Thanks a lot!!! In our hospital consultants are not present at most, we are being run by residents. There is only 1 IM resident for 3 ICUs and they are do not have deep understanding about MVs. When we have met acid patients, you can really see how they thrive to breathe deeply, ROD only knows AC or VAC so they only order that. VT is 6/7ml/kg. ABG result is present before intubation sometimes. Waveform is chaotic. It’s frustrating as an RT to see the waveform and px breathing chaotic. Every patient has different breathing pattern, some inhale up to 1.5-2 seconds but slow, some .7 but rapid and changes every now and then. I usually advise ROD to shift to PRVC and match their breathing pattern at least at the moment until they stabilize their bicarb. Also knowing the px diagnosis is vital not just looking at the px and monitors to match what is the suitable settings and management. sometimes I sneak up changing the machine with VC+ so that they do not see that the mode is changed. I see patients getting better a lot. I learned a lot with your previous videos, I know I have to stand on my grounds firmly but not stubbornly. Now, our doctors are slowly understanding other vent settings which are being overlooked before. Idk whats gonna happens next since I am resigning.
Thank you Coach!I work for a subacute and I always try to wean my patients.Some of them gets apneic and I just stop weaning.This lesson of yours really sheds some light into what I do as an RT.Excellent channel and keep up the good work!
Hello. Thank you sir! I have witnessed that RTs believe that if the PaCO2 or the ETCO2 is normal they believe there isn't anything that they should or could do to help our patients! Thank you for your teaching. Best, DM (full time intensivist).
Thank you for all that you do for the community of respiratory care. You are truly doing amazing work and making a difference in clinicians knowledge! Can you please do a video or do you have one that discusses respiratory compensation and the use of Winter's correction formula for metabolic acidosis?
Hey Danny! Thanks for watching. Great timing. This video on Winter's Formula just launched today. th-cam.com/video/vd7CkB5Pit8/w-d-xo.htmlsi=sFgC8ECz553--5R5
For some reason i tried to increased my apnea alarm, and it works! I tried this to many of my patients with metabolic problem and it really works, i thought im doing the bad things though but i guess my intuition was right. Thank you coach for this clarification, i don’t really know how to explain what i did to tell you honestly but now i have the answer, by the way i didn’t leave my patients while doing this, my eyes is on the cardiac monitor, ventilator and ambubag haha. But yes it works everytime. Extubation success!
I’ve increased the apnea alarm but like you said, only while I was in the room. Patients tend to love the vent and they need some time to allow their brain to tell them to breathe.
I had an experience with one patient who was a long term trach on an aerosolized tpiece. One night the nurse came to me and said the patient is breathing 30 BPM. She said that she was suctioning him constantly but he's still breathing fast. I told the nurse to stop suctioning and tell the doctor. It's a metabolic issue.
Head injuries cause a whole other set of issues, but in short, yes. Any patient in a state of alkalosis may present with a depressed drive to breathe and require patients when switching to a spontaneous mode of ventilation.
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Thanks a lot!!! In our hospital consultants are not present at most, we are being run by residents. There is only 1 IM resident for 3 ICUs and they are do not have deep understanding about MVs. When we have met acid patients, you can really see how they thrive to breathe deeply, ROD only knows AC or VAC so they only order that. VT is 6/7ml/kg. ABG result is present before intubation sometimes. Waveform is chaotic. It’s frustrating as an RT to see the waveform and px breathing chaotic. Every patient has different breathing pattern, some inhale up to 1.5-2 seconds but slow, some .7 but rapid and changes every now and then. I usually advise ROD to shift to PRVC and match their breathing pattern at least at the moment until they stabilize their bicarb. Also knowing the px diagnosis is vital not just looking at the px and monitors to match what is the suitable settings and management. sometimes I sneak up changing the machine with VC+ so that they do not see that the mode is changed. I see patients getting better a lot. I learned a lot with your previous videos, I know I have to stand on my grounds firmly but not stubbornly. Now, our doctors are slowly understanding other vent settings which are being overlooked before. Idk whats gonna happens next since I am resigning.
Thanks for watching and taking the time to leave a comment! I appreciate you!
Thank you Coach!I work for a subacute and I always try to wean my patients.Some of them gets apneic and I just stop weaning.This lesson of yours really sheds some light into what I do as an RT.Excellent channel and keep up the good work!
Hello. Thank you sir! I have witnessed that RTs believe that if the PaCO2 or the ETCO2 is normal they believe there isn't anything that they should or could do to help our patients! Thank you for your teaching. Best, DM (full time intensivist).
Thank you for all that you do for the community of respiratory care. You are truly doing amazing work and making a difference in clinicians knowledge! Can you please do a video or do you have one that discusses respiratory compensation and the use of Winter's correction formula for metabolic acidosis?
Hey Danny! Thanks for watching. Great timing. This video on Winter's Formula just launched today. th-cam.com/video/vd7CkB5Pit8/w-d-xo.htmlsi=sFgC8ECz553--5R5
For some reason i tried to increased my apnea alarm, and it works! I tried this to many of my patients with metabolic problem and it really works, i thought im doing the bad things though but i guess my intuition was right. Thank you coach for this clarification, i don’t really know how to explain what i did to tell you honestly but now i have the answer, by the way i didn’t leave my patients while doing this, my eyes is on the cardiac monitor, ventilator and ambubag haha. But yes it works everytime. Extubation success!
I love it! Strong work!
I am a flight nurse by trade. I have taught this very subject in a 100 different TNCC and PHTLS classes.
I’ve increased the apnea alarm but like you said, only while I was in the room. Patients tend to love the vent and they need some time to allow their brain to tell them to breathe.
Increasing the apnea makes sense but I've never seen anyone try it yet.
This is wonderful. Blood gases tell so much.
Apnea for 2 minutes?! 😅 i think the registered nurse at the bedside would tackle me.
I had an experience with one patient who was a long term trach on an aerosolized tpiece. One night the nurse came to me and said the patient is breathing 30 BPM. She said that she was suctioning him constantly but he's still breathing fast. I told the nurse to stop suctioning and tell the doctor. It's a metabolic issue.
Or could have had a P.E.. or effusion. Or spontaneous pneumo 😊
Thank you, coach!!
Hittin’ it out of the park, Coach 🙌🏼
Thx Joe❤
Thank you sir❤
❤❤ thanks coach
Can the same be done for pts hyperventilated pts with brain bleeds?
Head injuries cause a whole other set of issues, but in short, yes. Any patient in a state of alkalosis may present with a depressed drive to breathe and require patients when switching to a spontaneous mode of ventilation.