We think you have liked this presentation. If you wish to download it, please recommend it to your friends in any social system. Share buttons are a little bit lower. Thank you!
Presentation is loading. Please wait.
Published byNathaniel McCullough
Modified over 3 years ago
Medical Training - Monitoring - For internal use only
2 Objective of Presentation This presentation on Monitoring gives the reader an overview of current systems which can be used to monitor mechanical ventilation. It covers medical fundamentals and recognition of life- threatening situations. The reader will also become acquainted with the different priorities of alarms on MEDUMAT Transport. © WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June 2008
3 Contents Ventilation Monitoring Pressure/Volume Curve Capnometry /Capnography MEDUMAT Transport Alarms
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June Ventilation Monitoring Every use of mechanical ventilation has to be monitored continuously as a check of its effectiveness and success. In addition to oxygen saturation -- the sign of success – other measures are required for the assessment and management of the ventilation process. The following parameters can be used in an evaluation: –Clinic –Capnometry –Expiration volumetry –Ventilation pressures –(Blood Gas Analysis)
5 Important Parameters For Assessing the Quality of Ventilation Measurements: –Tidal volume –Respiratory Minute Volume –Respiratory rate –Maximum pressure –PEEP level –etCO 2 Curves –Flow curve –Pressure curve –Capnography © WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June 2008
6 Pressure Curve Composition of Pressure/Time Diagram
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June Flow Curve Composition Flow/Time Diagram
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June Capnometry /Capnography Non-invasive continuous monitoring of CO 2 portion of exhaled air –Check position of tube –Check ventilation –Check circulatory function Sensitive monitoring process Two different reporting means –capnometry (numeric value) –capnography (curve)
9 Structure of CO 2 Curve in Capnogram I.Inspiration II.CO 2 of upper airways (dead space) III.CO 2 of lower airways (alveoli) IV.Start of next inspiration © WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June 2008
10 Functional Principle of etCO 2 Measurement Infrared spectroscopy with wave length of 426 nm Absorption of light proportional to number of available CO 2 gas molecules © WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June 2008
11 Interpretation of CO2 Curves Exponential decrease in PCO 2 –Cardiac arrest –Pulmonary embolism –Sudden decrease in blood pressure Constant low etCO2 –Absolute hyperventilation –Low body temperature –Centralization of shock Constant high etCO2 –Hypoventilation Sudden decrease in etCO2 –Accidental extubation –Faulty esophageal intubation –Disconnection Slant in etCO2 plateau –Bronchospasms (e.g., asthma) © WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June 2008
12 Influences on etCO2 Level In patients depending on: –Circulatory function and CO 2 transport to lungs –Metabolism at cellular level –Ventilation for respiratory elimination of CO 2
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June Normal Capnometry /Capnography –etCO 2 in patient with normoventilation 4-5 Vol% = mm Hg –Conversion: 1 Vol% = 7 mmHg 1 mmHg = 0.15 Vol%
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June Alarms Distinction between physiological and system alarms in MEDUMAT Transport Graduated in three (3) alarm escalation levels Requires individual adjustment for each patient
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June Alarm – High Priority Tidal volume high/low Respiratory Minute Volume high/low Apnea Leak on patient side of device Expiratory CO 2 high/low Inspiratory CO 2 high Airway pressure high/low Oxygen supply low
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June Alarms – Medium Priority Respiratory rate high Oxygen concentration high CO 2 Occlusion
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June Alarm – Low Priority CO 2 module defective
© WEINMANN GERÄTE FÜR MEDIZIN GMBH+CO.KG, Medical Training - Monitoring, June Summary Every ventilation of a patient requires that thorough checks be made of the ventilation settings by measuring physiological parameters. Knowing the etCO2 numerical values and curves gives the user a greater degree of safety and certainty during ventilation of emergency patients. Device-specific alarms in three different priority levels indicate problems or danger.
CAPNOGRAPHY- and PULSE OXIMETRY : The Standard of RESPIRATORY Care Dr.Gehan A Tarrabih, MD, Ass. Prof.Anesthesia and SICU, Mansoura Faculty Of Medicine.
Used by anesthesiologists since the 1970s Standard of care in the OR since 1991 New recommendations and JCAHO standards now expanding utilization.
Noninvasive CO2 Monitoring Technology & Clinical Applications Lonnie Martinez Director of Respiratory Care Swedish Medical Center Lonnie Martinez Director.
Capnography for EMS A powerful tool to objectively monitor your patients ventilatory status.
Capnography Erika A. Gibson, DVM Michigan State University Small Animal Clinical Sciences.
CAPNOGRAPHY: THE VENTILATION VITAL SIGN Mazen Kherallah, MD FCCP Critical Care Medicine and Infectious DIsease.
SM Capnography Principles and Clinical Application.
Capnography: The Window Into Your Patient Capnography: The Window Into Your Patient Mike McEvoy, PhD, RN, CCRN, REMT-P Senior Staff RN – Cardiothoracic.
Ventilators All you need to know is…. Types Two types in general, volume control and pressure control. Pressure control primarily used in children Volume.
