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Disposable Ventilator-A dream or reality 

DR.UPENDRA BAITHA
ASSIST. PROF.
DEPT. OF EMERGENCY MEDICINE
AIIMS, NEW DELHI

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Disposable Ventilator-A dream or reality 

  1. 1. Disposable Ventilator-A dream or reality DR.UPENDRA BAITHA ASSIST. PROF. DEPT. OF EMERGENCY MEDICINE AIIMS, NEW DELHI
  2. 2. Lack of Ventilators during H1N1 Sales 1st Qtr 2nd Qtr
  3. 3. Hospital – Manual Resuscitators Used
  4. 4. Power cut kills patient in ICU
  5. 5. Manual Resuscitation by Nursing Staff
  6. 6. Challenges faced in hospital environment  Ventilation during CPR*  Lack of transport ventilators  Training for ventilators  Ventilation during MRI / CT  Inconsistency in manual ventilation  Lack of Medical Ventilators in routine or mass casualty *CPR – Cardio Pulmonary Resuscitation
  7. 7. Risk Associated with Manual Devices • Inconsistent delivery during transport and CPR • Pile up of breaths • Barotrauma • Risk of gastric insufflation • Over-inflation of lungs leading to (ARDS)
  8. 8. Vortran Automatic Resuscitator (Var®) ( Disposable Ventilator )
  9. 9. Features of VAR®  Plastic Body: Light weight, Transparent, Disposable  Easy to use: Minimal training required  Respiration Rate & Tidal Volume controls  MRI / CT Compatible  Pressure cycled ventilation  Gas powered – No power back up required  FiO2 50% or 100%  In line pressure manometer to measure PIP & PEEP  Use with Endotracheal (ET) Tube or mask
  10. 10. Ventilation Modes Pressure Cycled (IPV* Mode) for mandatory breathing Apneic patients - who can not breathe at all Pressure Support (CPAP** Mode) for spontaneous breathing Patients who can trigger / initiate breath *IPV – Intrapulmonary Percussive Ventilation ** CPAP – Continuous Positive Airway Pressure
  11. 11. VAR® comes packaged with • Automatic Resuscitator • 22 ID* flex tube • O2 Hosing *ID- Inner Diameter
  12. 12. VAR® Parts ManometerModulator Patient Tee
  13. 13. VAR® Part No. 1 - Modulator Respiration Rate (RR) Dial Peak Inspiratory Pressure (PIP) Dial Modulator: To control the Peak Inspiratory Pressure and Respiration Rate Peak Inspiratory Pressure (PIP) :: Tidal Volume (Vt)
  14. 14. VAR® Part No. 2 - Pressure Manometer Manometer: Inline manometer to measure the pressures delivered to the patient in cm H 02
  15. 15. VAR® Part No. 3 - Patient Connection Port Patient Tee: Includes Oxygen supply port (FiO )*, redundant pop-off valve, patient connection port. 2 Redundant pop-off valve Patient connection port Oxygen supply port (FiO ) 2 *FiO2- Fraction of inspired Oxygen (50% or 100% Oxygen)
  16. 16. VAR® set up – Step 1 1st Step - Choose 50% or 100% FiO2 Connect O2 hose to VAR, then to a High flow Flowmeter and set flow to 10 - 15LPM to start. *Supply Pressure Required: 50 + 5 psig
  17. 17. FiO2 setting 100% FiO2 Connect the O2 hose on green cap 50% FiO2 Remove the green cap and then connect O2 hose
  18. 18. VAR® set up – Step 2 2nd Step – Set PIP Once there is flow to the device set the desired PIP or Peak Inspiratory Pressure using the rectangular dial marked here.
  19. 19. Changing the Peak Inspiratory Pressure (PIP) T - Shape knob or Rectangular Knob 15 ~ 25 25 ~ 35 35 ~ 45 cm H2O Rotation: Clockwise – Increase PIP Anti Clockwise – Decrease PIP 15 20 25 30 35 40 45
  20. 20. VAR® set up – Step 3 3rd Step – Connect to Patient Now that the function test is done and movement of manometer has been verified, connect to the patient.
  21. 21. VAR® set up – Step 4 4th Step – Adjust Breath Rate / Select Mode Last step is to adjust the Breath Rate as per the requirement.
