1 / 38

New EMS Equipment T raining

New EMS Equipment T raining. AutoVent 3000 King Vision Video Laryngoscopy LUCAS CPR. Goals. BLS Providers - To become familiar with the use and set-up of the AutoVent 3000, King Vision Laryngoscope, and proficient with the LUCAS Chest Compression System

keaton
Download Presentation

New EMS Equipment T raining

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. New EMS Equipment Training AutoVent 3000 King Vision Video Laryngoscopy LUCAS CPR

  2. Goals • BLS Providers - To become familiar with the use and set-up of the AutoVent 3000, King Vision Laryngoscope, and proficient with the LUCAS Chest Compression System • ALS Providers – To become proficient with the use and set-up of the AutoVent 3000, King Vision Laryngoscope, and LUCAS Chest Compression System

  3. Outline • AutoVent 3000 • Chronic vs. Scene of an Emergency Ventilated Patients • YouTube Videos • Instructor demo • Practice • King Vision Laryngoscope • General Information • YouTube Videos • Instructor demo • Practice • LUCAS CPR Device • You Tube Videos • Instructor Demo • Practice

  4. 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

  5. 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.

  6. 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

  7. AutoVent 3000 • Contraindications • Children who have not reached their 9th birthday • THIS APPLIES TO BOTH “CHRONICALLY VENTILATED” AND “SCENE OF AN EMERGENCY” PATIENTS • Patient is in Cardiac Arrest • If patient is “bucking the tube”

  8. AutoVent 3000 • What does it mean if the patient is “Bucking the Tube?” • The patient could be regaining consciousness • The patient is in respiratory distress

  9. AutoVent 3000 • Signs of respiratory distress in a ventilated patient • Increased secretions from tracheostomy site (mucous plug) • Hypoxia, cyanosis, or decreased oxygen saturation levels • Increased work of breathing • Altered mental status due to hypoxia • Agitation and anxiety

  10. AutoVent 3000 • How To Use the AutoVent 3000 • Select Breaths Per Minute (BPM) • Select WHITE Adult setting • We will not be using the orange CHILD setting • Select Tidal Volume • 8mL per kg (or whatever the patient setting is) • Select PEEP setting • Match patient setting • Disposable valve • Max setting of 10

  11. AutoVent 3000 • What 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 exchange • Average healthy adult has PEEP of 5

  12. AutoVent 3000 • Destination • Closest appropriate hospital • Cleaning • Must be cleaned after EVERY use • Clean with Cavicide • On Boundtree website • Tubing is disposable but remaining equipment needs to be cleaned

  13. AutoVent 3000 • Who can use the AutoVent? • Paramedics ONLY • CRT-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

  14. AutoVent 3000 • Things 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

  15. AutoVent 3000 • Things to Remember (Continued) • Have two ALS providers check and verify the ventilator settings • Any acutely ill or injured breathingpatient at the “scene of an emergency” shall be manually ventilated • NOTE: This is referring to patients who are not chronically ventilated.

  16. 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

  17. 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 ventilator • High pressure alarm activates and dumps oxygen at 45-55cm H2O & Barotrauma occurs at 60cm H2O • THERE IS NO LOW PRESSURE ALARM

  18. AutoVent 3000 • Autovents are on M712, M715, M703 and PE732 • They will not be placed on any additional units • Restocking • Email Jon Fiedler at MCFRS.EMSSupplies@montgomerycountymd.gov • Troubleshooting/Broken Unit • Contact EMSDO

  19. AutoVent 3000 • AutoVent 3000 Tutorial (9:25 min) • Instructor Demo • Practice

  20. King Vision Laryngoscope • Why are we implementing this? • VL is a tool proven to improve first pass success • The EMS Management wants to ensure that providers have the latest technology and that every attempt is being made to make your job easier and safer • Data from Howard County was overwhelming • Initial success rate for ALL intubations was 68% • After implementing VL, success rate increased to 95% on the FIRST ATTEMPT

  21. King Vision Laryngoscope • General Info: • 90 minute continuous use • 3 AAA batteries • Be sure to put ribbon under the first battery • Motion 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

  22. King Vision Laryngoscope • Cost • Kit $927.00 (Display and 4 blades) • Replacement blades $24.39 (channeled and non-channeled) • Restocking • Initial blades will be purchased by the EMS Section • Additional restocking done through normal Boundtree ordering process

  23. King Vision Laryngoscope • General Technique • Not the same as with direct laryngoscopy • Three fingers and slide into place

  24. King Vision Laryngoscope • Channeled Blades • Does not require stylet • Size 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

  25. King Vision Laryngoscope • Technique for Channeled Blade • Insert tip of blade into Vallecula and gently lift until vocal chords come into view

  26. King Vision Laryngoscope • Technique for Non-Channeled Blade • Insert tip of blade and lift epiglottis until vocal chords come into view

  27. King Vision Laryngoscope • Things to Remember • Only to be used with patients who are 18 years and older • Continue to use capnography and all of your standard tube confirmation tools

  28. King Vision Laryngoscope • King Vision In-Service Guide (2 min) • Instructor Demo • Practice

  29. LUCAS Chest Compression System

  30. LUCAS Chest Compression System • Provides consistent CPR independent of: • Transport conditions • Provider fatigue • Variability in the experience level of the provider • Based on the international guidelines for CPR

  31. LUCAS Chest Compression System • Age Limits • None, as long as the patient fits • Size Limits • Alarm will sound if plunger is too low • This means that the patient is too small • If plunger cannot lower, patient is too big Should Fit Probably Not

  32. LUCAS Chest Compression System • Set at 102 compressions per minute • Can defibrillate while in use • BE SURE TO PAUSE THE LUCAS EVERY 2 MINUTES TO REASSESS

  33. LUCAS Chest Compression System • Allows for one person to be a dedicated scribe • This will improve the accuracy of the patient data

  34. LUCAS Chest Compression System • IMPORTANT TO REMEMBER: • Ensure that the LP15 is in “Paddles” mode so that the CPR information can be recorded into CODESTAT

  35. LUCAS Chest Compression System • LUCAS Demo (13:08 min) • LUCAS vs. Manual CPR (4:37 min) • Instructor Demo • Practice

  36. Review Questions • Autovent • When can we use the AutoVent? • When you can match the patients own ventilator settings • Peak pressures < than or = to 30 • PEEP < or = 10 • What is the minimum age to use the AutoVent? • 9 years old • What are the 3 contraindications for the AutoVent use? • Cardiac arrest • Pt not reached 9th birthday • Pt bucking the tube (in respiratory distress)

  37. Review Questions • King Vision • What 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 stylet • Non-Channeled Blade – requires stylet • Describe the hand technique for use of the King Vision • Hold handle with three fingers • Gently lift when entering the vallecula or lifting the epiglottis

  38. Review Questions • LUCAS CPR Device • Can 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 minutes • Do you need to pause the LUCAS to reassess the patient? • Yes

More Related