An excellent tool to treat refractory hypoxia. Target audience are ICU junior physicians and Respiratory Therapists. It will take away the fear of "What is APRV?" from your hearts and you will feel ready to give it a try.
The presentation deals with the principles of mechanical ventilation, its only for the educations purpose!
Any kind of replication, modifications and republication is strictly prohibited.
All Rights reserved to the Author. 2016
An excellent tool to treat refractory hypoxia. Target audience are ICU junior physicians and Respiratory Therapists. It will take away the fear of "What is APRV?" from your hearts and you will feel ready to give it a try.
The presentation deals with the principles of mechanical ventilation, its only for the educations purpose!
Any kind of replication, modifications and republication is strictly prohibited.
All Rights reserved to the Author. 2016
Non-invasive ventilation (NIV) is the use of breathing support administered through a face mask or nasal mask. Learn more about NIV in this presentation by Dr Somnath Longani, consultant Anaesthesiologist & Intensivist, Midland Healthcare & Research Center, lucknow
https://midlandhealthcare.org/
Basic information on the Graphics displayed on the Ventilators. Prepared to educate about the graphics to train the professionals who work with Ventilators.
Patient ventilator interactions during mechanical ventilationDr.Mahmoud Abbas
Patient Ventilator Interaction during Mechanical Ventilation lecture presented by Dr.Lluis Blanch at Pulmonary Critical Care Egypt Meeting and Exhibition, January 2014. www.pccmegypt.com
Non-invasive ventilation (NIV) is the use of breathing support administered through a face mask or nasal mask. Learn more about NIV in this presentation by Dr Somnath Longani, consultant Anaesthesiologist & Intensivist, Midland Healthcare & Research Center, lucknow
https://midlandhealthcare.org/
Basic information on the Graphics displayed on the Ventilators. Prepared to educate about the graphics to train the professionals who work with Ventilators.
Patient ventilator interactions during mechanical ventilationDr.Mahmoud Abbas
Patient Ventilator Interaction during Mechanical Ventilation lecture presented by Dr.Lluis Blanch at Pulmonary Critical Care Egypt Meeting and Exhibition, January 2014. www.pccmegypt.com
This presentation deals with the basic physics of human ventillation. I have made an effort to clarify most of the venti lingo , so as to make way for further discussions on ventilator use. Hope it turns out to be helpful for you. Thank you.
Learning Objectives Covered1. Explain the importance of monitor.docxsmile790243
Learning Objectives Covered:
1. Explain the importance of monitoring plateau pressures and its use in calculating static compliance
2. Explain the use of volume-controlled ventilation and pressure-controlled ventilation
3. List and describe ventilatory support treatment plans for patient’s based on their clinical diagnosis
Background
Compliance is a measurement of the distensibility of the lung or the ability of the lung to distend. It is expressed as a change in volume divided by a change in pressure using the standard units of Liters/cmH20. The normal lung + thorax compliance of an adult is around 0.1 L/cmH20. When the compliance is low, more pressure will be needed to deliver a given volume of gas to a patient. Diseases that cause low lung compliance are classified as restrictive diseases and include Adult Respiratory Distress Syndrome (ARDS), pulmonary edema, pneumonectomy, pleural effusion, pulmonary fibrosis, and pneumonia among others. Emphysema is a typical cause of increased lung compliance.
When measuring lung compliance one must know the delivered tidal volume and must also know the change in alveolar pressure that results from the addition of that known tidal volume. Alveolar pressure is the pressure in the distensible parts of the respiratory tract and is determined by the tidal volume and the lung/chest compliance. Airway pressure is the pressure measured at the patient’s airway during mechanical ventilation. Airway pressure is equal to alveolar pressure when there is no occurrence of airflow. At the end of a mechanical inspiration, flow to the distal parts of the lungs continues even after inspiratory flow from the ventilator stops, as time is required for gas to reach the periphery of the lung. To measure alveolar pressure, one must measure the airway pressure at a time when both pressures are equal, i.e. when there is no flow.
We normally assume that alveolar and airway pressure starts out at atmospheric (our zero reference) before an inspiration starts. To equalize airway and alveolar pressures, we only have to prevent exhalation after inspiration has ceased by utilizing an inspiratory hold maneuver. The actual calculation is to divide the delivered tidal volume by the plateau pressure where the plateau pressure is the steady-state pressure measured during an inspiratory hold maneuver. Since approximate values are adequate for clinical use, clinicians use the plateau pressure minus the end expiratory pressure that is then divided into the exhaled tidal volume as measured by the ventilator. This compliance measurement is referred to as static compliance since it is measured after an inspiratory hold and there is no gas flow during its measurement.
