Home ventilators

caliotter3 · Jan 14, 2015

There have been a couple of other threads where this has been discussed, NRSKaren also posted some links to vent info way long ago. That post may be in a sticky. Have not seen the PLV 100 series in a long time, most vents encountered lately have been in the LTV family. If you do an internet search on the LTV 1100 or 1200, you can find an operator's manual online that you can download. Handy particularly for the chapter on troubleshooting. I wrote a post one time that my best training came when I did an orientation with another nurse who was a very good trainer. The classes that I have been forced to go to locally have been almost worthless. Another class I had a long, long time ago was set up by the nursing supervisor for an inservice. She had the vent rep from the DME company come and we could ask all the questions we wanted. He brought a couple of machines and did a very good job of explaining the nuts and bolts we needed to do for the job.

CloudySue · Jan 14, 2015

I've been seeing the old vents go by the wayside as new vent cases pop up. The Trilogy is the new kid on the block, and it's fantastic.

Gooselady, BSN, RN · Jan 14, 2015

Thanks! I've seen videos on the Trilogy too, and there is one more that starts with an "A" I think.

I'll check out the links posted by NRSKaren, that's exactly what I was hoping for. Formal inservices are good, as are one on one training with someone who enjoys teaching. There is something about nurses just 'discussing' something like a vent where you get special nuggets of info, or get sparked to think of something or new questions arise 'better' than in formal training.

Gooselady, BSN, RN · Jan 14, 2015

Here's one of the links in case anyone else wants to follow up:

NRS Karen's Vent/Trach info

There are more. I put 'peds ventilator' in the AN search engine (duh!) and it was right there. This place has a decent search engine even I can use.

SDALPN · Jan 15, 2015

The equipment company can teach. Some do classes. The agency training usually is a joke. Training with another nurse helps with real life situations if you can get enough time with a good nurse. You can also research online. Just knowing the buttons to press on the vent isn't enough. Don't let anyone tell you different. There is so much more you need to know.

Like the others said, you can search the threads for more info. Check reputable sites to learn from. Review a&p on the respiratory system. Learn everything you can. The vents do the work for you mostly. But you need to know how to read and interpret the numbers and know interventions. The basic function of the vent is the same. The big difference with each vent are the features.

LTV is the most common. Trilogy is starting to show up more and more. I personally prefer the ltv. The trilogy is quieter though. I've been doing this for a while. So I've worked with older vents too such as the LP10 & tbird. Those vents are heavier/bulkier than the newer ones.

allnurses Guide · Jan 15, 2015

I find having the manual for the vent at my fingertips and reviewing it frequently is a great strategy. A fellow nurse gave me that advice when I started. Agree with Cali, the agency inservices I have had are close to worthless. More than anything the thing with vent cases is the way the person interacts with the machine. If you are lucky enough to have a good nurse orient you to that particular patient's patterns, take notes!

Another great resource is the Respiratory Therapist. If you are lucky enough to be working when they are there to check the vent, pick their brains. They know these things backward and forward. Vent cases are challenging, but really interesting cases. I've learned a lot and found it rewarding.

brillohead, ADN, RN · Jan 15, 2015

Trilogy here, too.

Be sure to know your scope of practice with regard to the vent. Both of the agencies I work a vent case for specifically prohibit the nurses (LPN or RN) from making ANY changes to ANY of the settings (other than switching from one pre-determined setting to another, such as primary settings for daytime and secondary settings for HS, etc.). All actual setting changes to any pressures, rates, etc., all have to be made by a Respiratory Therapist. So even if I had physician orders to change the vent settings, I'm not allowed to do it.

doodlebuttRN · Jan 16, 2015

I have seen both the LTV and the trilogy in the field, and in fact have a few patients who started on the LTV and transitioned onto the trilogy. Small difference I have noticed are that the trilogy is very quiet, compared to the LTV (as far as the breath sounds/exhalation) and there is no leak test to be done every time you turn off the vent to switch from primary to travel vent, do circuit changes, etc.

I agree with Caliotter, SDALPN and nurse 156, it is extremely helpful to work with another nurse to become familiar with the ins and outs of these vents, not just which buttons to push, etc. unfortunately in private duty we are working alone in the home, and often we only see our fellow nurses during report. I would recommend asking the agency for some one on one education with your nurse educator to answer your specific questions and reinforce your skills in the office with practice equipment.

There is a lot that nurses need to know, as a foundation, before becoming proficient in the management of mechanical ventilation. It is definitely a learning process. I have precepted several nurses in recent months, all of whom are supposed to have a minimum of one year experience (a requirement to work with many MFTD patients in my state), and unfortunately, it seemed that a few lacked the most basic understanding of respiratory physiology; those most basic building blocks without which they cannot obtain a working knowledge of mechanical ventilation. It seems like you are very motivated and eager to learn, and you have some good experience (from reading some of your past posts) so I think that it might just be a matter of time, for you to get the clinical experience under your belt, until you are proficient.

Best of luck at your new job!

Gooselady, BSN, RN · Jan 20, 2015

Thank you everyone! I've been gently pressuring the new nurse manager about training, and I would be able to work an 'orientation' shift in the home. In the meantime I've watched and bookmarked some videos and made some cheat sheets (as much as you can do without having a vented kid in front of you). I'm a kinesthetic learner so I know it won't kick in until I interact with the patient and the vent in real time.

I don't have a huge amount of faith that I'll get much education from the company office. That's fine, at this point I know how to learn without a manager to arrange it all for me. Not that they would lol and even then, I don't leave that kind of stuff up to anyone if I'm going to be the one caring for the vented kid. It doesn't surprise me that the staffing agency may not offer adequate education, I kind of figured they wouldn't. I wasn't being too cynical after all :)

I'm fresh out of acute care and did think to bookmark some videos about basic respiratory A&P. So, I'm all ready to pour it on thick with the manager. She ought to have caught on I'm motivated to learn by now I should hear something from her tomorrow. Thanks again everyone, very appreciated :)

smartnurse1982 · Jan 20, 2015

Can someone answer a question for me?

I have not been able to find any info on this.

Are the marine and lithium batteries supposed to be plugged in 24/7?

I was taught that for a decade and followed that rule.

I had a supervisor say recently that the batteries are not supposed to be plugged in 24/7 because it drains them,and thus you would need to recharge them longer and longer.

One mother said she has not charged the vent batteries in over a year,yet when she takes her son to school daily the batteries have never run out of power.

I usually err on the side of caution and keep them charging but lately lots of parents have seem to leave them unplugged.

caliotter3 · Jan 20, 2015

Can someone answer a question for me?
I have not been able to find any info on this.
Are the marine and lithium batteries supposed to be plugged in 24/7?
I was taught that for a decade and followed that rule.
I had a supervisor say recently that the batteries are not supposed to be plugged in 24/7 because it drains them,and thus you would need to recharge them longer and longer.
One mother said she has not charged the vent batteries in over a year,yet when she takes her son to school daily the batteries have never run out of power.
I usually err on the side of caution and keep them charging but lately lots of parents have seem to leave them unplugged.

I could swear that the vent DME rep told me one time that they should be plugged in at all times.