When I was a resident, every vent lecture either put me to sleep or left me dazed and bewildered. I gave a lecture of that ilk when I started working after fellowship. I had become part of the problem. I decided there must be a way to make vent management more understandable and if not interesting, at least bearable. Right now, the actual knowledge in most of EM on vents is dismal [PMIDs: 27330658 and 25497896]
This lecture was up on the soon to be defunct EMCrit Lecture site. It offers a path to managing any patient on the ventilator in the ED. I have tried to simplify as much as possible while still maintaining an evidence-based approach.
This is Part I, it deals with the lung injury strategy. Next week, we'll talk about the strategy for patients with obstructive lung disease.
There are only 4 things you need to remember for a lung injury patient:
Vt (Tidal Volume) = Lung Protection
Flow Rate = Patient Comfort
Resp Rate = Ventilation
FiO2/PEEP = Oxygenation
First, read my Ventilator Article [Managing-Initial-Vent-ED]
Then, print out this Handout
If you need just the audio [right or cntrl click here]
Now on to the Vodcast…
- COVID19 – Awake Pronation (aka the Pig Roast) A guest write-up by David Gordon, MD - April 6, 2020
- EMCrit Wee – Webinar I Gave to Pulm/Crit Care Fellows on Avoiding Intubation and Initial Ventilation of COVID19 Patients - April 4, 2020
- EMCrit 269 – Rationing of Critical Care and Ventilators in COVID19 with Reub Strayer - March 31, 2020