As a Psychiatrist 11 years out of Med school, I truly appreciate these lectures. If they need me beyond a mental health professional role then I want to be competent, even if I am relieving shifts. Truly dire times. I do feel like a soldier of sorts. God knows there will be a lot of PTSD on the healthcare worker side after this pandemic is over. Stay safe, your life is worth saving as well.
I am a respiratory student. Your videos are awesome. I have my midterm on intro to mechanical vent tomorrow. Please know that these videos you made have helped me and several of my classmates out. Thank you.
great videos, I'd love to see noninvasive ventilation videos and hemodynamic principles like SVR and PVR added to your list. Thanks for the great stuff :)
nice lecture....im an engineer and i get to learn the medical part of this ventilator. i sure hope i dont get to use one, nor any of my love ones, but it sure is helpful to learn how a ventilator works. thank you for these videos
Good overview, trigger is misrepresented. If on a PEEP of 5 you showed a pressure drop below zero to about -2 cwp. In actuality the pressure should only deflect -0.5 - 2.0, if using pressure triggering, below the baseline of 5 cwp in this example. What you demonstrated was a trigger set at -7 which would be an incorrect setting. And flow trigger would show no pressure deflection.
am a medicine resident in india ,but it was a rocket science for me before i saw this video now i feel confident about ventilator.thank you very much sir for simplifying this complicated machine.
THANK YOU! this is excellent lecture! I am RN in ICU for few years this is still a cloud for me :) after your video-lecture I started to understand better. What changes on vent will help to decrease PaCO2? vent: AC, FiO2 65%, PEEP 10, RR 10, Vt 450. Working on study case is helping but still not clear. Thank you
I am a retired RRT, and I worked 35 years in hospitals and home care. i am enjoying your lectures, brings back memories. Very important refresher for clinicians thank you
Your lectures are super helpful and allow for convoluted subjects to be understood in plain English all the while maintaining a generous amount of depth. Thank you.
See the whole series at www.medcram.com along with other top quality videos including reviews in pulmonary, cardiology, infectious disease, and hematology!
at 9:13 - you mention the set TV is given once the negative pressure is identified. This subsequently increases pressure. However, I thought based on PV=nRT; the two are inversely proportional so the increase in volume will lead to a decrease in pressure, provided the gas is constant. Can you please clarify this?
i just want to say THAN YOU SO MUCH FOR WHAT YOU DO. It is so helpful to get visual because just the books aren't going to do it, at least not for me. You do such an amazing job teaching, I review and get a much better understanding on these videos so THANK YOU SO MUCH FOR WHAT YOU DO!!
how many thanks !!! a million!! not enough.. im a resident finished my ICU rotation in surgery.. its disgusting how no one cared to stop a minute and give us the valuable knowledge u have.. I guess he who lacks something.. can't give it away!! thanks again
i just started my icu rotation-im a pgy 1 at howard in DC internal medicine..i freaked out my first day in ICU..but i must say im feeling more comfortable after watching this..thanx bunch
@@randyrick8019 I wonder what kind of modifications are needed. I mean I guess the program could be hacked into intervals. And some modifications in the intake of O². Resmed could make a program to change this. There must be tons of CPAP in people's homes gathering dust.
Dear Dr. Roger, I'm from Vietnam I'm grateful for your videos. I watched your video when I was in Med school, although the language barriers I completed my MBBS, and keep subscribing to your channel for further study. Thank you for contributing modern medicine to this corner of the world, I have learned a lot from your lectures which are clear explanations and well ordered. I wish you all the best.
Thank you SO MUCH! Im in the respiratory therapist program and we are having to do everything online because of the pandemic and I was struggling so bad with mechanical vent and this helped me so much! Thank you!!
What happens to "exhaled" air? Exhaled breath is not usually a hazard, however, in Covid-19 patients the virus is in their breath. If the air is just being dumped into the room then this increases the hazard to the healthcare workers. Can we install a UVGI chamber to sterilize the breath leaving the patient? A physical filter would impact the pressure and be a problem, but a chamber of UVC light would would safely sterilize the air.
