Posted 30 September 2008 - 04:14 AM
I am the Field Supervisor for a 10 truck operation in a major metroplitan city. My owner (no EMS experiance and minimal knowledge) seems to think that the Uni-Vent 73X is going to be able to handle the wide array of patients that we are taking out of an LTAC group. I have done my best to tell him this is not the case and to spend the money on a 750 or 754. He is not listening to me because (like all of us) I want newer better bigger fancier toys. That s what he hears anyway. I just do not want to have my guys out there with inferior tools and not able to give the best care to the patients.
Any REAL easy to understand suggestions out there. I can not make him understand so I am hopeing that someone else can.
Posted 30 September 2008 - 11:55 AM
Flight Medic Life Air,
A/C Valley Fire Department
Posted 30 September 2008 - 08:59 PM
The worst alternative (but the one I'm afraid it will come down to) might be that all the crews keep track of the outcomes of all the vent patients that you transport. Especially note the agitation / lack of synchrony and the increased amount of analgesic / sedatives it requires to transition the patient onto the old uni-vent. Point out how that increases the time and expense of the runs. I'd suggest trying to obtain follow-up blood gases but if your boss isn't medical, he probably won't get what that data is telling him....
Ok, that's my $0.02. Hope something eventually gets your boss to listen....
Posted 30 September 2008 - 09:17 PM
It seems this person needs to start at the very basic fundamentals of ventilation before he can even understand advanced. Hooking him up with the Respiratory Department or a hospital critical care course when they are discussing ventilation would be a good idea. Maybe the whole critical care course wouldn't be a bad idea either since one should NOT treat a ventilator separate from the patient.
Here's a couple of links to review to provide some arguments.
Performance Comparison of 15 Transport Ventilators
The above article points out what RRTs look for in performance. You can buy a Ferrari or a Yugo. The salesperson will give you the same sales pitch especially if they know you don't know that much about ventilator comparison.
Posted 30 September 2008 - 09:32 PM
Posted 03 October 2008 - 03:33 PM
Respiratory schools don't intubate and ventilate people for the heck of it even though there are some we would like to give a personal demonstration to.
I'm sorry, I did not mean to imply that they did - and I definitely should have explained my suggestion.
What I meant was: Most of the RT's I work with have described vent "labs" where they just held an ETT in their mouths, usually with the nose pinched shut with the clip-thing-ee, and in this way they simulated the experience of intubation. They got an idea of the effort required to breathe thru a tube. They described breathing thru long and short tubes to experience the increased WOB assoc with larger "dead space;" also breathing thru smaller and larger tubes to really feel the effect of airway diameter on resistance. Then they were "ventilated" this way with several different vents in different modes and settings to get the "feel" of how comfortable / uncomfortable the various modes and settings of mechanical ventilation are, the feel of PEEP within the circuit, the assistance that PS adds, the "feel" of the different flows and changing I time and rise times, etc. Probably lots of other stuff I don't appreciate as a non-RT. Some still describe that with a certain brand of vent, they were never comfortable no matter what settings they programmed into it; they still remember having the air hunger sensation, etc.
I had understood this to be a common resp therapy school practice, but I may have misunderstood - maybe it's just the school in my area.
Again, my apologies to anyone I (inadvertently) insulted. I should have already learned not to post when I'm post call because I'll stick my foot in my mouth, and yet I keep doing it.....
Posted 05 October 2008 - 07:04 PM
British Columbia Ambulance Service
Airevac and CCT Program