Conference Sessions Troubleshooting the Tangle of Patient-Ventilator Interaction Intricacies

The Participants will learn:
• Physics of Flow – The fundamentals
• Patient Respiration and Ventilation – Normal function and anomalies
• Ventilators – The Parameters (independent and dependent) – The User Interface(UI)
• Ventilation Modes – The Methodologies and Mechanisms
• The Ventilation Management Teamwork – Their Diverse Perspectives and Knowledge Base
• Troubleshooting Patient-Ventilator Systems – Identifying Cause and Effect and Root Cause(s) of problems

Effective Long-Term Ventilation Management is achieved by teamwork, comprising professionals with diverse education and training pathways. The gamut of the team’s expertise, perspectives and knowledge base all contribute towards the successful weaning of the patient for eventual adequate spontaneous breathing. However, for this to happen, it is essential that each professional to be familiar to some extent with other team members’ knowledge base and experience that drives their perspective. This session will start with a shared common basic knowledge base and build up to practical applications with appropriate and relevant examples. This would contribute to better effective communication and teamwork between team members for better ventilation management. Emphasis will particularly be on aspects that aid BMETs to apportion accurately the root causes of problems between ventilator, patient and ventilation technique/settings.
Of all the complexities of man-machine systems, the patient-ventilator system poses the greatest challenges. This stems from the varying individual expertise and perspectives of the team of BMETs, respiratory therapists(RTs), critical care nurses, pulmonologists, and intensivists. Given the fact that each and all professionals contribute to the successful patient ventilation management, i.e. the desired outcome of the patient being weaned off the ventilator eventually, it is essential for each to have some familiarity with each other’s perspective.
When things go awry, it can become a blame game, making it difficult to identify and assign/apportion the root cause(s) of the problem(s) – as a ventilator malfunction, a ventilator usage error, (e.g. inappropriate mode selection, or parameter(s) setting), ventilation management strategy(e.g. improper weaning protocol strategy over time) etc., or perhaps even an innate unfavorable outcome/prognosis for the patient. The intricate interdependencies of physical parameters of patient and ventilator individual functioning and their functioning as a combined system makes troubleshooting ventilator/ventilation problems even more problematic for the BMET.
The following approach shall help untangle the complex and complicated whorled web of perspectives and knowledge base of a patient-ventilator system
1. The Gas Laws applied in Breathing
2. The Fundamental Physics of Flow of Compressible Fluids
3. Ventilation Parameters of the Patient
4. Ventilator Parameter Settings
5. Interrelationships between Parameters in a Patient-Ventilator System
6. Common Patient Ventilation Problems
7. Common Ventilator and Its Application Problems