1. SPAG Delivery through the Ventilator
David R. Gibson 2016

2. Gather Parts: Non-disposables
Complete SPAG-2 set-up.
50 PSI O2 hose
Blender/hoses set-up

3. Gather Parts: disposables
3 filters
4-22mm ID (large) adaptors
2 – Briggs “T” adaptors
One-way valve
Corrugated tubing
PEEP valve & adapter
Scissors

4. SPAG Set-up Drying Flow OFF 1. Set up the SPAG as normal
The input should come from a blender, and Blender set same as the ventilators FIO2%.
Drying
Flow
OFF
1. Set up the SPAG as normal
See: PowerPoint on RTConnection.org explaining how,
Wall outlets connections
with the exception that the drying flow should be left OFF.

5. PEEP Relief Valve Set-up
2. Set-up PEEP valve and adapter:
Set PEEP on valve to same level of PEEP on the ventilator
Bacteria filter between briggs “T” and PEEP valve

6. Vent Circuit Set-up
Patient wye
3. “T” into inspiratory limb about a tidal volume length away (two 50cc sections for each 100cc tidal volume)
4. Use a one-way valve to avoid loss of tidal volume during inspiration.
Tidal Volume Length away
One-way Valve goes this direction
To SPAG

7. Other Considerations Assess for obstruction frequently!
Suction PRN
Watch for sudden high pressure limits
May need to changes expiratory filters
Discard HME during SPAG delivery, and replace afterward.

8. Expiratory limb Set-up
Q2 !
Place two filters on the expiratory limb.
Change Q2 hours…with each vent check

9. Summary view