Cstatic = exhaled VT (ml)
Pplat (cmH2O) – PEEP (cmH2O)
Where:
VT – Tidal Volume
Pplat = Plateau Pressure
A spontaneously breathing person has a normal compliance of approximately 100mL/cmH2O. In intubated patients, normal comp ...
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
2024.06.01 Introducing a competency framework for languag learning materials ...
Mechanical ventilation
1. Modern ventilators use electromagnetic proportional solenoid valves
controlled by microprocessors to control gas flow to patient
2. FIO2
FiO2 is the fraction of inspired oxygen. It is the
percentatge of oxygen delivered on inspiration.
Ranges from 21% to 100%.
The oxygen analysers In the inspiratory limb is used to
ensure the accuracy of
FiO2 delivered
3. Tidal volume (TV or VT)
Measured volume with each breath
Normal tidal volume should be kept at
6 – 8 ml/kg of patients ideal body weight
7. Peep
Positive end expiratory pressure is the positive pressure applied at the end of
expiration during mechanical ventilation.
The use of PEEP improves gas exchange by recruiting collapsed alveoli and
thereby improving functional residual capacity.
PEEP also helps in redistributing lung water from the alveolar space into the
pulmonary circulation and improving ventilation perfusion mismatch.
All these contributes to reduction in dead space ventilation and thereby
improving PaO2.
PEEP increases intra-thoracic pressure resulting in decreased venous return to
the right heart and increasing the right ventricular after load (the force needed
to eject blood from right ventricle) .
8. AUTO PEEP
Auto PEEP is the actual pressure difference between the
higher pressure and the baseline pressure (set PEEP level or
0) at the end of full expiration
It is measured by pressing the expiratory hold button on
the ventilator.
9. Peak airway pressure
Pressure needed initially to assure the flow of gas
down the airways and open up the alveoli.
Depends upon resistance and compliance
10. PLATEAU PRESSURE
Pressure required to hold the lungs and chest wall open when there is no air flow during
the inspiratory cycle
Measured at the end of a full inspiration during a breath hold (no air flow)
How to measure Plateau pressure
1. Switch to volume controlled mode ventilation
2. Press the end-inspiratory hold button
3. The machine will display plateau pressure. It is automatically done by the ventilator by
sensing the pressure which is required to keep the alveoli open at the end of inspiration
when there is no airflow which will be generally 10-15cm H2O less than Peak airway
pressure.
With decreased compliance, the plateau pressure will increase.
11. rESISTANCE
Degree of easiness to move gases down the airways
High resistance --- difficult to move gases in and out
Low resistance --- easy to move gases in and out.
Measured using the difference between peak airway
pressure and plateau pressure.
12. COMPLIANCE
Degree of easiness to distend the alveoli, lungs and
chest wall.
High compliance --- easy to distend the alveoli
Low compliance ---- hard to distend the alveoli
Compliance is measured with plateau pressure
13. REDCRUITMENT
Ventilation strategy whereby the non ventilated alveoli are opened by
progressively introducing higher pressures over a short period. The aim is
reinflate atelectatic alveoli without distending the normal lung units.
Techniques
1. PEEP is increased in increments of 5cm H2O from a baseline PEEP to 35cm
H2O reducing tidal volume to limit peak inspiratory pressure to 35cm H2O.
CPAP is maintained for 30s.
2. Intermittent higher tidal volume in pressure controlled ventilation applied
with escalating PEEP and constant driving pressure: peak pressure of 45cm
H2O, I:E ratio of 1:2 and PEEP level of 16cm H2O for 2min.
3. Sustained inflation by application of CPAP at 30-40cm H20 for 40s.
14. Weaning
Weaning is the process when the support of the ventilator is gradually
decreased to re-establish spontaneous breathing. Readiness for
weaning is evaluated by assessing level of consciousness, adequacy of
oxygen and ventilation, spontaneous breathing strength etc.
15. Anatomic dead space
Anatomic Dead space is the portion of the respiratory
system not involved in gas exchange.
It is be divided into alveolar and airway dead space.
Airway dead space is also called tracheal dead space as it is the
part of the respiratory system (mainly trachea) where tidal
volume remains in the conducting passages at the end of
inspiration and therefore does not participate in gas exchange.
Alveolar dead space is a measurement of the ventilated alveoli
without adequate blood flow for gas exchange. It is negligible in
healthy individuals.