Respiratory Therapy - Mechanical Ventilation Terminology Breakdown
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- เผยแพร่เมื่อ 30 ธ.ค. 2019
- Please subscribe, like and comment. Would love to hear what you think about the video. Also look for me on social media....
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Twitter @coachrrt
Feel free to email me any questions or concerns @ respiratorycoach@gmail.com.
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Hindsight...the timing on this video was great.
"No you don't. You're killing somebody." 😂😂😂
Best line! As usual man, great explanations. It's clear you know your stuff and you do a great job explaining that knowledge.
Haha...had to rewatch to see when I said that. Thanks for watching and commenting!
I've only just started watching...so 2 years late, but I agree that also was the best line 🤣
Thought I was the only one that laughed at that part😂😂😂😂
6:52 clever point!
I’m gonna discuss it with my supervisor 💪🏻💪🏻
I am watching this in 2023.and u realy did a great job explaining it..thanks sir
Great break down!!!! I wish our instructors explained like you. Thank you!!!!!
Glad it was helpful! Thanks for watching and leaving the kind comment!!
You’re a life saver! 2nd semester student here taking mechanical vent. Learning mechanical vent is like learning a foreign language. Thank you for making it clear for me. I was lost 😞 until I watch your video.
So glad to hear that, Erline. Thank you for watching. Glad the videos are helping.
you're vid was so good it made me shed a tear. Thanks alot
I literally used to hate this topic and didn't look forward revising it but your videos actually made me fascinated and eager to learn more! literally what the hell. Great job ^x^
It's vent time!!! Here we go with my quick refresher of vents. I hope it goes as well as my ABG review. Thanks for everything!!!
Ur explanation is really very good sir , thank you very much
You clarify to me a lot of misconsepts ! thank you , keep going you amazing work.
Love your videos. I feel like I learned more in your 20 min videos than in a whole semester. Keep uup the good work.
Wow, you are a legend! It's so clear 😊! Thank you for sharing your knowledge!
OMG, thank you, it is the first day of my second semester.
GO BE GREAT!
I'm a second year Respiratory student and wow this is so helpful! Thank you for sharing
You're so welcome, Rebecca! Best wishes along your journey to RRT!
Thanks Respiratory Coach, you break it down so simple.
Thanks, Karen. That's my goal! When do you graduate?
Your videos made me love Mechanical ventilation 😊
Man, this was right before COVID hit.
Crazy, huh! Time flies when you're having fun!
This is my first time watching one of your videos, and I have to say you are an amazing teacher. Clear and concise. You have helped me which intern allows me to better help patient’s thank you.
Awesome teaching...u r rocking...Ur knowledge is beneficial to the whole world
Absolutely makes sense. Thank you for the clarification. It is one thing to read a text book, teacher and try to figure it out but sometimes people just need to hear a different voice and you Sir are that person. Even the hand movements and pictures I understood better. Thank you for what your doing.
Thank you for the kind feedback. I'm here to help. As always, thanks for watching and commenting! Best wishes in 2020!
As you predicted, it does makes sense now!
Fantastic, Miguel!!! Thanks for watching!!
Great teaching, God bless you
Thank you so much I’m in school right now and this helps thank you again
Excellent maestro!
You are godsend bro keep it up
Filled with Gratitude! happy new year
Same here....filled with gratitude! Thank you for watching and commenting!
It really does makes sense now! Thank you!
Good, Stefania! Glad it helped clear up any confusion! Thanks for watching and commenting!
Thank you very much for this video, I have subscribed to your videos. I am a current RT student and this has helped so much especially with the classroom limitations. Your visual video helped me understand much more than what I was getting. Thanks again. Gil
Awesome, Gil! You're very welcome. Glad you find the channel helpful. Thank you so much for watching and commenting!!!
THANK YOU THANK YOU I'm using the Pilbeams workbook at the moment and we starting using these variables but I need to know what they they not just plug these variable into the equations! this was awesome!!!!
This is great thank you!
Hello, Respiratory Coach. I am a year in as an ICU nurse. We're not really taught much about the vents except for the basics. Most is self study. Try as I might, reading about vents is not as easy learning as would have thought (i.e. loops and wave forms). Super glad to come across your channel. What is your suggestion on the sequence/order of where to begin with your videos, let's say if new to vents then progress to expert level? Thank you again for making these video as they help us understand beyond basic.
Thanks a lot, appreciate your effort 👍🤍
Thanks for explanation..
Great job keep it up..
You're very welcome! Thank you for watching and kindly commenting!
Of only you knew what 2020 would bring!!!
Great vid thanks 😊 I can’t wait to learn more ima need all the help I can get😅 you made it very interesting wish you could be my professor 👨🏫
Thank you Coach , it such a useful video and great knowlage , thanks for a great video , Coach
Thank you for watching and commenting!
Beautiful teaching .......thankyou sir
Thank you!!!! Sent you an email a short while ago! Thanks for watching and commenting.
