Ventilator Management for Critical Care Transport

Course Outline

• Indications and Ramifications of Mechanical Ventilation

  • Positive pressure ventilation versus spontaneous respiration

  • Respiratory failure defined

  • Chest X-ray study: common causes of respiratory failure

  • V/Q mismatches

  • Physiological consequences of mechanical ventilation

• Arterial Blood Gasses

  • Normal and abnormal ABG values

  • ABG interpretation

  • Case studies

• Ventilator Overview

  • Types of ventilators

• Ventilator Modes

  • Volume versus pressure controlled ventilation

  • Modes

    • Assist/control

    • Synchronized intermittent mandatory ventilation

    • Pressure support

    • Non-invasive positive pressure ventilation

• Ventilator Settings

  • Frequency

  • Tidal volume

  • Inspiratory flow rate

  • FIO2

  • Positive end-expiratory pressure

  • Pressure control

  • Pressure support

  • Sensitivity

• Circuit Setup

  • Circuit legs

  • Ballard

  • ETCO2

  • Filter

  • Humidifier

  • Nebulizer

  • Trach balloon

  • Oxygen supply

• Airway Pressure Waveform

  • Peak pressure versus plateau pressure

    • Normal values

  • Resistive pressure

  • Elastic pressure

  • PEEP

  • Phases of ventilation

  • Lung compliance issues

• Alarms and Troubleshooting

  • High pressure

  • Low pressure

  • Low minute volume

  • Troubleshooting

• Ventilator Management Strategies

  • Lung injury Strategy

  • Obstructive strategy

  • Hold maneuvers

    • Inspiratory hold

    • Expiratory hold

• Phramacology

  • Sedation

    • Benzodiazepines

    • Propofol

  • Analgesia

    • Fentanyl

  • Paralytics

    • Depolarizing versus nondepolarizing

      • Succinylcholine

      • Rocuronium

      • Vecuronium

• End Tidal CO2 for Mechanical Ventilation

  • Data on the use of ETCO2 for transport

  • ETCO2 versus PaCO2

  • ETCO2 cases

  • ETCO2 in resuscitation

• Ventilator Use in Resuscitation

  • AHA guidelines

  • Settings

• Scenarios

  • Simulated patient encounters

References and resources:

• SpecMed: Ventilator Management
• ARDSnet Low Tidal Volume Study
• ARDSnet Protocol Card
• Mechanical Ventilation Cases
• Positive Pressure Ventilation: What is the Real Cost?
• Medscape: Mechanical Ventilation
• EMCrit: Dominating the Vent Part 1 andPart 2
• Resistance and Compliance
• Critical Care Medicine Tutorials: Mechanical Ventilation
• Ventilator Management: So You Think You Know How?
• Treatment of Respiratory Failure in COPD
• Carefusion Capnography Handbook
• Own the Oxylog 3000
• LTV 1200 Operator’s Manual
• Anesthesiology: Capnography Outside the Operating Rooms
• Pulse oximetry and capnography in intensive care transportation
• Manual of Emergency Airway Management
• ASTNA Patient Transport
• Aeromedical Certifications Exam Prep Course