remedial ventilator management?

[dragonfly99]

I'm a current cardiology fellow. I did a research year between IM residency and fellowship, during which I didn't do ICU/CCU care. I feel like my ventilator management skills are just not up to par. In truth, I probably never had a good understanding of ventilator management. Do any of you have recommendations for "remedial ventilator management" learning? I am very willing to do online reading/work and/or get a handbook or textbook. I'm sure I can relearn the stuff...or learn it better than I have in the past. We usually don't have horribly difficult to ventilate patients on the cardiac service (or would be getting a pulm/CC consult if we did) so I mainly am concerned that I don't mess up the basic things. I used to have the Marino ICU book at one point, but honestly I didn't find it very readable. I'm looking for something with maybe a more clinical bent and less theory.

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[Paseo Del Norte]

If you are willing to spend a little money, one of the best books I have seen on the subject is "Principles and Practices of Mechanical Ventilation" by Martin J. Tobin.

I am not all that keen on the physician perspective; however, are you looking for more of a refresher on the basic setup of a person initially being placed on mechanical ventilation, the basic mechanisms of cycling, triggering, basic parameters and modes, or more complex information such as how PRVC and APRV are utilised and work, or even the process of liberation and rehabilitation?

 

[proman]

If you are willing to spend a little money, one of the best books I have seen on the subject is "Principles and Practices of Mechanical Ventilation" by Martin J. Tobin.

I am not all that keen on the physician perspective; however, are you looking for more of a refresher on the basic setup of a person initially being placed on mechanical ventilation, the basic mechanisms of cycling, triggering, basic parameters and modes, or more complex information such as how PRVC and APRV are utilised and work, or even the process of liberation and rehabilitation?

Please, someone buy my copy of Tobin. I'd go to ccmtutorials.com It's likely what you're looking for.

 

[Hernandez]

If you are going to have vented pts that you're managing without a pulm or gas doc managing then you should know the info in marino's book. Marini may be more clinically slanted however. Ccm-tutorials does have a good site and it breaks down some other topics simpler than Marino. Tobin's book is way way overkill for a cards fellow, hell I'm a pulm fellow and find that many sections are still over my head aa I've not gotten west's physiology down pat yet. Personally I feel that foregoing some if the basics Marino goes over oils be akin to reading an EKG with no knowledge of the phys behind them. Larry Martin has what I think is a betterment easier read than ccm-tutorials on basic vent intro http://www.lakesidepress.com/pulmonary/books/physiology/chap10a.htm he also has probably the best abg interpretation books out there that he posts almost completly on his website for free

The ATS has a ppt on mech vent http://www.thoracic.org/education/teaching-slides/index.php

SCCM also has (what I think is) a good ppt http://www.slideshare.net/mobile/fergua/basic-mechanical-ventilation#24

 

[Paseo Del Norte]

The "ICU Rounds" podcast by Dr. Jeff Guy is another great resource IMHO. In addition, you can download it free from iTunes. He devotes several podcasts to ventilator management and related concepts.

 

[RT2MD]

Please, someone buy my copy of Tobin. I'd go to ccmtutorials.com It's likely what you're looking for.

Start here.

I did a post several years ago on VERY BASIC vent stuff (probably more geared toward the intern than a fellow)... you might search the archives.

Good luck!

 

[kemper6036]

The "ICU Rounds" podcast by Dr. Jeff Guy is another great resource IMHO. In addition, you can download it free from iTunes. He devotes several podcasts to ventilator management and related concepts.

love these podcasts. he has a lot on vents

 

[dragonfly99]

thanks!
This was very helpful advice.