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Henry GibbsBill Clinton
Hawkeye PerceBJ HoneycuttMike Smith
Steve HawkingConrad Black
Henry GibbsBill Clinton
Hawkeye PerceBJ HoneycuttMike Smith
Steve HawkingConrad Black
Jane SmithJane Smith
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Students work independently but areAllowed to consult with each other.
This same context asIn the clinical area.
Screen Layout
RR RR Set TVSet TV
pH
PCO2
PO2
HCO3
SaO2
Blood Gas
Ventilator Settings
Mode FiO2
Patient Responses
RR TVE MVE
Help
ActivateChanges
Timer
PEEP 5PEEP 5
This is an example of one screenLayout that the students can choose
This layout mimics layout of The Puritan Bennett 840.
Students have the option of choosingLayouts for Seimens 300C and the
Evita version 5 mechanicalVentilators.
These are currently the most commonlyUsed ventilators in practice.
Description of screen elementspH
PCO2
PO2
HCO3
SaO2
Blood Gas
Ventilator Settings
Mode
Set RRSet TV
FiO2
Patient Responses
RR TVE MVE
Help
ActivateChanges
Timer
This Section of the screen hasThe results of a blood gas. The student will have to interpret the blood gas before making any changes on the mechanical ventilation settings
RRRRSet TVSet TV
pH
PCO2
PO2
HCO3
SaO2
Blood Gas
Ventilator Settings
Mode FiO2
Patient Responses
RR TVE MVE
Help
ActivateChanges
Timer
This section has the changes the studentCan make to the mechanical ventilatorSettings. They are a simulation of the Buttons on a Puritan-Bennett 840A.
PEEP 5PEEP 5
Set TVSet TV
pH
PCO2
PO2
HCO3
SaO2
Blood Gas
Ventilator Settings
Mode
Set TV
FiO2
Patient Responses
RR TVE MVE
Help
ActivateChanges
Timer
Patients do respond to mechanical ventilation.In this box is how the patient is responding.
For instance if the student sets the respiratoryRate at 10, it is conceivable the patient could
Breathe above this set rate. The student will have to take into considerationThe patient’s efforts to breathe when making
Changes.
PEEP 5PEEP 5
RRRRSet TVSet TV
pH
PCO2
PO2
HCO3
SaO2
Blood Gas
Ventilator Settings
Mode FiO2
Patient Responses
RR TVE MVE
Help
ActivateChanges
Timer
Once the student has decided on whatChanges to make, they click on
This button to activate the changes theyHave selected. This mimics closely
What occurs in the clinical area.
PEEP 5PEEP 5
pH
PCO2
PO2
HCO3
SaO2
Blood Gas
Ventilator Settings
Mode
Set RRSet TV
FiO2
Patient Responses
RR TVE MVE
Help
ActivateChanges
Timer
Once the student has activated their changeA timer will count down from 20 seconds.
Most health care facilities will checkA blood gas result 20 minutes after a Ventilator change. For this simulation
1sec = 1 minute.The student will slowly see the blood gas
Change as time ticks down.This way they will know they are on the
Right track or not.
PEEP 5PEEP 5
pH
PCO2
PO2
HCO3
SaO2
Blood Gas
Ventilator Settings
Mode
Set RRSet TV
FiO2
Patient Responses
RR TVE MVE
Help
ActivateChanges
Timer
At any time the student can push theHelp button for assistance
The help button will flash to indicateThat it has something to contribute
Concerning the changes to ventilation.
