ECMO

Hi. I've posted here some before, with some educational questions. I've written a long post back in 2023 talking about myself so people would understand that I'm not a Nurse, but I'm a long term ventilator patient who honestly knows enough to the point where I think like a Nurse, or an RT, rather than a patient. I've spent more time in ICU than at home. I know ACLS, by heart, have even taken the course and passed, and being that I've been around this stuff all my life, It's natural. I mean I may be a patient, but I give ventilator lectures, and teach nurses a lot all of the time. And I explained that in that post. I jut wanted to point out before I go posting this question, so you all won't get annoyed that a patient I posting. And I tried posting in the area where patients can post, but never got responses when I did that. I just ask that you understand. I try not to post here very often, because my past posts annoyed a lot of people. My appologies. I have always tried to be kind and respectful here. My question is, I'm on a ventilator full time with a tracheostomy. I use a VOCSN ventilator, which doe Ventilation, it has it's own built in O2 Concentrator, AND it even has a 50 PSI connector for a green External High Pressure Hose so in the event I'm in a Hellicopter or ambulance, and they keep me on my portable vent, they can connect me to the 50 PSI O2 source and set precise Fraction O Inspired O2! It does Cough Assist Therapy, which I use often. It has it's own built in suction system, that delivers hospital quality suction which to this day is surprising, considering it isn't wall suction, and it has a Nebulizer function. I like this ventilator for several reasons, one of them being that I can see the Pressure, Flow, and Volume Waveforms, rather than just the Pressure and Flow waveforms like most home ventilators only allow! But my question is, I also use a Vest Airway Clearance System which used a modality known as High Frequency Chest Wall Oscillation to clear my lungs. In essence, it shakes my chest rapidly to help move secretions upwards so that they can be suctioned using my Ballard Closed Suction System, which gets changed daily. So I'm wanting to know from your experience both with vests, and the nice ICU beds that have Percussion & Vibration, what would you say does better with airway clearance? Would you say that's the Percussion & Vibration from the beds, such as the Hill-Rom Progressa beds, or Hill-Rom TotalCare SPORT beds, or would you say the vest does a better job at it? The only beds I've been in in ICU are the Stryker InTouch beds. These are beds that fitted with the XPRT mattress could do Percusion and Vibration, Lateral Rotation, Low Air Loss, Turn Assist, etc, but a lot of times, they're fitted with the air mattress that doesn't allow for P&V and only Does Lateral Rotation, Low Air Loss, Turn Assist, and a LOT of times, two or three days into my ICU stay the bed will not even let you do that, because It gives error notifications about the mattress not being connected. I can't count how many times that's happened. But the reason I ask this about the beds VS the Vest is because I'm just really curious as to what you nurses think about the Percussion & Vibration on the beds VS the HFCWO vests that us ventilated patients use at home! I use my vest Q2-3 hrs, and it really helps. Tank you for taking time to read this horibly long post! TAKE CARE, and God Bless!

