0Jun 14, '07 by phiposurdeI am new to the aeromedicine. I've been told you have to be cautious to use ventilator in rotary wing r/t Boyle law. So i was thinking, is it more safe to use pressure mode instead of volume mode?? Or how do you monitor and set the ventilator according to the altitude?
0Jun 14, '07 by RNFPCUsually for rotor wing transport, boyle's law doesn't come into play... As far as barotrauma is concerned, its just important to set your peak pressure alarm and to pay attention to your PIP's and MAP's. It helps to be conservative on your TV's (6-8cc/kg) and just titrate your TV's to maintain an appropriate ETCO2's. I usually only use Pressure Control with kids and asthmatics (or other restrictive airway diseases).
Usual starting settings for a patient that I've done a rapid sequence on:
keep ETCO2 between 37-43
(I'm using an LTV1000)
1Jun 16, '07 by GilaRRTI use the Crossvent 4. I agree that on rotor wing, altitude is not as much a problem as it is on a fixed wing.
Adults will usually be volume ventilated.
I start my initial settings at:
Tidal Volume: 6-8 ml per kg lean body weight
FIO2: 0.5 and titrate as needed
PEEP: 3-5 and titrate as needed
Plateau percent: 10-20 pecent of the insp time
Rate: 10-12 and titrate as needed
I try to keep the peak insp pressure under 35 and the plateau pressure under 35.
I try to keep End Tidal CO2 around 40 in the normal adult.