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flying ventilator

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by phiposurde phiposurde (Member)

phiposurde specializes in critical care,flight nursing.

3,240 Profile Views; 120 Posts

I 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?

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RNFPC specializes in ICU/Flight.

10 Posts; 908 Profile Views

Usually 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:

Volume Control

Assist/Control

Rate 10-12

Vol. 6cc-8cc/kg

PEEP 5

keep ETCO2 between 37-43

(I'm using an LTV1000)

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1 Article; 1,905 Posts; 15,760 Profile Views

I 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:

Mode: SIMV

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.

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picuman is a BSN, RN and specializes in ER, PEDS, PICU, PUB HLTH AIR GRND TRNSP,.

19 Posts; 1,604 Profile Views

Try the LTV 1000 we use it on ground and air transport.

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nghtfltguy is a BSN, RN and specializes in Emergency, Trauma, Flight.

314 Posts; 4,089 Profile Views

what gila said....

or just tube em... and bag em....

:cool:

very well put gila~

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