Well, after contemplating what to do, I have decided to post in patient education. I AM A PATIENT. But I'm not a conventional patient. I've been in and out of hospitals all of my life. I posted my full story Friday about myself, and It got accepted yesterday morning. But to make a very long and dragged out story short, due to my life around the medical field, IN AND OUT OF THE HOSPITAL, on and off ventilators, (Now being on one 24/7), after the operations I've had, (I've lost count), I've always had the interest in the medical field! It's not just an interest. It's a life of studying, taking what online courses I could get my hands on, studying ACLS THOROUGHLY, and other more advanced studies like in ECMO, HFOV, The management of the patient in the Operating Room, who's on Cardiopulmonary Bypass, and many other courses. It's stuff I've STUDIED. And then Studied more! And then studied until I learned what I desired to learn, and then found something else to learn. This is my life. I didn't let my conditions stop me. I have given it my everything, and THAT is why I know what I know today. I may not work in the hospital, but I wish to study like I do to the best of my ability! That's one reason I joined allnurses. Through the Community, I can sure get some good info. But I don't know what to do. I'm not a nurse, and I have so many questions for nurses, and other healthcare professionals. But being that I'm not a nurse, I don't know how to go about posting the questions that I have. Yesterday, I posted some questions in "General Nursing," about the Clinitron bed. I have studied the field of specialty beds for years. I've been in ICU beds many times, such as the Hill-Rom TotalCare beds, and Especially the Stryker InTouch bed. As for the Stryker InTouch bed, I have quite the story behind that special bed. That story actually got an article written about me in Stryker's monthly newsletter in April of 2021. But that's a story in itself. But there are many questions I have about beds like the Clinitron Air Fluidized bed. I asked some of these questions in "General Nursing," but when people see that I'm not a nurse, yet I know about these beds and have the types of questions that I do, It's going to seem weird to a lot of people, and chances are, that post will not get any responses. Hill-Rom does not even deal with the Clinitron Beds anymore. They are a part of Baxter now. They didn't have the User's Manual to this bed, and the company that deals with these beds couldn't help me either. But there are things I want to know about beds like this. I know the basics, but I want to learn the technical aspects of it. Yet I don't know what I should do to get assistance to these questions without looking strange on allnurses. I MAY BE A PATIENT, but I don't think like a patient, because of my major interest in the medical field, what I've studied, and because of how I've grown up DESIRING TO LEARN THE MEDICAL FIELD, Technical aspects, Pharmacological aspects, etc. The training courses Hill-Rom had back in the earlier 200s have been removed, and these were free E-Learning courses where you practiced preparing the bed for the patient, and you went through a patient scenario doing things such as defluidization of the bed when it was necessary, adjusting the temperature, you were taught when to defluidize the bed in certain scenarios, and when you WOULD NOT defluidize the bed during those scenarios. You learned a little bit about the bed. And It wasn't just the Clinitron bed. The TotalCare beds, Progressa bed, and their other beds either had E-Learning courses, or you just watched an in depth video on the operation of the bed. But those courses are gone, and I don't remember much about the Clinitron bed's operation. I never was able to find a user's manual online for the clinitron bed, and in service videos on the Clinitron bed on YouTube? To put it shortly, (THEY DON'T EXIST)! You have a few videos of the At Home version, but no real discussion about the bed's operation. And It's certainly not the Clinitron Beds, or specialty beds in general. I have a lot of other questions on other topics, yet I don't know how to ask these questions on allnurses being that I'm not a nurse. I certainly didn't want to post this question in General Nursing, so I thought that I'd post it in the "Patient Education," specialty to see if anything comes of it. Hopefully I'll get a response, and maybe some answers to my questions. I'd be so grateful! Have a great day, and GOD BLESS!

So I posted a bit about myself yesterday explaining that I'm not actually a nurse, but due to my life long medical conditions, and being in hospitals so many times, I just know the medical field, and study it very thoroughly, I have joined allnurses! I love to learn, and one of my many aspects of the medical field I like to study, is specialty beds. I find those very interesting to learn about. I've studied the Clinitron bed as best as I could for years, but there was limited info that I could get my hands on. I've looked for the User's Manual online, and can't find it. I called Hill-Rom, but they now work with Baxter, and the training modules of the Clinitron bed don't exist anymore. I've never gotten the chance to ask a nurse questions about these beds before. But I've accumulated so many questions about these types of beds, that it's not even funny. I know it's not typical for a patient to be asking these types of a questions, but I'm a patient who thinks like a medical professional. I've studied the medical field THAT MUCH!!! So It's going to be weird as I post questions in the allnurses community, but I'll do it in a professional way as best as I possibly can. As for the Clinitron beds. I want to know more about these beds than I do. I understand that these are silicone coated ceramic beads. I know they are inside of an air mattress, and there's a blower that blows air thus blowing this sand/Beads, in a manner that essentially creates a fluid like material. This allows the patient to float essentially and helps reduce pressure on the skin to allow pressure ulcers to heal. There is a hospital version, and a home version of the Clinitron beds. The Clinitron bed also blows heated air through the beads! There are things I don't understand about the bed. Keep in mind, I am legally blind. I can see sme, but not that much. I know there are the silicone coated ceramic beads in the air mattress. But what I don't understand is isn't there also those beads in the bottom of the bed? Somebody said the Clinitron bed is shaped like a bathtub, but there are several versions of the Clinitron, being that they were developed in the 1960s by tHill-Rom. I've been in ICU beds, but I've never actually had to be in a Clinitron bed, for which I AM VERY THANKFUL, because I've never had a pressure ulcer that severe. I've come close, but thankfully never needed this type of air fluidized bed. I want to learn more about the Clinitron bed. Being that I can't find the manual, and It's been YEARS since I took the training module on the bed that Hill-Rom had, I'm trying to refresh my mind on what bit I was able to learn about the Clinitron beds. If someone could help describe what this bed looked like, It'd help me understand it better I think. I know the beds have now been replaced with new sand beds, like the Hill-Rom Envella bed. There's suppose to be a training module on this bed, but I can't locate it. So to those who read this, and can answer my questions, (THANK YOU!) Have a great day, and GOD BLESS!!

