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Home Ventilator Education

An Easy Guide to Understanding Home Ventilator Terminology

Jan 21, 2009 Delphine Cull

Understanding the terminology used for mechanical ventilators can be confusing to people with little or no experience in the medical field.

This confusion can cause anxiety and uncertainty for those who are now faced with caring for a ventilator dependent patient at home. The following definitions are stated in simple, everyday words anyone can understand.

Regardless of the type of ventilator your home care company has provided, certain basic settings are common to all ventilators.

Modes on the Ventilator

A mode determines how the air is delivered to the patient. The physician will order a pressure or volume mode, depending on the needs of the patient.

Pressure Modes: During Pressure Control mode, the ventilator delivers a pre-set amount of pressure with each breath. The lungs expand with this pressure and inspiration occurs. The volume of each breath is determined by how much pressure is set.
Volume Modes: During SIMV or Volume Control, the ventilator delivers a pre-set volume of air with each breath. The lungs expand with this volume and inspiration occurs.
Spontaneous Modes: CPAP and Pressure Support are used to assist the patient who can breathe on her own. CPAP is a continuous airway pressure that holds the airways open and prevents collapse of lung sacs. Pressure support will boost the patient's inspiratory effort with additional pressure, thus increasing the volume received with each breath.
In a pressure mode, the pressure is set and the volume of the breath may vary. In a volume mode, the volume of the breath is set and the pressure may vary.

Respiratory Rate:

The ventilator knows how often to give the patient a breath because of the set respiratory rate. For instance, if the ventilator rate is set at 12 breaths, the patient will receive 12 breaths every 60 seconds, or one breath every five seconds. If the patient is capable of breathing on his own, he can initiate an additional respiration in any mode.

PEEP: Positive End Expiratory Pressure

This is simply a term that means a constant positive pressure is being delivered through the ventilator to the lungs to keep the alveoli (tiny air sacs) from collapsing after the patient exhales. PEEP keeps these air sacs open to increase their surface area, which means more opportunity for oxygen to move into the blood.

Fi02: Fraction of Inspired Oxygen

This term is used to communicate how much oxygen a patient is receiving. Right now, people on Earth are breathing 21% oxygen from the atmosphere. A patient on supplemental oxygen, such as a ventilator patient, may be breathing anywhere from 21% to 100%. If the oxygen a patient is receiving is expressed in a percentage instead of liters per minute, it is called Fi02.

I Time or Inspiratory Time

Imagine the cycle of a normal breath. When you breathe in, it's inspiratory time. When you breathe out, it's expiratory time. Inspiratory time on a ventilator determines how long it will take for the ventilator to deliver the inspiratory part of the breathing cycle.

Apnea and Pressure Alarms

Apnea occurs when a patient stops breathing. The apnea alarm senses respiratory effort, and it will alarm to alert you that the patient has stopped breathing, or the ventilator tubing has become disconnected.

Pressure alarms limit how high the patient's airway pressure can get. This alarm will occur if the patient needs suctioning or is coughing, the tracheostomy is occluded, and so on. An abrupt or steady increase in airway pressure can signify a change in the patient's condition and the physician should be contacted.

For the safety of the patient, never turn off the ventilator alarms.

By understanding basic ventilator terminology, you will be able to communicate more effectively with the physicians and health care professionals. You will also feel more comfortable caring for your loved one at home.

The copyright of the article Home Ventilator Education in General Medicine is owned by Delphine Cull. Permission to republish Home Ventilator Education in print or online must be granted by the author in writing.

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