EHC ED Critical Care

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How to Set-up the Vent

This will show you how to physically set up the vent for intubations and non-invasive positive pressure ventilation. This is not a tutorial on ventilation management.  Click Here for Vent Management
	How do I set up this ungodly machine?
	You need 2 new filters and 1 blue tubing. They are in boxes between bed 3 and 4 in the Cardiac Room. These MUST be replaced for EVERY patient.
	See picture.
	Close caps A. Make sure the blue cap (B) is still connected. Any vent set-up WITHOUT a blue cap should be thrown out. Do NOT pre-emptively attach the inline-suction, end-tidal CO2 or humidor. Now the vent is ready.
	The on/off button on the back.
	When you turn it on, you'll see this. Click "new patient" if this is a new patient. If you are resuming a previous vent set-up for a patient (i.e. they were just brought back from CT scan), just hit "resume current".
Continue for setting up non-invasive positive pressure ventilation. Jump below to set up for invasive ventilation.
	NIPPV Masks are stored here.
	You can (and should) continue giving nebs while on NIPPV. You need to find the 22 mm connector that came with the vent tubing. You are allowed to steal one of the connectors from a new set of tubing if you have lost it.
	Find the inspiratory (to patient side) limb of the vent tubing
	Cut the tubing on the "to the patient" side (inspiratory limb) at a point 14" from the Y.
	Place the 22mm connector into one side of the cut tubing, it does not matter which side.
	Place the nebulizer in the other side and put it all together
	Attach the neb's O2 tubing to the vent, not the wall.
	Press the nebulizer button to start the nebs
	On the screen, press the top left corner. (It usually shows Volume A/C from the previous intubated patient settings.)
	Press NPPV CPAP PSV. Press Mode Accept.
	This is a biphasic setting. The PEEP is continuous pressure throughout respirations. The NPPV PSV is additional pressure during inspiration. The inspiratory pressure = PEEP + NPPV PSV. Examples For CPAP of 5 - Set NPPV PSV to 0. Set PEEP to 5. For BiPAP of 10/5 - Set NPPV PSV to 5 and PEEP to 5. For BiPAP of 15/5 - Set NPPV PSV to 10 and PEEP to 5. MAKE SURE THERE IS MINIMAL/NO LEAK FROM MASK. OTHERWISE IT'S LESS EFFECTIVE. TIGHTEN AS NEEDED.
For setting up invasive ventilation:
	On the screen, make sure in the top left corner, it says Volume A/C. (If not, press that button to change to this mode)
	Adjust Respiratory Rate, Tidal Volume and Peak Flow as needed. Click Here for Vent Management
	Adjust PEEP and FiO2 as needed. Click Here for Vent Management
YOU MUST CALL RESPIRATORY FOR ALL PATIENTS ON VENTILATOR. THEY HAVE TO BE NOTIFIED OR WE GET IN TROUBLE. THEY ALSO SET THE ALARM LIMITS.