STRATEGIC NATIONAL STOCKPILE SNS VENTS

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STRATEGIC NATIONAL STOCKPILE (SNS) VENTS
Lynn Chlebananowski, RCP, RRT, NPS Clinical
Educator, Respiratory Care Childrens Memorial
Hospital
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Advantages

• Portable
• Easy to set up
• Electrical or battery powered
• Can ventilate without high pressure source
• Volume ventilators (but pressure can be limited)

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Battery Life

• LP10 Internal battery 30 min 1 hour
• External approximately 10 hours
• Uni-Vent Compressor use 3 hours
• External gas source 12 hours

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Circuits

• Pediatric (lt50 kg)
• Adult (gt50 kg)

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Settings

• Mode (A/C or SIMV)
• Rate
• Tidal Volume (10 ml/kg)
• Inspiratory Time (typically 0.7 1.0 sec)
• PEEP (typically start at 5cwp)
• Sensitivity (set based on pressure below PEEP)
• Alarms
• No pressure support

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Patient Circuit
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LP-10 Rear Panel
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Oxygen Enrichment
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Oxygen Delivery

• Lower FiO2 can be bled from front of vent
• Higher FiO2 require oxygen enrichment kit and is
  bled in from back.
• Requires external analyzer to measure

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Tidal Volume Considerations

• Set at 10 ml/kg
• Some volume lost to circuit
• Volume measured with spirometer
• Minimum 100 ml
• Can limit using pressure limit control (volume no
  longer guaranteed)
• Peak pressure measured on manometer

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Setting the Pressure Control Limit

• Allows vent to function like a pressure limited,
  time cycled ventilator
• Intended for use with uncuffed airways
• Remove patient from vent
• Occlude Wye
• Turn pressure limit control to the desired
  pressure on manometer.

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PEEP

• Set on external valve
• Turn spring loaded valve to set desired PEEP
• Value seen on manometer

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Lower Front Panel
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Upper Front Panel
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Ventilator circuit set-up

• Connect 22mm corrugated hose to ventilator GAS
  OUT fitting

• Connect green TRANSDUCER HOSE to ventilator
  TRANSDUCER hose barb (Green)

• Connect clear EXHALATION VALVE HOSE to Ventilator
  EXHALATION VALVE hose barb (clear)

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Oxygen Delivery

• Can run off internal compressor for 21
• High pressure air/O2 hose for oxygen delivery
• FiO2 set on control panel
• Measured on screen

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The basics
Select a Mode of operation
Set a Ventilation Rate
Set an Inspiration Time, or IE Ratio default
Set a Tidal Volume
Set an FI02
Set the High and Low Limit Pressure Alarms
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Tidal Volume Considerations

• Set at 10 ml/kg
• Some volume lost to circuit
• Can set lower tidal volumes than the LP10 (as low
  as 10 ml)
• Set/Delivered measured on screen

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PEEP

• Set directly on vent
• Each push of button equals 1 cwp of PEEP

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Additional functions

• External Air

• Sigh

• PEEP

• Pressure Plateau

• Manual Breath/Trigger

• Alarm Mute/Cancel

• Apnea Backup (Automatic)

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The LCD Screen what you can see
ALARM MESSAGE CENTER (AMC) The centralized
location for displaying up to 4 lines of alarm
message information.
MODE and Vmin indicators Displays operating
mode and minute volume (A/C Mode).
Inhalation/Exhalation indicator Alternately
displays the inspiration and exhalation phase of
mechanical and/or spontaneous breaths.
BATTERY and EXTERNAL POWER source
indicators2-line area that displays the current
status of external power, internal power, and
fuses.
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The LCD Screen what you can see
Cont.
Peak Mean inspiratory pressures are displayed
after each breath
The digital bar graph displays peak pressure
during each breath
High and Low Pressure Limit Alarm setting tics
are continuously displayed
6-seconds of pressure wave form data, including
PEEP is displayed
Set and Delivered tidal volume are alternately
displayed
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Assessment

• Chest rise
• Breath sounds
• Respiratory Rate
• Work of Breathing
• Pressures required to deliver volume
• ABG/TCM/SaO2

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Troubleshooting
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High Pressure Alarm

• Look at patient
• Coughing or other high-flow expiratory efforts
• Patients inspiratory resistance or compliance
  changes
• Airway obstruction
• Increased secretions
• Water in tubing
• Crimped tubing
• Malfunction of the exhalation manifold
• A sticky Pressure Limit control
• Pressure limit setting is higher than the High
  Alarm setting

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Low Pressure/Apnea Alarm

• Sounds when 2 breaths do not reach the selected
  limit or if pressure does not return to selected
  limit
• Will continually sound when patient becomes
  disconnected. You must manually reset the low
  pressure alarm by pushing silence button.
• Look at patient
• The patient is not breathing
• Water in small bore tubing or crimped
• The patients breathing effort is less than the
  Breathing Effort control setting.
• Patients speech or other activities lower patient
  airway pressure.
• Low alarm setting is higher than Pressure limit
  setting
• Pressure Limit level is set too low
• Leak or obstructions in the patient circuit.