Here is a video I produced for Adult Retrieval Victoria on Hamilton’s proprietary intelligent ventilation mode, ASV, using the Hamilton T1 Ventilator, but it’s applicable to our Hamilton C1.
Please do not distribute, as these videos are AV property.
ASV takes into account the patient’s respiratory mechanics, which are measured breath-by-breath by the proximal flow sensor. ASV ensures optimal ventilation for each patient during passive ventilation but also has automatic adjustment in spontaneously breathing and weaning patients.
In passive patients, ASV is a volume-targeted pressure controlled mode with automatic adjustment of inspiratory pressure, respiratory rate, and inspiratory/expiratory time ratio. Maximum tidal volume is controlled by setting a maximum inspiratory pressure. Expiratory time is determined according to the expiratory time constant in order to prevent dynamic hyperinflation.
Watch the following video, together with the Initial Setup (Page 2) & Troubleshooting Guides below:
remember the trigger – GIVE – GCS <5; Intubated, Ventilated, End of life care
Acute intracerebral catastrophe (eg bleed) is the most likely ED scenario wherein donation may be considered
patient’s wishes regarding donation can be unknown to their family and must be broached sensitively
discussions regarding donation may be appropriately deferred to the ICU team or the on-call Donation co-ordinator (phone number found via ICU or switchboard) to maintain separation between ED care-givers and the Donation team
Brain death testing is usually deferred to ICU
Donation after circulatory death is an extremely unlikely ED outcome
observe the fewer absolute contraindications to donation eg. active malignancy, HIV, age > 80
An in-depth look at the management of hyponatraemia, with special attention to a new concept called the “dDAVP clamp.”
– 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