Tips for putting a patient on a F-60 You have 8-9 breaths (or less) to stabilize the patient and not to leave a bad impression. How to do this right?

Stage 1 – Make sure vent is ready Vent and cart are fixed to eliminate vibrations O2 hose and AC cable are well connected & Batteries are OK Breathing circuit and filters – connected and tested Support arm is properly adjusted and fastened Last look at the whole system

Stage 2 – Adjust BASIC ventilation parameters Go to Home/Parameters and “Copy” ventilation mode and all available parameters from erlier ventilator If not available, use site’s default or SIMV VOL (time cycled) – For adult: Vti: 500, Rate: 12, Ti: 1.2, F trig: 3, PEEP: 5, PSV: 10 Record monitored parameters: PIF, PIP, Ti, RR Understand how patient is spontaneously breathing (if at all)

Stage 3 – Adjust ADVANCED ventilation parameters Go to Advanced and fine tune your settings – Rise profile (3*) PSV Flow termination (15) PSV Ti (1.1) Descend Flow VG to On *Understand how patient is spontaneously breathing (if at all)

Extended Screen: Rise Profile Controls the rise time – from PEEP to Target Pressure 1 (= fastest) to 5 (= slowest) Faster rise time = higher peak inspiratory flow Tip - Set the initial Rise Profile to 3 and then adjust it according to the patient comfort.

Extended Screen: PSV Flow Term. Exhalation starts when the flow reaches the set percentage of the peak flow Lower/Longer - the Lower the percentage the longer the breath

PSV Flow Term. 30% of peak flow Peak flow

Extended Screen: PSV Ti Used to select maximum inspiratory time for Pressure Support breaths

Stage 4 – Adjust Alarms Settings High Pressure Alarm If set too low will cause breath termination and patient will not tolerate the ventilator Should be set based on patient mechanics Check PIP (if already ventilated) and set high pressure alarm limit to PIP+10

Stage 4 – Adjust Alarms Settings Apnea Interval If set too low will cause BUV and awake patient will not tolerate the ventilator Should be set according to rate and current mode Suggested Apnea Alarm = 20 seconds

Stage 4 – Adjust Alarms Settings Set the optional alarms to OFF After patient is comfort and stabilize work together with the caregiver to set the additional optional alarms

Stage 5 – Connect patient Go over and approve settings with site’s clinician Let clinician connect the patient Look at: Patient, Waveform (Pressure & Flow), Actual rate

Stage 6 –Adjust vent If patient is not calm, try to identify: Adjust: Flow Hunger Aggressive Flow Built-up Triggering Problem Adjust: PSV, Ti (Vol), PCV, Rise profile, NPPV low/high Rise profile Flow/Pressure Trigger Look at Waves & Loops together with site’s clinician Increase/Optimize spontaneous breathes volume