# Ventilator w/CPAP



## AlphaButch (Jun 27, 2011)

I'm searching for a CPAP/Ventilator unit that is easy to teach and easy to learn. My med director has agreed that given a 3 day class on this, and a patho-test and skills checkoff - it can be authorized for use by an EMT-B.

I personally like the omnivent - used in the service and was almost indestructible -  and the autovent 4000 - alot of control -, but I know alot of folks around here are intimidated by them.

So, given your experiences with vent units, what CPAP/Vent units would you recommend I look into for my service? I'm looking for a combined, portable unit (so fewer machines on the truck) that doesn't look like a NASA control panel.


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## medicdan (Jun 27, 2011)

Are your basics authorized to use the vent? Why invest in a vent for bls trucks if all they're going to use is the CPAP?

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## AlphaButch (Jun 27, 2011)

I need to buy a vent anyway, as I don't have one yet and will be running as BLS with MICU capability. Having a combined unit will give me one less piece of gear to maintain/service.


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## usafmedic45 (Jun 27, 2011)

> I need to buy a vent anyway, as I don't have one yet and will be running as BLS with MICU capability. Having a combined unit will give me one less piece of gear to maintain/service.



How the heck do you have a BLS/MICU?  Isn't that kind of mutually exclusive?  If you're just planning on having a nurse sent from the hospital for transfers, make them handle the purchase and training related to the vent because most nurses don't know their butt from a hole in the ground when it comes to vents and the last thing you want to expose yourself to is the liability associated with someone who isn't up to speed handling a piece of gear you provided for them to use. 

Also keep in mind that the cost of maintaining and purchasing any transport vent worth bothering with is going to severely cut into the money you are looking to save with a combined unit.  Stay away from the Parapac 'ventilators' and the other ones marketed solely to EMS.  The better transport vents on the US market are the Univent 754 Eagle and the various LTVs.  However, I strongly caution against having anyone but trained ALS personnel messing around with this sort of thing.



> that doesn't look like a NASA control panel.



So basically you're not wanting a ventilator then?  It sounds like your looking for a mechanized BVM.


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## TransportJockey (Jun 27, 2011)

BLS w/ MICU capability is the TX DSHS EMS term for a truck that is fully equipped as an ALS truck, but can be staffed by as little as two EMT-Bs.


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## usafmedic45 (Jun 27, 2011)

TransportJockey said:


> BLS w/ MICU capability is the TX DSHS EMS term for a truck that is fully equipped as an ALS truck, but can be staffed by as little as two EMT-Bs.



Ah....as I said before, if you're not going to have people on board full-time with the requisite education and experience (read as: respiratory therapist or a veteran nurse or medic with a lot of device specific training and experience), then that's a potentially lucrative payday for a malpractice attorney.


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## Aidey (Jun 27, 2011)

usafmedic45 said:


> So basically you're not wanting a ventilator then?  It sounds like your looking for a mechanized BVM.



I would say the autovent 3000 doesn't look like a NASA control panel. It has 3 dials.


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## usafmedic45 (Jun 27, 2011)

> I would say the autovent 3000 doesn't look like a NASA control panel. It has 3 dials.



Yeah, that's exactly what I was talking about when I mentioned staying away from devices designed specifically to be EMS-grade idiot proof.  That's a fully featured and useful 'ventilator' about as much as I as a 125-hour pilot lucked out and was selected to be the commander of the last space shuttle mission.  In other words: it's not.  



> and the autovent 4000 - alot of control



With any of the Autovents, you have about as much control as you do with a cab driver who barely speaks English: you decide when to start and stop but beyond that, all the screaming and cursing in the world isn't going to get it to do much beyond the basics.


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## usalsfyre (Jun 27, 2011)

The Autovents are like an automated BVM, with the bonus feature of being completely unable to judge compliance (not that a BVM is great for that anyway).


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## usafmedic45 (Jun 27, 2011)

> with the bonus feature of being completely unable to judge compliance (not that a BVM is great for that anyway).



Remember, it's not the tool that's not great for it.  It's the tool using the tool that leaves much to be desired.


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## ArcticKat (Jun 27, 2011)

usalsfyre said:


> The Autovents are like an automated BVM, with the bonus feature of being completely unable to judge compliance (not that a BVM is great for that anyway).



The Carevent ALS+ can, if you monitor the ventilatory pressure on the guage.

I like it, it's easy to use and can be made portable quite easily.

http://www.otwo.com/pdf/Product Manuals/CAREvent ALS Manual Rev K Sept 08a.pdf


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## medicdan (Jun 27, 2011)

If you're going to properly train your medics (or take RTs along), I highly reccomend the Newport HT50 vent-- its small, but packs a broad range of features (pressure support, CPAP, BiPAP, etc. Sorry, it does have a lot of buttons, but that shouldn't be a problem if you train your medics well... 
If you're looking for a standalone CPAP for basics, I suggest the boussiac (sp?)... 

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## usafmedic45 (Jun 27, 2011)

> If you're looking for a standalone CPAP for basics, I suggest the boussiac (sp?)...



....or just find a Downs flow generator.


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## AlphaButch (Jun 27, 2011)

Thanks, I'll look into the carevent. The newport looks good, I'll have to find a service or supplier nearby so my medics can look at it in person.

I'm looking for the vent for when the medics are onboard (and I'm not worried about education in regards to my cct guys), and a cpap for the basics to use (which I would like to be simple or have a lockout feature). I was just hoping there would be one machine available to fit that need vs. having to buy and maintain two seperate machines. 

This just wasn't my area of expertise and I wanted to ask around.


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## exodus (Jun 28, 2011)

I'm privvy to the LTV 1200: http://www.viasyshealthcare.com/prod_serv/prodDetail.aspx?config=ps_prodDtl&prodID=54

It does vent stuff, as well as AC / SIMV as well as CPAP/BiPAP. Very rugged, and they sell a metal exoskeleton that latches to the back of gurneys.... Very easy to learn as well..


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## NomadicMedic (Jun 28, 2011)

exodus said:


> I'm privvy to the LTV 1200: http://www.viasyshealthcare.com/prod_serv/prodDetail.aspx?config=ps_prodDtl&prodID=54
> 
> It does vent stuff, as well as AC / SIMV as well as CPAP/BiPAP. Very rugged, and they sell a metal exoskeleton that latches to the back of gurneys.... Very easy to learn as well..



+1 on the LTV. It's what we use. Easy to learn and flexible enough that the RTs like it. As a matter if fact, our medical director "suggested" that the LTV should be the vent we buy. 

Of course, it's still just a transport vent... And takes education before you just start mashin' buttons.


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## usafmedic45 (Jun 28, 2011)

> and a cpap for the basics to use (which I would like to be simple or have a lockout feature).



Then get yourself a Downs flow generator.  It's about as simple as you can get and the maintenance on one is significantly less than anything you will see with a ventilator or electronic CPAP unit.


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## exodus (Jun 28, 2011)

Our service has about 12-15 of the LTV's for the CCT units. Rarely is one out of service as well.  But we also stick to a strict maintenance schedule and each unit is tested before shift.


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## medicsb (Jun 29, 2011)

I'd probably just buy disposable CPAP for the EMTs and nice vent for the people that know how to use it.  All an EMT should have to do is turn the device on and then place it on the patient.  How many patients in a year are EMTs CPAPing anyways?


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