  22. 22. Pressure Cycled Ventilation 5 10 15 20 30 40 60 Inhalation Exhalation PIP = 25 cm H2O PEEP = 5 cm H2O PEEP is preset to 1/5th or 20% of PIP Pulmonary Modulation Technique
  23. 23. Patient Safety – Pop off Valve • The VAR® is equipped with a safety pop – off valve which pops out at pressures exceeding 60 cm H2O to avoid Baro-Trauma or Tracheo- Bronchial Injury (TBI).
  24. 24. Applications (1 / 5) • Automatic, hands free ventilation during: – Inter-facility, intra-facility transports – ER or ICU, replacing manual resuscitators (bags) – MRI or CT procedure – Emergency back-up ventilator for home, hospital or alternative care facilities – Patient transport in Ambulance – Disaster management or field hospital
  25. 25. Applications (2 / 5) • Cost Saving – Single patient use/disposable resuscitator: – Eliminates cost of capital equipment – Reduces labour intensity associated with manual resuscitators (bags) – Save on maintenance and repair cost – Save rental cost on ventilator – Save therapist time for getting and setting up ventilator for short-term use
  26. 26. Applications (3 / 5) • Convenient – Lightweight, disposable, single patient use resuscitator: – Easy to store – no large ventilator to take up limited ER/ICU space – Quick set-up and easy operation with no clean up cost or recycling time required – No missing pieces of ventilator when needed – Flexible usage with mask or ET tube – Use in-line with HME and/or Bacteria filter
  27. 27. Applications (4 / 5) • Reliable – Delivers consistent and reliable pressure cycled short term ventilatory support: – High pressure pop-off safety valve reduces potential of pneumothorax. – Technology minimizes gas trappings to reduce the potential for barotrauma
  28. 28. Applications (5 / 5) • Safety – Promotes safe and efficient hospital transports by: – Eliminating the need for a manual resuscitator and/or additional ventilation – Freeing up the EMT’s hands to perform other critical functions – Ideal for use with chest compression/Cardiopulmonary Resuscitation (CPR)
  29. 29. Dismantle • In the chance of an occlusion in the VAR. The VAR can be taken apart in sections. Remove the Modulator to allow the flow of gas to push out the contaminate.
  30. 30. Quality Standards • FDA* approved • Meets ASTM** requirements • Meets CSM*** ventilatory assistance mandate • certified • ISO 13485:2003 * FDA : Food & Drug Administration ** ASTM : American Society for Testing & Materials *** CSM I: Centre for Medicare & Medicaid services : Conformité Européenne
  31. 31. Airway Pressure Monitor (APM) • For digital display of Patient’s respiratory parameters • Connects to VAR® • LCD Screen • Easy to setup • Visual & Audible Alarms • Portable • Adult & Pediatric Models
  32. 32. Airway Pressure Monitor (APM) Peak Inspiratory Pressure (PIP) Positive End Expiratory Pressure (PEEP) Respiration Rate (RR) Inspiration Time (IT) Expiration Time (ET) I:E Ratio Non Cycling Alarm High Rate Alarm High Pressure Alarm Display Alarms
  33. 33. E surge kit • Prepare for a major Ventilator Emergency • Use a single gas source for multiple ventilators in Mass Casualty Incidents (MCI) 7 ventilators (VAR®) using 1 Oxygen Supply
  34. 34. O2 Supply Multi output Manifold E surge kit
  35. 35. THANK YOU
  • seyedahmadmousavi3

    May. 4, 2021
  • MuradNizami

    Sep. 11, 2019
  • dilsherece

    Sep. 6, 2019

DR.UPENDRA BAITHA ASSIST. PROF. DEPT. OF EMERGENCY MEDICINE AIIMS, NEW DELHI

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