Yodog, I personally do not view automode as a mode by itself on the Servoi. All it does is switch from PC-PS or PRVC-VS or VC-VS and back so it is not really a mode but an addition to the mode. I feel it sad if the staff at your hospital can not realize this fact. Now I know the Servoi will make the patient re-earn the right to go back to the spontaneous mode choice in automode, but all it really does is switch back and forth between a control mode and a spontaneous one, not much education needed there.
As far as PRVC vs VC and different waveforms in each for head patients, why not do the simple thing and just switch to PC. Now we can set the pressure we want the lungs to be exposed to and let the patient breath what ever they want. This is what we do for our patients that breath this way, which we have quite a few due to us being a level1 trauma facility.
I do have to disagree with you on your ranking of vents (only my opinion) The Servoi and DragerXL, or E4 are the top two vent on the market for ability, versatility and design of APRV. That is the only thing I knock the 840 for other than the fact their ATC is a mode by itself and can not be added to anyother. The 840 in my mind is a very close 3rd to the other but a long ways away from the rest of the pack behind them. Just responding to your comments, I do not want to change this to my vent is better than yours post, we have that in another section.
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Posts: 104 | Location: Springfield, MO | Registered: March 08, 2004
I know what you mean about whether Automode is really a mode or not. Current ventilator manufacturers have added so many systems that augment basic modes. For lack of a better word, like with ATC and other modifiers, are they modes?
As for the use of PC for the heads (we're also a level 1 trauma center) the attendings here pretty much stick with AC or PRVC as their primary mode. Getting them to use PC seems to be like pulling teeth from a chicken. The favored tactic with the tachypneac patients is more sedation.
I'm also not into the mine is better than your's thing but find healthy debate good for making you see other sides of the coin. I worked with the 840 for over 4 years and found myself able to tweak it to make most of my patients comfortable. As I said earlier, I think each therapist has the obligation to know the equipment they use and be able to apply it for the patient's benefit. So, like you, it was just my rating based on my experience. Thanks for your thoughts.
Cumbersome? the 840? Those are two words that I never thought would go together. I purchased the Evita XL to add to my current 840 fleet and it was a nightmare from a training standpoint. The therapists complained about the Evita and the vents now sit in the back of the equipment room.
The Ventilator market is filled with excellent products and Evita 4, PB 840 and Servo I are just a few of them. Unfortunately in most cases it's the end-user and not the Ventilator that is lacking in the end. The reality is that most hospitals still use SIMV-VC as their primary mode for ventilation and weaning. It's like debating the best Laptop on the market when most are using it to check their emails. Of course you don't want to choose a lemon but I'm convinced that choosing one high-end ventilator over another high-end ventilor is not going to improve patient outcomes. Knowing your ventilator inside and out, using all of its features and knowing its limitations will serve your patients better. Lets be honest, no one is going to come out and say that Ventilator A has better outcomes then Ventilator B. A lot of great ideas and information gets debated on this site but I think we can do without the yearly " My ventilator is better then your ventilator discussion"
well written fztella! If I may add, I think it's also important that you get the post sale support you and your staff deserve from whichever manufacturer you decide to choose
I posted this on another topic, but our facility is getting to begin and eval next month. I am curious to know which ventilator company offers the best support post sale and how and what do they provide after the sale is made?