As for my interest in specialty beds, such as the Clinitron beds, and other special beds such as the RotoProne, RotoRest, and TriaDyne therapy systems. I find the workings of these beds very interesting. And there have been some good stories on this website about these devices, especially some funny stories about the Clinitron Air Fluidized beds. So THANK YOU! I know I am NOT a nurse, but I want to learn, and that is what I will do as a member of all nurses!

(The following post is very long, but what I have to say, is important, and even though I am not a nurse, I have grown up around the medical field, have studied it, will study it for as long as I live, and will teach others what I know. Hello! My name is Peter. I am 31 years old, I am a trach patient, who uses a ventilator, I have a G-Tube, I am legally blind, with very little vision, and have a variety of other medical conditions. This does not stop me from enjoying life, and making the most of it. Everyone should make the most of their life, no matter what situation they are in, whether they were born with multiple health conditions, whether they developed these conditions later on in life, or whether it's some other circumstance. I say this, because at least you are loving, and breathing. I may be breathing with the help of a ventilator, but I am just thankful to be alive. I've had many operations, to the point that I've honestly lost count of how many operations I've had. I've spent many many nights in the Intensive Care Unit, have been coded several times, but have survived to tell the story. I was adopted by a wonderful Mother, and Father who both worked in the medical field, as nurses, took care of children with special needs, and who have nothing but love, and care. My Dad passed away in the year of 2017, and I miss him a whole lot, but my Mom is still doing well. Due to my many hospitalizations, many operations, and many Dr.'s visits,, I've always since a very very young age had a massive interest in the medical field. I've always wanted to learn. When I was in the hospital, I always asked a whole lot of questions, because no matter how sick I was, I found a way to communicate, and I would learn whatever I could during that hospitalization. As I got older, and obtained medical textbooks, I would read these books through thoroughly to learn the conduct of procedures such as Line placement, all the way up to the management of a patient in the OR who is on Cardiopulmonary Bypass. I always kept up to date on the latest protocols, for example the ACLS algorithms. If there was an online course I could get my hands on, I always loved to take those courses. I loved to take E-Learning courses, that allowed me to study onlone material. I can remember this one website called SimCode ACLS, where there were simulated cases of Rhythms such as V-Fib, Pulseless V-Tach, V-Tach with pulse, Atrial Fibrillation, Atrial flutter, Asystole, and SVT, and you placed the monitors, oxygen, IV, if necessary initiated CPR, Defibrillated, paced, administered drugs, etc. You would get a grade on those cases afterwards. But I LOVED that website. They had some really good simulations. It was courses like that, that I would get access to, and that's how quite a bit of my knowledge has been given to me. The medical field has been my biggest hobby! Of course, when you live your life around medical equipment, that's something that could very likely happen. You develop an interest in this field, and then as the case with me, you want to teach others what you know, to further their knowledge. Many times, I've helped nurses, Drs., Respiratory Therapists, Anesthesiologists and other healthcare professionals learn about something. Many years ago, in the pediatric unit, I was helping a nurse who didn't understand the concept of High Frequency Oscillatory Ventilation. She didn't understand it, and I managed to get an RT to bring in an oscillator, I set it up, I showed her the machine's controls, explained concepts of the ventilator like how instead of adjusting PEEP, you adjusted Mean Airway Pressure. She didn't know how many breaths these types of ventilators delivered, and so I explained that in the case of High Frequency Oscillatory Ventilation, we calculated the tiny breaths in Hertz. Each Hertz is equal to 60 Breaths, or rather Oscillations Per Minute. For example, a Hertz of 8 is equal to 480 oscillations per minute. Right before I was being discharged, the nurse thanked me for helping her understand HFOV. There have