Medical Training - Physiology & Pathophysiology - For internal use only.
Created by Joshua English, EMT-P James Pointer, MD Mike Jacobs, EMT-P.
Patient Monitoring Stuart Nurre, MS, R.R.T.. Oxygenation Goal of respiratory therapy is return the patient to a normal oxygenation status, while minimizing.
Ventilation / Ventilation Control Tests RET 2414 Pulmonary Function Testing Module 5.0.
Dr Chaitanya Vemuri Int.Med M.D Trainee. The choice of ventilator settings – guided by clearly defined therapeutic end points. In most of cases :
Mechanical Ventilaton Ramon Garza III, M.D.. Indications Airway instability Most surgical patients or trauma Primary Respirator Failure Mostly medical.
Capnography for the intensivist Sarah Philipson. THE END.
Capnography Taken from Zoll Medical Corp pamphlet on Capnography.
Capnography Tom Archer, MD, MBA Clinical Professor Director, Obstetric Anesthesia UCSD July 3, 2012.
Review Lung Volumes Tidal Volume (V t ) volume moved during either an inspiratory or expiratory phase of each breath (L)
1 Section II Respiratory Gases Exchange 2 3 I Physical Principles of Gas Exchange.
Dr. Jeffrey Elliot Field HBSc, D.D.S., Diplomat of the National dental Board of Anesthesia, Fellow of The American Dental Society of Anesthesia.
Capnogram Dr.C.N.Chandra Sekhar M.D. Definitions Capnometry: Measurement and numerical display of CO 2 level during resp.cycle Capnometer: Device that.
VENTILATION CHAPTER 4 DR. CARLOS ORTIZ BIO-208. PARTIAL PRESSURES OF RESPIRATORY GASES AIR IS A GAS MIXTURE OF MOSTLY N 2 AND O 2. THIS TRACES OF ARGON,
Capnography: Current and Future Use by EMS Presented by: Tim Ludwig EMT-P.
Monitoring of Patients during Anesthesia and Surgery Haim Berkenstadt MD Director, Department of Anesthesiology Deputy Director, The Israel Center for.
Noninvasive Monitoring in The Intensive Care Unit Iskander Al-Githmi, MD,FRCSC, FCCP Assistant Professor of Surgery King Abdulaziz University.
1 Part 3 Respiratory Gases Exchange 2 3 I Physical Principles of Gas Exchange.
Medical Training - Ventilation Options - For internal use only.
EE 4BD4 Lecture 27 Carbon Dioxide Monitoring 1. CO 2 Concentration During Breathing (Capnogram) 2.
1 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license.
Partial pressure of individual gas Gas pressure Gas pressure Caused by multiple impacts of moving molecules against a surface Directly proportional to.
Chapter 39 Physical Principles of Gas Exchange By Dr. Mudassar Ali Roomi (MBBS, M.Phil.) Assist. Prof. Physiology.
Transport of gases in the blood. Gas exchange between the alveolar air and the blood in pulmonary capillaries results in an increased oxygen concentration.
Optional, Advanced EMT Capnography/ End-tidal CO 2 Monitoring.
Dr Archna Ghildiyal Associate Professor Department of Physiology KGMU Respiratory System.
Copyright 2008 Society of Critical Care Medicine Mechanical Ventilation 2.
Chapter 46 Respiratory Monitoring and Management of the Patient in the Intensive Care Unit.
Respiratory Calculations Gas Laws Oxygen therapy Humidity Ventilator Management Hemodynamics.
Troubleshooting and Problem Solving Chapter 18. Troubleshooting vs Problem Solving Problem solving: determining a solution to a problematic situation.
OXYGENATION AND VENTILATION. Oxygenation Oxygen Delivery Devices.
Physiology of the Respiratory System. Pulmonary Ventilation Breathing, 2 phases Inspiration: air moves into the lungs Expiration: air moves out of.
Human Physiology Respiratory Physiology Chapter 12.
Respiratory System Physiology. Respiratory Physiology All tissues receive adequate Oxygen supply Prompt removal of Carbon Dioxide Efficient regulation.
Interpretation of Ventilator Graphics Dr.Ahmed Abd Elmaksoud, MD.
CAPNOGRAPHY In Emergency Care EDUCATIONAL SERIES Part 2: Introduction.
Capnography – Principles & Pitfalls Keith Simpson BVSc MRCVS MIET(Electronics) Abbotskerswell, Devon.
The Respiratory System Pharynx 2. Larynx – Houses the vocal chords 3. Trachea 4. Primary bronchi 5. Diaphragm.
Pulmonary Function During Exercise Chapter 10. The Respiratory System Provides gas exchange between the environment and the body Regulates of acid-base.
Overview of topics 1. Settings 2. Modes 3. Advantages and disadvantages between modes 4. Guidelines in the initiation of mechanical ventilation 5. Common.
Respiratory Physiology. Overall function Movement of gases Gas exchange Transport of gas (oxygen and carbon dioxide)
© 2017 SlidePlayer.com Inc. All rights reserved.