PEEP 5PEEP 5
Example of setting changes using Rate change
pH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode A/C
Set RR 10Set TV 250cc
FiO2 .45
Patient Responses
RR 10 TVE 240 MVE 2.5 L/m
Help
ActivateChanges
Timer
PEEP 5PEEP 5
Student resetting ratepH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode A/C
Set RR 10
FiO2 .45
Set TV 250cc
Patient Responses
RR 10 TVE 240 MVE 2.5 L/m
Help
ActivateChanges
Timer
16151413121110
Student is changing set respiratory rate
PEEP 5PEEP 5
Timer activated after changepH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode A/C
Set RR 16Set TV 250cc
FiO2 .45
Patient Responses
RR 16 TVE 240 MVE 4.0 L/m
Help
ActivateChanges
19 sec
Student has activated the changesAnd the timer has started the count down
PEEP 5PEEP 5
10 secs after changes.pH 7.32
PCO2 50
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode A/C
Set RR 16Set TV 250cc
FiO2 .45
Patient Responses
RR 16 TVE 340 MVE 4.0 L/m
Help
ActivateChanges
10 secs
10 secs have passed since change, some changes Are apparent on the blood gas
PEEP 5PEEP 5
Congratulations; can you solve it another way
pH 7.38
PCO2 41
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode A/C
Set RR 16Set TV 250cc
FiO2 .45
Patient Responses
RR 16 TVE 240 MVE 4.0 L/m
Help
ActivateChanges
00 secs
Excellent. You have correctlyResolved the respiratory Acidosis by adjusting the
Respiratory rate.Can you think of another way
To solve the acidosis? Let’s go back to the start
and See if you can solve it withoutAdjusting the rate.
I am here if you need help. Just click on “Help”.
PEEP 5PEEP 5
Re-setting TVpH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Mode A/C
Ventilator Settings
Set RR 10Set TV 250cc
FiO2 .45
Patient Responses
RR 10 TVE 240 MVE 2.5 L/m
Help
ActivateChanges
Timer
Returned to the same situation
350325300275250
Student has determined they can change TV
PEEP 5PEEP 5
Changes activatedpH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode A/C
Set RR 10Set TV 350cc
FiO2 .45
Patient Responses
RR 10 TVE 340 MVE 4.0 L/m
Help
ActivateChanges
19 sec
Student has activated the changesAnd the timer has started the count down
PEEP 5PEEP 5
10 secs after changes.pH 7.32
PCO2 50
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode A/C
Set RR 10Set TV 350cc
FiO2 .45
Patient Responses
RR 10 TVE 340 MVE 4.0 L/m
Help
ActivateChanges
10 secs
10 secs have passed since change, some changes Are apparent on the blood gas
PEEP 5PEEP 5
Congratulations; solved both ways
pH 7.38
PCO2 41
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode A/C
Set RR 16Set TV 250cc
FiO2 .45
Patient Responses
RR 16 TVE 240 MVE 4.0 L/m
Help
ActivateChanges
00 secs
Excellent. You have correctlyResolved the respiratory Acidosis by adjusting the
Respiratory rate and TV.By adjusting the rate and/ or TV you can blow
Off CO2.Knowing this what settings would you manipulate
For respiratory alkalosis??
PEEP 5PEEP 5
Example of setting changes using mode change(PC)
pH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode PC
Set RR 10Set Pressure 22
FiO2 .45
Patient Responses
RR 10 TVE 240 MVE 2.5 L/m
Help
ActivateChanges
Timer
Note same blood gas but different Ventilator settings
PEEP 5PEEP 5
Student resetting ratepH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode PC
Set RR 10
FiO2 .45
Set Pressure 22
Patient Responses
RR 10 TVE 240 MVE 2.5 L/m
Help
ActivateChanges
Timer
16151413121110
Student is changing set respiratory rate
PEEP 5PEEP 5
Timer activated after changepH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode PC
Set RR 16Set Pressure 22
FiO2 .45
Patient Responses
RR 16 TVE 240 MVE 4.0 L/m
Help
ActivateChanges
19 sec
Student has activated the changesAnd the timer has started the count down
PEEP 5PEEP 5
10 seconds after changespH 7.32
PCO2 50
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode PC
Set RR 16Set Pressure 22
FiO2 .45
Patient Responses
RR 16 TVE 240 MVE 4.0 L/m
Help
ActivateChanges
10 secs
10 secs have passed since change, some changes Are apparent on the blood gas
PEEP 5PEEP 5
Congratulations; can you solve it another way
pH 7.38
PCO2 41
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode A/C
Set RR 16Set TV 250cc
FiO2 .45
Patient Responses
RR 16 TVE 240 MVE 4.0 L/m
Help
ActivateChanges
00 secs
Excellent. You have correctlyResolved the respiratory Acidosis by adjusting the
Respiratory rate.Can you think of another way
To solve the acidosis? Let’s go back to the start
and See if you can solve it withoutAdjusting the rate.