Loving these videos. Can you guys do more videos with anesthesia management? This ventilation material is very much related to that. Anesthesia Perioperative Management will help the CRNAs, AAs & MDs/DOs! Thanks!
NEW-4 patients on the same respirator !!! -The solution is called Ventsplitter and is an open-source code solution for 3D printing. The idea that several patients could potentially share respirators Microsoft News.
this is not easy to explain or understand, but I am a nursing student, 4th semester and already am doing my clinical rotations with vent patients, so as difficult as it is to GET the ventilation system, I still have to learn it. It is nearly impossible for me to get it the first time when the professors teach it, so I appreciate very much how this is explained in English and the visual animation. This is so much better than listening to someone read off a power point. I still don't quite get it, but I will watch this entire lecture multiple times over the next few months. Thank you very much for putting in the time to make this visual lecture.
When should we start the patient on Volume controlled or Pressure Controlled types of Mech Vent? Like in Pediatric patients can we use Volume or Pressure controlled?
Around minute 10 (the diagrams) you explain how the PEEP in a patient remains at 5 due to the setting, but the volume of a patient returns to zero. Wouldn't the patient still have some volume since there needs to be air in the lungs keeping the PEEP at 5? I'm just trying to understand. Thanks!
Jason thanks for the question. The volume in the lung refers to the extra amount of air in the lung above the FRC. A paralyzed patient on a vent when there is exhalation goes to the FRC. This is set at zero by definition. The lung still has air in it regardless of the PEEP. What we are measuring when we measure volume is the volume of air given by the ventilator into the lung not the volume of air in the lung.
I love the bite sized length of your lectures, it makes them easily accessible and the clear explanations that you demonstrate on each subject are great and easy to understand. Keep up the fantastic work. Thank you
very helpful lecture. i would like to know more about neonatal and pediatric mechanical ventilation , setting and the different from adult , also how to use HFOV. THANK YOU
I am a 54 year old male in moderately good health now working from home. I use a CPAP machine as was wondering should I come down with symptoms, what are the ramifications of my CPAP usage? If symptomatic, should I continue to use or would it exacerbate the course of the illness. BTW, I get very little quality sleep if not on my CPAP machine.
An Ontario🇨🇦Canada🇨🇦 Doc has figured out a way to DOUBLE ventilator capacity! There’s a catch......the patients need to be of similar size and lung capacity. It’s still fantastic and if one vent can help two people, less horribly difficult decisions will have to be made by Docs like what has/is taking place in Italy......who gets a ventilator? Small miracle but still a miracle and heck yeah, any miracle right now is welcome! Way to go Dr. Gauthier!!!
I am a tad confused. You state that Pressure Support is "kind of like AC except that instead of delivering a specific volume it delivers a specific pressure". How then does this differ from Pressure Control CMV. PC-CMV also provides a pre-specified pressure on patient initiated or time-controlled (back up rate) breaths. Is the only difference between PS and PC that the patient has to initiate ALL breaths in PS? Thank you for the videos and help!
Dr. What vent modes would you expect to be most productive for COVID-19 patients? I am a retired engineer wondering about how fast track vent devices might be created for this Pandemic.
Wow! Reminds me of Mr. Mandrelle, my high school biology teacher, who always made me see myself in a white coat but limited dalliance with calculus would time and again sneak in and point the other direction..:))
Hello MedCram, Very cool videos! I am very happy about these; precise and extensive but kept short. I have a question though. In your opinion, what is the best ventilation mode for critical Covid-19 cases?
I wonder if one ventilator has the capacity to ventilate two patients. I understand that there are Pressure Volume parameters that relate to each patient, but in a pandemic situation with a massive shortage of ventilators, I wonder if you could skip the P/V feedback, put sort of a splitter on the tubes and find a mid-range setting that would statistically work most of the time to treat two patients that have similar ventilation needs.
If this is answered in a later video of the 5 part series, I'll delete it, butttt when the pressures increase due to a lower compliance, what is your next step of action in adjusting the vent settings? Would you get some ABG's to determine your next move? Thank you and thx for the vid! Well made!
I work as a safety assistant and these lectures are awesome for me to know just to be informed and to be able to inform staff of problems. Thank you for providing such valuable knowledge! You have earned my subscription.
