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Any Peds Teams Using Ltv 1200 Or Enve Vents?


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#1 Kiddomedic

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Posted 03 March 2011 - 04:45 PM

We are looking to get rid of our Crossvent 4's and move to a more modern vent. We would like the ability to have a true CPAP and BiPap is this possible with these two vents.
Also anyone with real hands on experience with either of these in the pediatric setting?

Thanks,

Marc
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#2 Mike Mims

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Posted 03 March 2011 - 10:41 PM

We've had the LTV 1200 for a little over two years, and love it. We transport about 300-400 pediatrics a year. Our previous was a Eagle 750 and it was "OK"

Don't have any experience with the other vent's, but just from past history of the LTV vents, you won't be disappointed in their performance.
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#3 SerendepitySaki

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Posted 04 March 2011 - 06:15 PM

contact me off-line and i can hook you up w/ both LTV and EnVe reps....
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#4 allison

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Posted 07 March 2011 - 10:50 AM

Hi. Lets try this again, lol. It has been that long. Okay. We used the LTV 1200 for my specialty team in TN. I am back in NC transporting both adults and peds, and we switched to the LTV 1200. Love it. It delivers both BiPAP and CPAP, easy to use, easy to manage. I do have a question since we are talking about the LTV...it does not deliver a tidal volume less than 50. Our Airborne isolette does not fit a baby bigger than 10 lbs. What do you do with the inbetweeners??? bag the entire way????
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#5 Mike Mims

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Posted 07 March 2011 - 11:36 AM

Hi. Lets try this again, lol. It has been that long. Okay. We used the LTV 1200 for my specialty team in TN. I am back in NC transporting both adults and peds, and we switched to the LTV 1200. Love it. It delivers both BiPAP and CPAP, easy to use, easy to manage. I do have a question since we are talking about the LTV...it does not deliver a tidal volume less than 50. Our Airborne isolette does not fit a baby bigger than 10 lbs. What do you do with the inbetweeners??? bag the entire way????

You can use the LTV.
I don't know what your protocols are for peds, but it should be a tidal volume of a least 5 ml/kg. The popular tidal limit is 6-10 ml/kg.
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Mike Mims

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#6 FloridaMedic

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Posted 07 March 2011 - 02:33 PM

Hi. Lets try this again, lol. It has been that long. Okay. We used the LTV 1200 for my specialty team in TN. I am back in NC transporting both adults and peds, and we switched to the LTV 1200. Love it. It delivers both BiPAP and CPAP, easy to use, easy to manage. I do have a question since we are talking about the LTV...it does not deliver a tidal volume less than 50. Our Airborne isolette does not fit a baby bigger than 10 lbs. What do you do with the inbetweeners??? bag the entire way????


Bagging for an extended period of time is DEFINITELY NOT advised.

The LTV 1200 will work on children 5 kg (11 pounds) and larger with preferrably a peds circuit used.

For infants and neonates you should have the appropriate ventilator for them.

This should have been covered in your training/education for competency when you changed jobs if peds/infants were part of your job description. No one (not RN, Paramedic or RT) should be attaching a ventilator to any patient if there are questions about that age range and what the ventilator can do. Have your training officer contact the LTV clinical rep along with getting some hands on inservices with an RT department that specializes in peds and infants.

There are some RNs and RTs who are very, very familar with babies and can work magic with just about any piece of technology if they have to. BUT, they know the risks and will NOT use any piece of equipment on any child they are not totally familar with and how it works on a specific age group.

I don't know what your protocols are for peds, but it should be a tidal volume of a least 5 ml/kg. The popular tidal limit is 6-10 ml/kg.


Popular recipes don't always cut it with infants and children since some may have congenital abnormalities which require careful adjustments to the VT. This is why CXR viewing is very important before attaching the patient. A child may weight X kg but that may not mean X ml/kg will be appropriate for that child. With adults you have a little more room for error in determining VT.

A smaller hospital may also have been over ventilating (or under ventilating) and the CXR will allow you to see where there needs to be adjustment. Keep in mind the differences in the way each ventilator compensates for compressible volume and PEEP/PIP pressures from whichever baseline. Just matching numbers between two different ventilators will be dangerous.
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#7 Macgyver

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Posted 08 March 2011 - 04:18 PM

Bagging for an extended period of time is DEFINITELY NOT advised.

The LTV 1200 will work on children 5 kg (11 pounds) and larger with preferrably a peds circuit used.

For infants and neonates you should have the appropriate ventilator for them.

