AutoVent 3000 King Vision Video Laryngoscopy LUCAS CPR Goals BLS Providers To become familiar with the use and setup of the AutoVent 3000 King Vision Laryngoscope and proficient with the LUCAS Chest Compression System ID: 708600
Download Presentation The PPT/PDF document "New EMS Equipment T raining" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
New EMS Equipment Training
AutoVent
3000
King Vision Video Laryngoscopy
LUCAS CPRSlide2
GoalsBLS Providers - To become familiar
with the use and set-up of the AutoVent 3000, King Vision Laryngoscope, and
proficient
with the LUCAS Chest Compression SystemALS Providers – To become proficient with the use and set-up of the AutoVent 3000, King Vision Laryngoscope, and LUCAS Chest Compression System
2014
2Slide3
Outline AutoVent
3000
Chronic vs. Scene of an Emergency Ventilated Patients
YouTube VideosInstructor demoPracticeKing Vision LaryngoscopeGeneral Information
YouTube VideosInstructor demoPracticeLUCAS CPR Device
You Tube Videos
Instructor Demo
Practice
2014
3Slide4
AutoVent 3000
Chronically Ventilated Patients
Indications
Point of origin could be from anywhere:
Long term facility
Home
Outpatient setting
Hospital
AND
Reason for transport isn’t a respiratory problem
2014
4Slide5
AutoVent 3000
Indications
(Continued)
Patient’s ventilator settings are:
PEEP less than or = to 10 cmH2O
Peak pressures are less than or = to 30
AND
No changes in the patients normal ventilator settings are required during the transport.
2014
5Slide6
AutoVent 3000
Scene of An Emergency Ventilated Patient
Indications
A non-chronically ventilated patient who is in respiratory arrest.
A SECOND PROVIDER (ALS or BLS) IS REQUIRED TO ASSIST WITH PATIENT CARE
2014
6Slide7
AutoVent 3000
Contraindications
Children who have not reached their
9th birthday THIS APPLIES TO BOTH “CHRONICALLY VENTILATED” AND
“SCENE OF AN EMERGENCY” PATIENTSPatient is in Cardiac ArrestIf patient is “bucking the tube”
2014
7Slide8
AutoVent 3000What does it mean if the patient is “Bucking the Tube
?”
The patient could be regaining consciousness
The patient is in respiratory distress
8
2014Slide9
AutoVent 3000Signs of respiratory distress in a ventilated patient
Increased
secretions from tracheostomy site
(mucous plug)Hypoxia, cyanosis, or decreased oxygen saturation levelsIncreased work of breathingAltered mental status
due to hypoxiaAgitation and anxiety
9
2014Slide10
AutoVent 3000
How To Use the AutoVent 3000
Select Breaths Per Minute (BPM)
Select WHITE Adult settingWe will not be using the orange CHILD setting
Select Tidal Volume8mL per kg (or whatever the patient setting is)Select PEEP settingMatch patient setting
D
isposable valve
Max setting of 10
2014
10Slide11
AutoVent 3000What is PEEP?Positive End Expiratory Pressure
Constant pressure that keeps the alveoli open
Increases the
volume of gas remaining in the lungs at the end of expiration Improves gas exchangeAverage healthy adult has PEEP of 5
11
2014Slide12
AutoVent 3000DestinationClosest appropriate
hospital
Cleaning
Must be cleaned after EVERY useClean with CavicideOn
Boundtree websiteTubing is disposable but remaining equipment needs to be cleaned
12
2014Slide13
AutoVent 3000Who can use the
AutoVent
?
Paramedics ONLYCRT-I can only transport chronically vented patient if the patient has his own vent and the pt’s care provider manages the vent during transport
132014Slide14
AutoVent 3000Things to Remember
Always treat the PATIENT
Maintain situational awareness when managing the AV3000
ALWAYS default to what you know – USE THE BVM IF PROBLEMS ARISE WITH THE VENTILATOR
2014
14Slide15
AutoVent 3000Things to Remember (Continued)Have two ALS providers check and verify the ventilator settings
Any acutely ill or injured
breathing patient at the “scene of an emergency” shall be manually ventilated NOTE: This is referring to patients who are not chronically ventilated.
