Tag: ventilation

ASV (Adaptive Support Ventilation) with the Hamilton Ventilator

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:

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

 

 

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:

 

Non-invasive ventilation – basics

Presented below is Dr Terence Yuen’s presentation on the basics of non-invasive ventilation (NIV) which was deferred from March 16th 2016.

Non-Invasive-Ventilation-Western-ED-teaching-2016

 

Also consider this brief troubleshooting guide from Life in the Fast Lane:

 

NIV-guide-from-LITFL

 

Please also see these relevant Western Health policies:

Guideline for Non Invasive Ventilation (NIV) in the Cardiac Care Unit (CCU) – last review September 2012

fine print of note:

  • other contraindications listed in the policy include
    • upper airway obstruction from foreign body (intervention required clearly different)
    • chronic restrictive lung disease (consider pressures and alarms, also check for limitations of treatment)
    • unilateral lung disease (undefined in policy)
    • Raised intracranial pressure
    • Pre-existing hyperinflation (unsure if this means asthma and obstructive lung disease)
    • Compromised cardiac output related to hypovolaemia (NIV may still be a necessary intervention with other adjuncts eg. fluid / inotropes)
    • Patients who have had a Fontan Procedure performed (a paediatric cardiac procedure for congenital cyanotic disease)
    • Normal lungs (presumably a trigger to consider alternative diagnosis other than APO)

Admission and Discharge to the Intermediate Respiratory Care Unit (IRCU) – last review May 2010

fine print of note:

  • re: NIV, other than patients with COPD and type 2 respiratory failure, IRCU will also admit (if indicated) patients with
    • obstructive sleep apnoea
    • non-respiratory conditions eg. neurological or neuromuscular; consider first however if these patients will require HDU
  • IRCU also accepts patients with non-NIV related issues such as:
    • acute asthma on low-dose adrenaline infusions
    • tracheostomy management
  • IRCU does not accept patients who require invasive monitoring