Pneupac transport ventilator parapac manual

Failure to check equipment is a common factor in a large proportion of critical incidents. Two thirds of all claims involving equipment misuse resulted directly (in fact, almost exclusively) from the actions of the primary anesthesia care provider.Д¬auses of or contributors to ABS problems include wear and tear, damaged components, improper or infrequent maintenance, improper assembly, carelessness, and failure to check the anesthesia workstation before use. In the ASA closed claims analysis, equipment misuse was three times more common than equipment failure (75% versus 24%). In that report, the total number of incidents related to the ABS was 282 (14.1%). The Australian survey of critical incidents revealed similar results: ABS circuit disconnection (6%), partial failureto ventilate or a circuit leak (5.2%), and unidirectional valve malfunction (3%). In Cooper's report, critical incidents related to the ABS accounted for 10% of all incidents. ABS control errors most often involved maladjustment of the airway pressure limiting (APL) valve this is especially true on older machines, where the APL valve had to be shut off when the ventilator was turned on. In the seminal report by Cooper and colleagues, the following ABS-related incidents ranked high on the list of critical problems: ABS circuit disconnection during mechanical ventilation (5.2%), ABS circuit leak (1.7%), ABS circuit misconnection (1.7%), and ABS control errors (1.4%). This may be more evident in patients with decreased blood volume or impaired cardiac function. Rapidly rising airway pressure quickly impedes venous return, which reduces stroke volume and arterial pressure, even in healthy patients. The state of anesthesia decreases protective cardiovascular reflexes and contributes to cardiovascular compromise during positive-pressure ventilation. Patients with lung disease, especially those with emphysematous bullae, are especially susceptible to injury produced by increased airway pressure (barotrauma).

High tidal volumes, high respiratory rates, and fresh gas flows increase this risk, especially in small patients. Ramachandran Satya-Krishna, in Complications in Anesthesia (Second Edition), 2007 Risk AssessmentДЄll patients having general anesthesia are at risk for ABS-related complications.

27-4), and therefore the work of breathing, is reduced. By applying external PEEP at a level similar to that of the generated auto-PEEP, the inspiratory threshold load (see Fig. 22 Patients with increased airways resistance whose ventilators are set to an inadequate expiratory time may trap gas and generate auto-PEEP. High levels of PEEP (15 to 20 cm H 2O) may be required in patients with acute respiratory distress syndrome (ARDS). 20,21 A low level of PEEP (5 cm H 2O) should be applied to all patients who are invasively ventilated. This improves oxygenation, increases lung compliance, and reduces the risk of developing ventilator-induced lung injury. PEEP reduces extravascular lung water, prevents the opening and closing of small airways, and helps to recruit collapsed alveoli. It is applied by placing a pressure-limiting valve on the expiratory limb of the ventilator circuit. PEEP is positive pressure within the alveoli at endexpiration.

David Buckley, Michael Gillham, in Cardiothoracic Critical Care, 2007 Positive End-Expiratory Pressure

Pneupac transport ventilator parapac manual