Tag: guidelines

Hamilton Ventilator Education

Here are some videos I produced for Adult Retrieval Victoria, using the Hamilton T1 Ventilator, but all are applicable to our Hamilton C1.

Please do not distribute, as these videos are AV property.

 

To begin please watch the videos linked below produced by Hamilton to familiarize yourself with the Hamilton T1:

Device Overview

Setup and Preop Checks

User Interface

Basic ventilator settings

Alarm Management

 

Then watch the following videos, together with the Initial Setup & Troubleshooting Guides below:

Initial ventilator settings, Western, Draft, Feb 2020
 Ventilator problems algorithm, Hamilton, Version 5, May 2018

 

 

 

Initial Setup:

Troubleshooting:

Idiosyncracies of the Hamilton:

 

Hyponatraemia

An in-depth look at the management of hyponatraemia, with special attention to a new concept called the “dDAVP clamp.”

Summary:

– only treat hyponatraemia if symptoms are severe – coma, seizures or severe delirium
– use 3% saline 100ml, up to three doses
– consider giving dDAVP to prevent a rapid climb in the serum sodium
– aim to correct the serum sodium by only 3-6mmol/L in the first 24 hours

For more information, have a look at Scott Weingart’s EMCrit Wee, and Josh Farkas’s blog post.

Thanks,
Stacy

New ANZCOR resus guidelines

ANZCOR have updated their guidelines.

The main changes – as summarised by Dr Stacy Turner:

ALS
Defibrillation – can increase 2nd shock energy to maximum available on defib, if first shock unsuccessful.
Cooling anywhere between 32-36 degrees.
Post-ROSC PCI – immediate in STEMI, new LBBBB and selected patients if coronary ischaemia is considered the likely cause on clinical grounds (although Level of Evidence III – poor)

BLS
Chest compressions now 100-120/min instead of 100

Neonatal
For term babies, start with air, not oxygen; for pre-term babies start at 21-30% O2, then titrate O2 to sats (minimum at 1min 60%, 2min 65%, 3min 70%, 4min 75%, 5min 80%, 10min 85%)

Paediatric
Chest compressions now 100-120/min instead of 100
Cooling anywhere between 32-36 degrees post ROSC

First Aid
C-spine collars for suspected spinal injuries by any first aid provider in the pre-hospital environment no longer recommended