I am here if you need help. Just click on “Help”.
PEEP 5PEEP 5
Adjusting set pressurepH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Mode PC
Ventilator Settings
Set RR 10Set Pressure 22
FiO2 .45
Patient Responses
RR 10 TVE 240 MVE 2.5 L/m
Help
ActivateChanges
Timer
Returned to the same situation
282624222018
Student has determined they can set pressureAs this will change TV
PEEP 5PEEP 5
Timer activated after changepH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode PC
Set RR 10Set Pressure 28
FiO2 .45
Patient Responses
RR 10 TVE 405 MVE 4.0 L/m
Help
ActivateChanges
19 sec
Student has activated the changesAnd the timer has started the count down
PEEP 5PEEP 5
10 seconds after changespH 7.32
PCO2 50
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode PC
Set RR 10Set Pressure 28
FiO2 .45
Patient Responses
RR 10 TVE 405 MVE 4.0 L/m
Help
ActivateChanges
10 secs
10 secs have passed since change, some changes Are apparent on the blood gas
PEEP 5PEEP 5
Congratulations; can you solve it another way
pH 7.38
PCO2 41
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode A/C
Set RR 10Set Pressure 28
FiO2 .45
Patient Responses
RR 16 TVE 240 MVE 4.0 L/m
Help
ActivateChanges
00 secs
Excellent. You have correctlyResolved the respiratory Acidosis by adjusting the
Set pressure.To resolve respiratory acidosis in PC ventilation
Adjusting either the rate or the set pressureAllows for more CO2 to be blown off.
PEEP 5PEEP 5
Example of choosing the wrong settings
10 10
.45.45PCPC
pH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode
Set RRSet Pressure 22
FiO2
Patient Responses
RR TVE MVE
Help
ActivateChanges
Timer
PEEP 5PEEP 5
Student selecting PEEP- wrong choice
pH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode PC
Set RR 10Set Pressure 22
FiO2 .45
Patient Responses
RR 10 TVE 240 MVE 2.5 L/m
Help
ActivateChanges
Timer
PEEP 5PEEP 5
98765
Student is changing the PEEP in this caseWhich is not the correct choice
Timer activated after changepH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode PC
Set RR 10Set Pressure 28
FiO2 .45
Patient Responses
RR 10 TVE 405 MVE 4.0 L/m
Help
ActivateChanges
19 sec
Student has activated the changesAnd the timer has started the count down
PEEP 10PEEP 10
No change after PEEP adjustedpH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode PC
Set RR 10Set Pressure 28
FiO2 .45
Patient Responses
RR 10 TVE 405 MVE 4.0 L/m
Help
ActivateChanges
0 sec
Student has activated the changes, time hasExpired and no changes have occurred to
Blood gas. Help button flashes indicating the tutor can help
PEEP 10PEEP 10
Tutor gives first level of advicepH 7.12
PCO2 75
PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode PC
Set RR 10Set Pressure 28
FiO2 .45
Patient Responses
RR 10 TVE 405 MVE 4.0 L/m
Help
ActivateChanges
0 sec
The change you have selected will not work.Look again at the blood gas and determine
the correct interpretation
PEEP 10PEEP 10
Tutor gives second level of advice
pH 7.12
PCO2 75PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode PC
Set RR 10Set Pressure 28
FiO2 .45
Patient Responses
RR 10 TVE 405 MVE 4.0 L/m
Help
ActivateChanges
0 sec
The change you have selected will not work.The blood gas is a respiratory acidosis indicating
Inadequate ventilation
PEEP 10PEEP 10
Tutor gives Third level of advicepH 7.12
PCO2 75PO2 89
HCO3 24
SaO2 92%
Blood Gas
Ventilator Settings
Mode PC
Set RR 10Set Pressure 28
FiO2 .45
Patient Responses
RR 10 TVE 405 MVE 4.0 L/m
Help
ActivateChanges
0 sec
The change you have selected will not work.The blood gas is a respiratory acidosis indicating
Inadequate ventilation. You need to make changesTo either the rate or the set pressure.
PEEP 10PEEP 10