This should have been covered in your training/education for competency when you changed jobs if peds/infants were part of your job description. No one (not RN, Paramedic or RT) should be attaching a ventilator to any patient if there are questions about that age range and what the ventilator can do. Have your training officer contact the LTV clinical rep along with getting some hands on inservices with an RT department that specializes in peds and infants.

There are some RNs and RTs who are very, very familar with babies and can work magic with just about any piece of technology if they have to. BUT, they know the risks and will NOT use any piece of equipment on any child they are not totally familar with and how it works on a specific age group.


X2

While you can play with pressure limiting delivery options etc, low tidal volumes (like 50cc) cause problems with the delivery - the flow rate is such that you can get really high I:E ratio's at that low a delivered volume. Dial it down to 50cc in pressure limited mode and you'll see a 0.3 sec I time. Depending on the rate you can have a ratios as wild as 1:7 at 25/min (at least when I tried it on our neo test lung) that only goes up to 1:3 when you hit 50/min.

Aside from that the FDA has not approved it for pts under 5kg - and the manufacturer pretty much says "use at your own risk" if you do. If I understand it the mass air flow sensor that calculates the tidal volume won't read accurately if the volumes/flow rate is under a certain level... also, do you have a neo circuit? 'cause the dead space in a pede circuit is a lot higher... Kind of like using an adult circuit on a pede. Not even sure they make one for the LTV - although another brand of the same design MIGHT work. A whole 'nother liability risk...

But then again, if they are 5kg they can go in an isolette with a dedicated neo vent (most are rated to 5.5kg)
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#8 Gila

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Posted 08 March 2011 - 09:35 PM

After spending a majority of the past few months in ICN rotations, I agree that there is a difference between paediatric and neonatal patients. You really should have a dedicated neo ventilator. However, if you do, you absolutely must have training in how to use it. I agree that knowing your equipment is important such as PEEP versus non-PEEP compensation; however, you really need to know about flow and calculating various times. For example, the popular vent in my area for neonates is the MVP-10. You had better know how to calculate TCT, I times, E times, rates, work a blender and analyser and know how to assess the patient. In fact, you don't even have a rate setting with the MVP 10, so your rate is derived from the I time and E time setting.

Anyway, I'm not sure if the OP is really looking to address neonates as paeds was mentioned. Assuming we are transporting patients that can be managed on the LTV, the LTV should be work out for that role.
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#9 Thinking

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Posted 11 March 2011 - 08:20 PM

While we are limited to patients over 5Kg for our LTV 1200 useage, I know of one dedicated neo/peds team at a tertiary care center that uses it for ALL their transports regardless of patient weight, and have done so for a few years without any issues.
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#10 FloridaMedic

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Posted 12 March 2011 - 12:18 AM

While we are limited to patients over 5Kg for our LTV 1200 useage, I know of one dedicated neo/peds team at a tertiary care center that uses it for ALL their transports regardless of patient weight, and have done so for a few years without any issues.


As I stated before, some RNs and RTs can do anything with just about any machine. BUT, they are extremely knowledgable with that age group and their know their machines from every angle by working with neonates/peds everyday both in and out of the hospital. Give me an old BIRD Mark 7 or Servo 900 and I can do some impressive stuff also.

I would NOT advise anyone who does not have extensive experience with neonates and pediatrics to experiment on babies or children with a mechanical ventilator of any type especially on transport. One should be extremely competent with their equipment before ever being allowed to touch a baby or child on transport. Unfortunately some teams may get as little as one hour of training on a ventilator and then are expected to mechanically ventilate all age groups. For this reason I believe only dedicated neonatal/pediatric teams should be transporting sick babies and children. There are some flight/CCT teams that transport all ages but are jack of all but master at nothing. Some may just luck out getting the child from point A to point B without doing serious damage and others bring in disasters that now have more problems that must be addressed in addition to what they started out with.

To be a successful part of any team that is asked to transport sick patients of any age you should be able admit that there are things you may not know and have sources close to you for accurate information and hands on experience.
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#11 Kiddomedic

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Posted 14 March 2011 - 04:00 AM

We use Bronchotron/Phasetron by Airborne vents for both conventional and HF ventilation for our sub 5KG patients.

Also thanks for the response about LTV. Our biggest concern was that we had been using our crossvent 4's to use BiPap but this wasn't approve by the manufacturer. Hence the reason we need an easier to use ventilator.

Again thanks for the response guys. I just contacted our local rep and he's bringing a few by for the team to take a look.


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#12 jmalia1

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Posted 23 December 2015 - 07:54 PM

We use the Hamilton T1. It will ventilate down to 200g and does everything we need.


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