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DEAD SPACE 2 DIFFICULTY DIFFERENCES HOW TO
DEAD SPACE 2 DIFFICULTY DIFFERENCES MANUAL

Single limb ventilatorĬircuits with a patient valve located distally already exist on the market, butĪre not necessarily optimized for use with a manual resuscitator. So that gases can be recaptured by the ventilator. Ventilator circuits have two limbs, one for inspiration and one for expiration, To move the patient valve of the manual resuscitator closer to the patient is Extending the tubing through which bidirectional flow of inhaled/exhaled gas mixture occurs only increases dead space. Considering gas exchange occurs at the alveoli in our lungs, every anatomical structure above it can be considered “dead space”: nasal/oral passages, pharynx, larynx, trachea, and primary / secondary / tertiary bronchi. Our natural anatomy has dead space as well. Note: In a 1 m long tube of nominal 2 cm diameter, there is an unacceptable 314 mL dead space that the patient will breath in and out and not be oxygenated.ĭead space simply means volume in the respiratory circuit that does not participate in gas exchange in the lungs. If a simple tube is used to do so, it creates a critical safety concern of “ dead space.” Therefore, a safe method to extend the “reach” and flexibility of the manual resuscitator to a patient lying on a hospital bed is needed.

DEAD SPACE 2 DIFFICULTY DIFFERENCES HOW TO

Even when patients are paralyzed, the paralytic may wear off at times and we must consider how to keep the patient safe from inadvertent breathing circuit disconnection or extubation. In addition, patients need to be turned intermittently for routine care and patients can thrash and move in their beds. When a manual resuscitator is placed into an MIT Emergency Ventilator, or similar design, the system cannot be placed right up against the patient’s head. A fundamental challenge is the location of the one way and expiratory valves, which are typically directly integrated into the bag. Care must be taken to prevent rebreathing of CO 2 due to long hoses.

This is a fault condition that should be detected by pressure sensing.

Bag should be secured to ventilator to prevent an awake patient from pulling on it or otherwise disengaging the bag from the mechanism.

The ventilator must be placed as close to the patient as possible.

Some considerations regarding how the patient should be connected to a manual resuscitator-based ventilator include:

Sensing port for manometer connection (we useĬaution: Manual resuscitator bags are in no way FDA approved for use as long-term ventilation solutions.

PEEP valve that is installed post the exhalation.

Exhalation valve (this stays closed while.

One-way valve that guides air to the patient.

Pop-off valve for safety (location not important).

Integrated into the end bag valve mask (BVM) are a number of critical features: Manual resuscitators have a “patient valve” that directs oxygen/air gas mixture into the patient and shunts the exhaled gas out to the environment. Normally, self-inflating manual resuscitators are directly connected to the patient’s endotracheal tube adapter. For a detailed primer on Breathing Circuits read Mapleson’s Breathing Systems. This details a key dead space issue, which if not addressed, will result in a patient breathing in expelled CO 2 and deoxygenation fast with immediate adverse result. This page describes critical design requirements of the patient breathing circuit.