RAM Cannula - Page 2

We just started using (well, trialing) it a month or 2 ago. It's not being used in lieu of intubation, but rather we use it with the baby on Si-pap. They are a great, wonderful improvement over the old CPAP mask/cannulas, and cause very little damage to the nose. They only recently bought updated modules for our ventilators that allow us to use the si-pap. (Sy-pap?)

Our unit does not use Vapotherm. That was before my time I guess, but now we just use Fisher Pykels. We also use Sipap- a lot.

I think vapotherm is a more recent thing. We get kiddos from hospitals that don't use vapotherm and the kiddo comes on cpap and we're able to get them on vapotherm usually​ pretty easily. We use it a lot more then cpap or si-pap

What is vapotherm?

Vapotherm Therapy This is a parent site, but had some info. @Boratz: your hospital may be doing it but calling it something else.

We used Vapotherm in our unit until they had their recall. We switched to Fisher Pykel and we've been using that since then. I believe they are pretty much the same thing.

We use the RAM canulas at our facility & I like them very much. One major difference from a standard NC is that you can do bubble CPAP or NIMV with the RAM & the switch is fairly simple. There seems to be far less nasal septum breakdown. Babies can start to dry breastfeed sooner & transferring to kangaroo care is soooo much easier. The one downside is that it doesn't work well for all babies though. Some just really need those Inca prongs which give a better bubble.

So I Know this is an old post but I had to share. I just saw this used on my unit for the first time. This is a pedi CICU and it was used on a 3 mo old whose been intubated his whole life. They extubated to it and so far he seems to be tolerating it pretty well (RR in the 100's though but appears comfy). He is on the vent mode with a rate. I'm still not understanding how he gets any peep and it's pretty obvious that its all going out his mouth as there's not much for tidal volume registering. I have no idea if we are using this in my NICU yet or not, honestly, the respiratory therapists think one of the attendings just ordered a trial, found it somewhere, and decided to give it a go! No one has had ANY education on it and all we have is the manufacturers "ad" type thing kept at the bedside.

I still do not see how this differs from vapotherm, nor do the RT's i've talked to. It's essentially just providing high flow with "breaths" at a slightly higher flow.

My unit uses the RAM cannula and at first we had a lot of excessive bloody noses plus some breakdown on the septum. At first I didn't like it because of all the trauma, but we have found ways to prevent it especially the breakdown. I am used to using it now and it works well on the older babies but as for the little ones I guess the jury is still out for me.

The Columbia bubble cpap method has been in use for fifteen plus years and is far superior to the
ram Cann. The Ram is a one way flow device, meaning the patient cannot exhale back into it. That is
why it cannot be allowed to fill more than 80 per cent of the nare. If used correctly, it cannot
provide a seal and therefore is inefficient and ineffective when compared to Hudson prongs which
maintain a seal, transmit known pressures, allow the patient to breath physiologically in and out.
In most cases the Ram is used incorrectly, allowed to occlude the nares, and therefore
impedes the normal process of exhalation. Co2 is purged by "blowbye" out the mouth. Babies are
perfectly capable of breathing on their own, they don't need the elevates rates that Ram Cann
users apply with no apparent criteria.
Yes, it is easy to use, and everybody likes the "easy button", but it is not the best choice
for patients with surfactant deficiency. The Hudson cpap system is far superior, but it
is labor intensive. It is sadly too much work for people who are more committed to their
own comfort than the correct treatment of the smallest and most vulnerable of patients.