15
2014Slide16
AutoVent 3000
Things to Remember (Continued)
Only hand tighten the fittings
Use a full size D portable oxygen cylinder – AV3000 machines consume a portable O2 cylinder within 23 minutes.Will not run if the oxygen tank has less than 200L
2014
16Slide17
AutoVent 3000
Things to Remember (Continued)
When switching a chronically ventilated patient over to the
AutoVent 3000:Monitor/trend for ONE minute to ensure that the patient tolerates and accepts the ventilatorHigh pressure alarm activates and dumps oxygen at 45-55cm H2O & Barotrauma occurs at 60cm H2O
THERE IS NO LOW PRESSURE ALARM
2014
17Slide18
AutoVent 3000
Autovents
are on M712, M715, M703 and PE732
They will not be placed on any additional unitsRestockingEmail Jon Fiedler at MCFRS.EMSSupplies@montgomerycountymd.gov
Troubleshooting/Broken UnitContact EMSDO
2014
18Slide19
AutoVent 3000AutoVent
3000
Tutorial
(9:25 min)Instructor Demo
Practice
2014
19Slide20
Why are we implementing this?VL is a tool proven to improve first pass successThe EMS Management wants to ensure that providers have the latest technology and that every attempt is being made to make your job easier and saferData from Howard County was overwhelmingInitial success rate for ALL intubations was 68%
After implementing VL, success rate increased to 95% on the FIRST ATTEMPT
2014
20
King Vision LaryngoscopeSlide21
King Vision Laryngoscope
General Info:
90 minute continuous use
3 AAA batteries
Be sure to put ribbon under the first batteryMotion Activated
60 second shut-off
57 Kits On Order
Kit includes
(1) Digital Display
(3) Channeled Blades
(1) Non-Channeled Blade
Will be placed on AFRA’s and chase cars/medic units
2014
21Slide22
King Vision Laryngoscope
Cost
Kit $927.00 (Display and 4 blades)
Replacement blades $24.39 (channeled and non-channeled)
RestockingInitial blades will be purchased by the EMS Section
Additional restocking done through normal
Boundtree
ordering process
2014
22Slide23
King Vision LaryngoscopeGeneral TechniqueNot the same as with direct laryngoscopyThree fingers and slide into place
23
2014Slide24
King Vision LaryngoscopeChanneled
Blades
Does not require
styletSize equivalent to a 3 Mac
More popular choice
Non-Channeled Blades
Useful in patient with small
anatomy,
or other circumstances where you need more room to work.
Requires
stylet
or bougie
24
2014Slide25
King Vision LaryngoscopeTechnique for Channeled BladeInsert tip of blade into Vallecula
and gently lift until vocal chords come into view
25
2014Slide26
King Vision LaryngoscopeTechnique for Non-Channeled BladeInsert tip of blade and lift epiglottis until vocal chords come into view
26
2014Slide27
King Vision LaryngoscopeThings to RememberOnly to be used with patients who are 18 years and older
Continue to use
capnography
and all of your standard tube confirmation tools
2014
27Slide28
King Vision Laryngoscope
King Vision In-Service Guide
(2 min)
Instructor Demo
Practice
2014
28Slide29
LUCAS Chest Compression System
29
2014Slide30
LUCAS Chest Compression SystemProvides consistent CPR independent of:Transport conditionsP
rovider fatigue
V
ariability in the experience level of the providerBased on the international guidelines for CPR
302014Slide31
LUCAS Chest Compression SystemAge LimitsNone, as long as the patient fits
Size Limits
Alarm will sound if plunger is too low
This means that the patient is too smallIf plunger cannot lower, patient is too big
31
2014
Should Fit
Probably NotSlide32
LUCAS Chest Compression SystemSet at 102 compressions per minuteCan defibrillate while in useBE SURE TO PAUSE THE LUCAS EVERY 2 MINUTES TO
REASSESS
32
2014Slide33
LUCAS Chest Compression SystemAllows for one person to be a dedicated scribeThis will improve the accuracy of the patient data
33
2014Slide34
LUCAS Chest Compression SystemIMPORTANT TO REMEMBER:Ensure that the LP15 is in “Paddles” mode so that the CPR information can be recorded into CODESTAT
34
2014Slide35
LUCAS Chest Compression System
LUCAS Demo
(13:08 min)
LUCAS vs. Manual CPR (4:37 min)Instructor DemoPractice
2014
35Slide36
Review QuestionsAutovent
When can we use the
AutoVent
?When you can match the patients own ventilator settingsPeak pressures < than or = to 30PEEP < or = 10What is the minimum age to use the
AutoVent?9 years oldWhat are the 3 contraindications for the AutoVent use?
Cardiac arrest
Pt not reached 9
th birthdayPt bucking the tube (in respiratory distress)
36
2014Slide37
Review QuestionsKing VisionWhat is the minimum age for use?18 years old
What is the main difference in
stylet
use between the 2 types of blades?Channeled Blade – does not require styletNon-Channeled Blade – requires stylet
Describe the hand technique for use of the King VisionHold handle with three fingers Gently lift when entering the vallecula
or lifting the epiglottis
37
2014Slide38
Review QuestionsLUCAS CPR DeviceCan you defibrillate while the LUCAS is on?Yes
What is the age limit for the LUCAS?
None, as long as the patient fits
How often do you reassess the patient while using the LUCAS?Every 2 minutesDo you need to pause the LUCAS to reassess the patient?Yes
38
2014