came back with a high CO2 and a low O2. Then to address the low oxygen we would increase EPAP, let's say to 8. To address the high CO2 we need to increase the PS, which we know is the difference between IPAP and EPAP. If we placed IPAP on 13, we would do nothing for the high CO2 because the difference is still 5. So we would need to increase the IPAP to 15 or 18, now our PS is 7-10, which is an increase from 5 and our CO2 should come down. Does that answer your question?

    • @joannefurman2196
      @joannefurman2196 4 ปีที่แล้ว

      @@RespiratoryCoach Yes! Awesome!!! Thank you for your help!!!!

  • @mitchkrdr
    @mitchkrdr 3 ปีที่แล้ว +2

    How would you know how much to go up when you make adjustments? Like when you went up by 5 and by 4 on your IPAP and EPAP to address oxygenation problem but keeping your PS the same.

    • @arun4udude
      @arun4udude 3 ปีที่แล้ว +1

      How much should be the change IPAP/ EPAP / PS
      Will it damage the lungs?

  • @dlewispromed
    @dlewispromed 3 ปีที่แล้ว

    This was a great explanation, I wish I'd watched it before checkoffs. Will you go over how the HIP and LIP alarms are set and what the LIP T alarm is used for?

  • @manadoctorvanama9068
    @manadoctorvanama9068 3 ปีที่แล้ว

    Great explanation fan from indian

  • @tessymoljacob6843
    @tessymoljacob6843 3 ปีที่แล้ว

    Great class..

  • @arianahyde4782
    @arianahyde4782 2 ปีที่แล้ว

    Thank you so much

  • @amsg2948
    @amsg2948 ปีที่แล้ว

    Great explanation

  • @marilyntorresrrt6763
    @marilyntorresrrt6763 5 ปีที่แล้ว +1

    YOU ARE A LIFE SAVER> this helped me so much. I appreciate it. Now im ready for Wednesday, very confident. Will keep you posted :)

    • @RespiratoryCoach
      @RespiratoryCoach  5 ปีที่แล้ว

      I don't know about that. Lol. Just doing what I can to help.

  • @honeyb0625
    @honeyb0625 4 ปีที่แล้ว +1

    Thanks, life saver

    • @RespiratoryCoach
      @RespiratoryCoach  4 ปีที่แล้ว

      Hi! Thanks for this kind comment and for watching!!!! Best wishes!

  • @maimounasaleyadamou5685
    @maimounasaleyadamou5685 3 ปีที่แล้ว

    Thanks so much, you made my day.

  • @timbailey6548
    @timbailey6548 2 ปีที่แล้ว +1

    Thank you trying to understand cse practice exams and have it coming up soon

  • @tonyawright7708
    @tonyawright7708 2 ปีที่แล้ว +2

    What recommendations for a COPD patient with ph of 7.46, PCO2 of 66, PO2 of 119, and HCO3 of 39.9?

  • @kalfatk2133
    @kalfatk2133 3 ปีที่แล้ว +1

    Great class. Thanks

    • @RespiratoryCoach
      @RespiratoryCoach  3 ปีที่แล้ว

      You're very welcome!!! Thank you for watching!

  • @Jerome2k1
    @Jerome2k1 2 ปีที่แล้ว +1

    Helpfull

  • @lisastauffer9877
    @lisastauffer9877 ปีที่แล้ว

    Great job!

  • @irinaostapenko7017
    @irinaostapenko7017 3 ปีที่แล้ว

    Thank you so much!

  • @appleipad1177
    @appleipad1177 2 ปีที่แล้ว

    Thank you for such a wonderful lecture