"Ambulance, our defecit is now $12 million pa. What is the exact address of your emergency?"
PEEP valve on BVM's
- Thread starter Jeremy89
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"Ambulance, our defecit is now $12 million pa. What is the exact address of your emergency?"
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Exactly. Give the bean counter a choice between a transport vent that does well controlled PEEP, and a little cheap valve you put on a BVM... that you're only going to use once for say 20 minutes... and you'd be reimbursed the same amount for using either device... the cheap little valve wins. Specialty Transport? The nod goes to the transport vent...
Actually it is not always the bean counters but the EMS providers themselves. If the vent looks "real easy" with cooler knobs then that is their choice rather than a more sophisticated one. Most won't know the difference between the different valving types or the internal turbine and how flow is delivered to meet demand or not.
And, how many know the parts of their BVM and what makes a good bag except for how it looks or maybe squeezes?
Aidey
Community Leader Emeritus
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That is assuming you are in a system where the line employees get any say at all about what gets ordered. I know that we have no say in what brand or style or color of item get ordered where I work. We've replaced out glucometers twice in the last 6 months, and we've had no say, its all been upper management.
And it's not about features or anything, there was no difference in features between glucometers 2 and 3. It just happened that company 3 offered us a better deal than what we had with company 2.
And it's not about features or anything, there was no difference in features between glucometers 2 and 3. It just happened that company 3 offered us a better deal than what we had with company 2.
redcrossemt
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We have the little PEEP valves for trucks that go out with AutoVent 3000s. Dumbest things in the world. I can't even believe they suggest we use that vent for any sort of transport gig.
As mentioned previously in this thread, a little extra PEEP might make their respiratory problem worse, depending on what their problem is.
Are you using that thing for CCT?
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Jeremy89
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redcrossemt
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We have LTV1100s and 1200s for CCT.
However, they do ask crews with the autovent to do routine ventilator transfers when a CCT truck is not available. It's ridiculous.
I've had patients tell their horror stories of being transported to and from the subacute with these ventilators. Unfortunately, some just the match numbers for the basic setting of the ICU or Subacute ventilator and don't notice the other options or even the mode variations between the ventilators.
We've also had a couple of CCTs using the LTV that did not know there were additional settings on that ventilator besides the obvious on the face. They thought the "internal stuff" was a "default" of some type. They had no clue about the rise%, NIV mode or even the apnea, low pressure detection by mode and PEEP alarms.
redcrossemt
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I've seen many patients made very uncomfortable, anxious, and even sick by "stupid" ventilators. They are *okay* for CPR and for a *few* paralyzed or extremely sedated patients when monitored very closely, depending on the patient's problems and needs.
Whoa, extended feature menu?? Who needs that anyway? Apnea alarm? Rise time? Patient comfort? ...but it's only a 20 minute drive!
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Vent,
The CCT RN vent is a LTV1200, the ALS vent is a LTV1000. We were taught to adjust PEEP on the LTV1000 using the external valve, but to measure it using the vent itself. I can read PEEP on the display and see what it's really set at... for example, the dial may say 10, but it's only giving 7-8 of PEEP.
And before we got the vents, we had 2 classes... a respiratory/vent A&P review and discussion on vent settings, etc by our Doc, and a lecture and practical on the LTV's from a few folks on local SCT teams for pedi and adult.
Oh - FYI - I've got a LTV AND an Autovent on my truck. The Autovent is for one thing - CPR. That's it.
Did they tell you about compressible volume and how the vents with external PEEP measure PIP from a zero baseline while other measure from PEEP? Did they tell you how moisture affects the external valve? Do you notice fluctuations in VT or PIP? Did you check if leak leak compensation is switched on? Did you check if the NIV mode is on? Is the patient spontaneously breathing? Is there adequate flow in the system to meet patient demand? Is there a noticeable negative deflection on inspiration?
As it should be.
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Jon and redcrossemt,
Here is a great webcast that is now available free of charge for your viewing. Since the LTV 1200 is the national stockpile vent, this broadcast was done to provide additional access to information. For those who are interested in disaster management, it shows how warehouses are setup and supplies dispatched to various locations.
The ventilator application portion explains PEEP, the turbine, battery life, gas consumption, expanded menu, temperature, FiO2 fluctuations and altitude.
http://www.aarc.org/education/webcast_central/archives/2009/09_22_2009_ltv_1200.asp
http://www.aarc.org/education/webcast_central/viewer_n.asp?id=0086
The Q&A section also has some good information.
Here is a great webcast that is now available free of charge for your viewing. Since the LTV 1200 is the national stockpile vent, this broadcast was done to provide additional access to information. For those who are interested in disaster management, it shows how warehouses are setup and supplies dispatched to various locations.
The ventilator application portion explains PEEP, the turbine, battery life, gas consumption, expanded menu, temperature, FiO2 fluctuations and altitude.
http://www.aarc.org/education/webcast_central/archives/2009/09_22_2009_ltv_1200.asp
http://www.aarc.org/education/webcast_central/viewer_n.asp?id=0086
The Q&A section also has some good information.