been many times I've given in services like that. In the year of 2013, I traveled from Kentucky, to Tennessee to pay a visit to the Middle Tennessee School For Anesthesia. I took a tour of the school, got to perform a couple intubations on SimMan, and got to do some other skills that I'd always wanted to practice. The instructor allowed me to speak to the class a little bit about my massive interest in the medical field. Needless to say, Wednesday, July 24th, 2013, was one of the most memorable days in my life. My friend Heather, who was there to witness such a special day commented afterwards, and just said, "Peter? You just look so happy when you are teaching others about the medical field!" She was right! A few months later, I was hospitalized, and that's when I failed a Modified Barium Swallowing Evaluation, at which time I underwent placement of a Percutaneous Endoscopically Inserted Gastrostomy tube. I didn't let that hospitalization or how sick I was stop me from just being happy. Why? Because you can go through unpleasant situations with a negative attitude, or you can say, "This is not a good situation, but I'm going to go through it, and remember that someone else, always has it worse." I've always felt that way about life. Now, I'm 24/7 ventilator dependent, with a slew of other health conditions. But my life in the medical field, in and out of the hospital has given a perspective on life that I believe has made me the person that I am today. Throughout my life, they thought that I would die, but I haven't. Of course, when Mom brought me home from the hospital, she was told that I'd be a vegetable. I wasn't though! I was home bound a lot because of my health, but I went through grade school, learned to read braille, and the usual subjects, and in 2010, I graduated highschool with a highschool diploma, all the while gaining what medical knowledge I could, especially from Mom and Dad as being that they were nurses, they taught me what they know. I remember one night at the age of eight, asking Dad about the procedure for pumping a patient's stomach. I knew it wasn't done as often as it use to be in the day, but as someone who wanted to learn, I asked questions like that, and was told what they knew. Mom and Dad both explained to me the concept of Gastric Lavage, and, just like many other questions I would ask back then, I would remember what I learned, and when I was in the hospital, or when I got the chance to speak to a nurse or a physician, I discussed stuff like that with them. I'd ask about subjects such as defibrillation, intubation, what the protocol was for a code back then, and other topics, that I found of interest at such a young age. Through myyears of studying, I have found that subjects such as Critical Care Medicine, and Respiratory Care are my favorite. I also find an interest in burns, Anesthesiology, Neurology, Emergency medicine, Cardiothoracic Surgery, and many other specialties. Now, I would like to discuss a little bit about Why I joined allnurses? I understand that I am not a nurse, but I have a massive interest in some of the topics that are discussed here. There are some great stories that I've been able to read through this website, and I've learned quite a lot! You know, I understand it's not conventional to have many of the interests I do. But I believe that the interest in the medical field with which I've lived, all my life, has brought me a very long ways! Keeping up with stuff such as ACLS, General nursing care, Critical Care, Respiratory Care, and many other subjects has taught me stuff that I've been able to teach others! I may not be able to work in the medical field with all my health issues, but I believe that I can still learn what I desire to learn. I believe that I can still teach others what I know, and that's my goal! I've been a member of allnurses since the year of 2015, or maybe earlier. And I SUPPORT YOU ALL, in your work that you are doing for patients like me! I truly see people who will do anything that is necessary to help a patient! If I post on occasion to ask questions I have, as I would like to do, I do that to further my knowledge on a certain topic! That's what I have always wanted to do! It's what's gotten me where I am today. I want to say thank you to those, who read this entire post. I know it's long, but I had a lot to say that I wanted to say to healthcare professionals that I truly hope and pray will understand where I'm coming from with this. Have a great day, and God Bless!

