Transport Vents

[scubanurse]

I'll have to look next time at work what we use when we send our vent patients out. In house we use Respironics, but we use something different if they go to a doctors appt or out on pass.

[croaker260]

We also use the CAREVENT ATV+CPAP at my service, and at my PT gig. At my main service we use a different CPAP, but otherwise both are very pleased with them.

Ive used them on a variety of adult and large ped patients. I have not used them on the very small.

[ERDoc]

We are having issues with one of our transport companies and they use the Autovents and don't seem to understand why we don't want our pts on them.

[Just Plain Ruff]

Honestly, my experience in the past with the Autovents was strictly for patients in full arrest where the autovent allowed us to ventillate and have two hands free.

But we never used the autovents on patient transfers, too few parameters to set for patients that need them. To me the autovent is a one size fits all (which when it comes to airway maintenance is never a good thing)

For our transports we always used the portable ventillator that our respiratory therapy department used.

[systemet]

Have used the carevent atv+ a handful of times. As I recall there's no way to manipulate i-time independent of rate / minute volume. Your pt. has their physiology and you get what you get.

You can sort of get a plateau by doing a manual ventilatiin and covering the exhalation port, but I dont know how accurate or valid this really is.

Not sure how good it would be on someone with a high minute volume or inspiratory flow, but I'm no expert.

[mikeymedic1984]

You need to be very cautious about placing ventilators on a pedestal. Once you start talking about sufficiently complex ventilators, subtle differences can have significant consequences. For example, would you choose the ivent over a LTV 1200 if you had to manage a 7kg patient?

No, I wouldnt as the lowest setting on the IVENT is for 10kg, but you have to ask how many infant/ventilator patients did you transport last year ? If you had a significant amount, then consider it, but I am guessing most of us did not have any. In my area, the childrens hospitals and the major trauma center have pediatric and neonatal transport (not to mention helicopter ambulance service), so they handle these transports --- maybe i am lucky.

[Just Plain Ruff]

No, I wouldnt as the lowest setting on the IVENT is for 10kg, but you have to ask how many infant/ventilator patients did you transport last year ? If you had a significant amount, then consider it, but I am guessing most of us did not have any. In my area, the childrens hospitals and the major trauma center have pediatric and neonatal transport (not to mention helicopter ambulance service), so they handle these transports --- maybe i am lucky.

No you aren't lucky, my area has the same type of system and we bless the EMS gods that they are available to us.

Edited March 20, 2014 by Ruffmeister Paramedic

[rock_shoes]

No, I wouldnt as the lowest setting on the IVENT is for 10kg, but you have to ask how many infant/ventilator patients did you transport last year ? If you had a significant amount, then consider it, but I am guessing most of us did not have any. In my area, the childrens hospitals and the major trauma center have pediatric and neonatal transport (not to mention helicopter ambulance service), so they handle these transports --- maybe i am lucky.

Could you not just trick the vent if this is a rare occurrence for your service? As in drop the volume input per kilogram to make up for having to input the patient weight as 3kg greater than it actually is.

Just for easy numbers let's say you have a 7 kg patient you want to ventilate with 10mL/kg. You're looking for 70mL per ventilation.

If you have to input the patient weight as 10kg set the volume to 7mL/kg. That should force the machine to still do the desired 70mL per ventilation.

[chbare]

Until something happened and you are crucified for using a machine that was never intended to be used for these patients.

[rock_shoes]

Until something happened and you are crucified for using a machine that was never intended to be used for these patients.

I certainly wouldn't call it best practice, but if a patient is drain circling and they require care not available at the sending facility (or it's a scene response) get that patient out. It's a matter of evaluating what the higher degree of liability is. Is it using a piece of equipment outside of the manufacturers suggested parameters or is it allowing a patient to die when you could have at least made an attempt? I strongly suspect the answer to that question is region specific.