I wish u were my teacher 😂
I wish you were my student!!
Wow! God bless you
Thank you so much!
you are amazing sir.
Thank you for sharing such kind words. And thank you so much for watching!!
Awesome man....
Thank you, Rajasekhar. Glad you enjoyed it. Thank you for watching and posting the awesome comment.
Great videos I wish you make one special episode for pediatric mechanical ventilation
Thank you! I have limited neo/pedi experience. I am currently attempting to have my neo/pedi expert join me for an episode to discuss this topic. Cross your fingers it happens soon!!
It does now
Awesome. Would you please talk about Bi-level mode and how to titrate it by any chance? Thank you
4:47 hahahaha “no you don’t” got me😂😂😂😂😂
Tqqq so much ....for saying basics of pressure ,bcz I am always confused but now I have clarity about pressure...hpy new year
Happy New Year, Naveen. Thanks for watching my friend.
Thank you thank you thank youy
You are a great instructor and make everything easy! I am an ICU nurse and it makes more sense with the way you explain it. Thank you so much! 🙌🏼
Hi, Valentina. Glad you enjoyed the video. Always love to see nurses on the channel. Thanks for watching and kindly commenting!
Wow thank you so much
Can you take these videos and make them into podcast type stuff? I would love to be able to listen to your videos while I am working.
the best❤❤❤❤
Dammit!! I should’ve been listening to you already
Thank you
It does now!
Awesome! Thank you for watching!
@@RespiratoryCoach quick question. Do you have chronological order for your vids. I had to miss a semester and now I'm trying to refresh for the upcoming semester
Hey Don. I don't. If you're ever looking for a video and can't find it using the search bar on my channel, send me a message and I'll let you know if I have one or not.
What determine the end of inspiration is called LIMIT.
What determine the initiation of expiration is called CYCLE.
Not exactly. The end of inspiration and the beginning of expiration are the same thing. Cycle ends insp, which allows exp to begin. Limit is a variable during mechanical ventilation that can not be exceeded. For example, in volume control we set insp flow of 50lpm. That flow is a limit. Which means, during insp, the flow will increase to 50, but will not exceed 50. Some texts refer to limits as target variables. Does this make sense? I really appreciate you watching and commenting.
So basically...
Mechanical ventilation
RR (respiratory rate) = x breaths/min
(ex. You want to give 1 breath each 4 seconds you'll do 60sec/min ÷ 4 sec to find out what your RR would be, so here your RR would be 15/min, as 60sec ÷ 15/min = 1 breath each 4 seconds)
Vt (tidal volume) = x ml/inspiration
(ex. Patient weight 80kg and you want to give 6ml/kg you'll give 480ml/inspiration as a Vt of 480ml) (please don't be killing anybody by giving a Vt of 500L thank you.)
Ve (minute ventilation) = x L of volume given/minute
(ex. You've installed a Vt of 480ml at a RR of 15/min so you're giving 7,20 L of volume each minute as Ve = RR * Vt = 15/min * 0,480ml/L which = 7,20 L/min) (and remember that hyperventilation is, for example, not only high RR but a high Ve that affects your PaCO2 by decreasing it so much that the patient is now in respiratory alkalosis, as an RR of 24/min with a Vt of only 150ml is not necessarily hyperventilation because Ve would only be of 3,6 L/min!)
Trigger (breath starter)
Time triggered breath : when patient is not breathing, breath delivering depends on set RR.
Pressure triggered breath : when patient takes pressure away from the circuit
Flow triggered breath : when patient sucks flow out of the circuit
Cycle (inspiration ending allowing expiration to begin)
(here, two most used in mechanical ventilation)
Set inspiration time (Ti) is reached so inspiration ends and expiration starts
Set inspiration volume (Vt) is delivered so inspiration ends and expiration starts
Etc. (differs from modes to others)
Pressures
-PIP (peak inspiratory pressure) = airways pressure + alveoli pressure
When inspiration starts, pressure rises until the breath is delivered and the highest that pressure got is the PIP
-Pplat (plateau pressure) = pressure representative of the pressures within the alvioli only (manoeuvre : at inspiration's end breath is hold for a few seconds and pressure lowers from PIP to Pplat and stays there until the inspiratory hold is released)
-MAP (mean airway pressure) = average of all the pressures throughout the entire cycling of the breath (area beneath the pressure curve)
The higher the PIP and Pplat are, the higher the MAP is going to be and vice-versa
-PEP or Peep (positive end-expiratory pressure) = set pressure that prevents the alveoli to completely collapse at the end of exhalation (atelectasis) by holding continuous pressure throughout the ventilation
-Driving pressure = Pplat - PEP
(We want that pressure to be minimal as well)
PIP - Pplat = representing airway resistance
Hello sir. I just wanted to ask if you can tell the order in which i should watch the videos for MV it will be really helpful🙏🙏... Love your explanation sir
Thank you so much for sharing those information with us.I have recently started my internship in anesthesia and ICU department and I got a lot of benefit from your videos. But the problem is your videos are not well organized in terms of categories, I mean I don't know which video comes first, so that I start from scratch and gather up my knowledge with each upcoming video?!