Thank you so much. I have survived several things that it was said that I would not. I'm very very blessed

I would rather not discuss the story behind my illness but I will say that I'm a RRT! The reason I am asking this forum the questions that I have is because I just want to learn I've had massive experience with the medic field. Not only am I an RRT But I came here Because it seems like a nice place for several healthcare providers. I hope you would understand.

Yes that is all that matters. That we made it and are still alive at the end. Recovery is still in progress for me but I'm doing well and Air Mattress thankful that I made it to the end when it wasn't known if I would. Well now, we both can say, WE KNOW THAT WE BOTH BEAT THE ODDS! I take a minute every day to appreciate what good recovery feels like.

Ok, this is EXTREMELY UNCONVENTIONAL QUESTION! I know this is going to leave some nurses gasping thinking, 'Why on earth is he asking this? I know but on Allnurses I have gotten a huge amount of good laughs. The medical field is of such profound depth, and reading stories and learning soooooooooooooooooooooooooooo much is just a fraction of what you can do here. You can also laugh yourself into the position where your sides are hurting and you end up gasping for a breath. I mean, come on. A Clinitron bed mattress being punctured, sending those beads flying and lots of other things. What I am going to ask is you to tell me your strange specialty bed stories. I would like this thread to be pages and pages and Pages long. If you have had a strange bed story. Examples might be your experience with Clinitron beds gone wrong, TotalCare bed hoses coming disconnected during a Patient Percussion And Vibration treatment, or something really strange like that. This could involve the Critical care beds with the air mattress, the RotoProne bed, The RotoRest Bed, the Clinitron bed, The Triadyne bed, etc. I've often wondered what would be the result of a disconnection of One of the hoses of a TotalCare bed hoses during Continuous Lateral Rotation Therapy or Percussion And Vibration treatment Or if you have had a popping air mattress when you it the bed in Max Inflate Mode. I've heard a couple of strange stories on here already. Not to mention any names. I am going to list what I know so far. A rather painful story is a nurse accidentally has her foot under the Clinitron bed. I'm glad she was all right. I'm sure that HAD TO HURT! Next story is a Clinitron bed bed air mattress being punctured accidental sending beads floating ALL OVER, sending people sliding and not that this is funny, but rather interesting. Another rather strange story was a patient who had died on the Clinitron bed and after the bed had been turned off, it was turned back on so that the family could visit the Patient and the bed inflating in sections causing the Patient to sit up rather, when the family arrived. Another story including liquid stool making s strange sound and rather boiling from the Clinitron bed. I consider this rather interesting. Specialty beds are so interesting, and I'm sure can make numerous strange and at times funny stories to hear/Read. On another forum on another website, there is a post entitled 'Why RotoProne bed sucks,' or something like that a nurse is venting about the high tech RotoProne bed that malfunctioned whilst the Patient was in the PRONE POSITION, thus causing them to have to CUT THE Patient OUT PRONE. WOW, In thinking, these specialty beds are truly prone to strange and funny stories. A nurse falling into the Beads of a Clinitron bed could be funny if a Patient was not injured m. Thank you and all at Allnurses for your greatness.

I would like to thank you for sharing your story I know from experience how long hospital stays can be. They are NOT Pleasant. Especially the dreams and the hallucinations When it's around and on Christmas and you wake up realizing that one month and three days had passed, it is a real shock. When you realize that you were an inch away from death, that is gut tearing. I know. I really appreciate you telling me what your Brain could remember of the RotoProne bed.

Wow. That is interesting. Thank you for sharing that info on these defibrillators with me.

Hello. I know this is unconventional, however I have a question. Have any of you even gotten to experience what it is like to actually experience the KCI RotoProne bed for your yourself? I know this question is not your every day question, however, I would like to know what it felt like. Thank you so much. God Bless you all.

Hello all. I have an unconventional question. You know now days, at the most a defibrillator will charge is 360 J I am curious to know if any of you can recall using one that actually would charge up to 400 Joules. I know that the Lifepak six would charge up to 400 J, however Intramuscular wondering if you remember any others that did. Of course now days, you would not charge to 400 J because that is not in the ACLS Protocol. Thank you so much.

Hello. I have a question. For those working in Intensive Care Do you ever use BIS Monitoring when you have sedated and ventilated patients, and if so, I would like to know what you think from your experience both with and without Neuromuscular Blocking Agents. Thank you all so much. God Bless.

Hello. I have a question. Has anybody who works with cardiothoracic Patient care ever seen a Patient who is on CPB Being placed into Deep Hypothermia AND Circulatory arrest? I am not sure how many nurses have never heard of this but occasionally in the OR When they are working on a cardiac case they will actually not only place a Patient onto the full CPB Flow Cardiopulmonary Bypass, but they will also cool the Patient down whilst they are In ASYSTOLE AND After reaching profound hypothermia at around 11-19 degrees C, they can turn the CPB PUMP OFF! WHILE THE Heart is still in ASYSTOLE. Isn't that amazing? It is only for up to around 20-45 minutes however I find this amazing to know that a Patient can recover after an operation that involves this. When the Patient is cooled down to these hypothermic temperatures the EEG Is nearly silent. And then after it all, the Patient usually wakes up neurologically intact This all depends on fact that the metabolism is slowed Down so much that Oxygen consumption is decreased significantly. Have you ever gotten to observe this? This is why patients who are involved in accidental drowning in Extremely cold water have in some cases been resuscitated and rewarmed on CPB And have made a remarkable recovery. DHCA Is truly amazing.