Chapter 1182 【1182】It Is Important to Do Your Homework Well

The above statement is not very accurate. The reason is that ventilators are divided into invasive and non-invasive. There are not as many invasive ventilators as ICU in other departments. There are not only one or two non-invasive ventilators in respiratory medicine.

First explain what is invasive and what is non-invasive. The difference lies in the word invasive, which is trauma. The invasive and non-invasive ventilators correspond to invasive mechanical ventilation and non-invasive mechanical ventilation respectively.

Mechanical ventilation, simply put, refers to the connection between the machine and the patient. Invasive, is to connect the ventilator while the patient is intubated. Non-invasive, is to connect the ventilator and the patient with a non-harmful method such as a mask.

Broadly defined non-invasive ventilation, not only refers to the use of ventilators, but also diaphragm pacing. The latter are rarely used clinically and are difficult to see. There has always been only one reason for the technology that is rarely used in clinical practice, the cost of treatment does not match the effect.

Non-invasive ventilators can be used more in respiratory medicine. For the same reason, the cost is less. Compared with invasive ventilation, patients can afford it and have good curative effect. Giving non-invasive ventilation very early can reduce the possibility of further deterioration of the condition to require invasive ventilation.

Invasive ventilators can also be used for non-invasive ventilation. So in the ICU, you can see that some patients may need non-invasive ventilation after extubation, and use the invasive ventilator directly. Anyway, there are many ventilators in the ICU. However, it is impossible for a non-invasive ventilator to become an invasive ventilation. Because non-invasive ventilators are cheap, it is doomed that indicators such as compressor power are far from meeting the requirements of invasive ventilation.

Ventilators are precious, especially invasive, and must be managed by a special person, usually a designated nurse. It is also nurses who usually perform maintenance and management such as disinfection of ventilators.

Nurses can adjust some simple parameters after ventilator training, but it is only possible for doctors to adjust ventilator parameters for critically ill patients, because only doctors can understand the monitoring indicators of patients.

How to adjust the parameters of the ventilator can be said to be the skill of professional doctors related to the study of human breathing.

This morning, when I had time, the enthusiastic teacher Xin Yanjun stood next to the ventilator and gave a lecture to the new students: "Do you know what we use to adjust the parameters of the ventilator?"

"The most commonly used and most useful monitoring indicator should be the patient's blood gas analysis." Xie Wanying said.

Hearing her quick answer, Xin Yanjun was stunned for a moment, because she didn't expect her to be so accurate. Ventilator management has always been the focus of internal medicine. It is not easy for a surgical student to come to the department of respiratory medicine on the first day to learn to answer this question.

Xie Wanying's answer didn't seem like she just learned it from books, but she had some clinical experience. Xin Yanjun wondered if she had learned relevant knowledge in clinical practice.

Teacher Xin's suspicion was right, Xie Wanying just couldn't confess, she was born again. I used to work in the laboratory department, and it was common for the ICU to perform blood gas analysis on the ventilator patients every three days, or even do these tests urgently in the middle of the night. With the work experience accumulated over the years, it is entirely possible that she understands the monitoring indicators of ventilators better than ordinary physicians.

The work of the laboratory department must be connected with the clinic, and the content of these tasks will follow the clinical study and research.

"There may seem to be many modes of the ventilator. In fact, the principle of the ventilator is this. At the beginning, there is no sensor, and the machine directly fills the airway of the patient. With the sensor, the machine can sense the patient's breathing situation and make corresponding adjustments. Make the machine and the patient's breathing more coordinated. The adjustment can be controlled by the computer of the machine, or it can be operated by the medical staff. Based on this principle, a variety of computer modes can be distinguished."