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Tiny Talk – Anesthesia Ventilator

Views: 14955 - Comments: 9

Megan Brashear, CVT, VTS(ECC), discusses the use of a ventilator for anesthetized patients. Benefits, tidal volume calculation, and patient monitoring concepts are covered.

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Megan Brashear's picture
Megan Brashear


Enrolled: 07/2011

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Pamela Kay Bell's picture

The video on ventilators was very well presented and very informative. The speaker was very organized and thorough in her explanation. thank you!

Robyn Watts's picture

Thanks for posting this. I think it's a great basic getting started with a anesthesia ventilator. I will add this one to our training checklist for our techs who are starting anesthesia.

Andrea Dawson's picture

Excellent video, thank you! One question - what do you do when your patient starts to fight the ventilator - say they get painful during a procedure and start to pant? I tend to increase the resp. rate, turn up my iso and decrease the minute volume and let them come back down. Is there a different/better/safer method? Thank you!

Sarah Harris's picture

Hi Andrea. Increasing anesthetic depth may help some with patients who are trying to buck the ventilator, but it is really only putting a band-aid over the problem. Remember inhaled anesthetics don't really provide much, if any, analgesia. Intraoperatively, I really rely on injectable medications to keep my patients at the appropriate level of pain control. I may temporarily make the adjustments you mentioned, but if I'm finding that my premedication isn't providing adequate analgesia, I will request additional medications or ask for a titratable CRI that can help me maintain the patient on lower isoflurane. We use a variety of medications but personally, I love going into surgery with a fentanyl or ketamine CRI to help with situations just like this. Thanks for the great question!

Logan Ransone's picture

Hi Megan. I really enjoyed the video. We are just starting to use the ventilator in some of our anesthetic cases at my practice. I was confused about the section about blood pressure...if blood pressure drops and you rule out all other reasons, you would decrease tidal volume? Do i understand this correctly? Thanks!

James Reid's picture

Hello Logan. You are correct. In the 8th minute of the video Megan is correlating excessive positive pressure with decreased venous return. Excessive positive pressure ventilation can have a negative effect on blood pressure especially if they have concurrent hypovolemia and or vasodilation. Decreasing the tidal volume will increase the ETCO2. I aim to keep the ETCO2 near the higher end of normal (remember 35-45mmHg is the normaI range) if am suspicious of the ventilator being a factor with my patients hypotension.

Heather Mahoney's picture

Will placing a patient on the ventilator mask a sudden drop in end tidal due to a clot or impeding arrest? I am thinking if we have monitor capnography carefully for clots (cushings) or a patient about to code(capnography trending) the vent would hide this? Am I thinking about this incorrectly?

James Reid's picture

Hello Heather,
The ventilator will not mask a sudden drop in end tidal Co2. The ventilator is only mechanically ventilating the patient. It is not preventing or masking gas exchange. If there is a clot or the patient has arrested you will still see a drop in the end tidal Co2 even when they are on a ventilator. I have seen this with critical patients that have arrested and with patients that are euthanized while under anesthesia.