Hello! Thank you for your comment and I hear you. I do the best I can, with the little time I have, to publish regular content. Sorry it's not more organized.
Thank you again for breaking it down for us. A great way to help me review while on the new job =)
Hi Elaine! How's the new job and life after RT school treating you?
Respiratory Coach it’s been going well ty! When there’s something I’m not sure of or need review, I just find one of your videos so thank you!
@@ElaineAnourack That's great. Glad it's going well. Let me know if you ever can't find what you're looking for. Best wishes!
Could you explain how to affect Vt, Ve, ect. on the ventilator?
thank you
Hello
May I ask...
Because in a mechanical ventilator that I see..
That is on Dynamic Bi Level Setting..
The parameter has "Pressure Support" and "Frequency"..
May I know, what is the difference between the Frequency and Pressure Support please.
I love this channel 🥹
This channel loves you! GO BE GREAT!
This may be a silly question: but for Ve I understand the formula rr x vt. But when you said 24 x .150 = 3.6L doesn’t mean hyperventilating because you cant use the RR on its own to dictate that (I understood that). I’m just wondering how we can know if a patient is hyperventilating? Do we use pH to dictate that or is there a target Ve we need to look for to consider “hyperventilation”
Can u also teach ecg just summarize thank you
Thank u from icu nurse
thanks again
What’s a normal driving pressure ?
Hello , good videos ,,, are you posting new videos? Most of them are 2 years ago ?
So it Peak pressure the same thing as PIP?
11:30 if I may ask, why do we need to measure the mean pressure? What is the point?
What are normal ranges for each one?
So I was with another rt today and their patient is a chemical code so everything but compressions. The patient was on a vent fio2 100% peep of 20 and satting 30%, at one point would you take them off the vent and start bagging? 30% saturation is so low I was getting worried and wondering when we would start bagging? The patient was eventually changed to comfort care so patient didn't end up coding
I would question the validity of that pulse oximeter reading. Sounds like there were likely perfusion issues present, which we know greatly impacts the accuracy of pulse oximetry.
Can you do a video on cmv indications
Got it on the list! Thanks for watching and requesting!
And then came 2020 😢
True story
Great video! Is tidal volume is inhale volume or exhale ?
HI Jiao! Tidal volume is the amount of volume of a single breath. What goes in should come out. So inhaled vs exhaled tidal volume should be relatively close. During mechanical ventilation both inhaled and exhaled tidal volume can be measured and monitored.
@@RespiratoryCoach Thank you so much for replying. What confuses me is if we need to add inhale and exhale volume...lets say inhale volume is A, so tidal volume is A or 2A?
It does now,😁🙏🙏🙏
AWESOME!!
When in pressure support ventilation, what is an appropriate setting for end cycle time? On most vents I have seen it set at .25 or .30.
25% is standard on most vents, and appropriate for most patients. You can shorten this to 10 or 15% to allow the pressure support to sustain for a longer time during inspiration for your restrictive lung disease patients. Likewise, you can increase this to 35 -50% to shorten the time of the inspiratory pressure support, which will allow for a longer expiratory time for your obstructive lung disease patients. I only adjust though when the standard 25% doesn't seem to be meeting the patient's needs. Hope this helps!
@@RespiratoryCoach thanks videos are awesome
Peak flow % cut off...could you please explain this better
👍🏾
Hey Tracey! Thanks for watching. 👍
Sir kindly arrange videos in sequence.its difficult to understand to see which video after other
I'm working on that now. Stay tuned! And thank you for watching!
9:30 I'm confused. I thougth Boyle's law states, that pressure and volume is inversely related. So the higher the volume the lower the pressure.
Hey Alex, great thought. Let me help clarify. Boyle's law talks about the pressure exerted by a given mass of gas within a constrained volume. So make it relatable to mechanical ventilation. We deliver a mass of gas (tidal volume) into a constrained volume (alveolar units) and a pressure results (peak, plateau, mean). If a patient develops a pneumothorax and loses half of their alveolar units, then the volume of the container, decreases and pressure will increase, as we deliver that set tidal volume (mass). @9:30 I was referring to increasing the mass of gas (set tidal volume) which will yield a higher pressure. Did this help to clarify?
Hello doctor, my dad has been infected by covid19 and her lungs are damaged more then 90%, after 3 months and half he's still with oxygen machine and VNI machine,
Please how i can contact you?
How do you calculate O2/Air ?
Are you talking about air to oxygen ratios with entrainment devices?
No, you said to give 40% O2 you blend 100% O2 with Medical air, what’s the blending equation
i need normal values/range for each of that ventillator settings plsss
There are maxes and minimumss to which u can applied othewise ur lung will get destroyed for barotrauma dont u think??