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VentWorld Manager
Dear VentWorld Community,

I am pleased to announce that big plans are in the works for an infusion of more resources regarding ventilators and ventilation!

This change is the result of new leadership at VentWorld. Within a reasonably short amount of time, Garry Mefford, RRT, will be taking over as the VentWorld director. I've been talking with Gary extensively and he has explained several of the programs he wants to implement in the coming year. It definitely is a win for the ventilation community!

Gary has been a strong advocate of VentWorld since its inception, and he is very knowledgeable about ventilation while retaining a great eagerness to learn and discuss.

I wanted to make this announcement because Gary may be contacting people in the coming weeks as he begins to take over the reins. We will make a formal announcement and press release when everything comes together.

Please join me in wishing Gary great success in helping to make VentWorld all that it can be!

Posts: 34 | Location: Philadelphia, PA | Registered: November 14, 2002Reply With QuoteReport This Post
On Nov. 3 ˜05 Jon Kaye put up a post on the RCP discussion board that he was looking for someone to take over or update the site. The first of December I was accessing the site looking for some vent data I needed and just stopped in on the discussions and saw the post. I was intrigued as I am sure many were. That post has had 87 views by the time of this writing. I pondered for a bit and concluded since the post had been up a month that some lucky individual had already acted and on the offer.

A couple of days later I had the really great fortune of being able to attend the ˜05 AARC Congress in San Antonio. What a powerful experience! If you didn't get there I am sorry. For me the whole thing kicked big time. I always seem to miss some land mark presentation every time I go to one of these, and this year was no difference. One of the biggest challenges for me with all the offerings that are going on at the same time is to pick the presentations that will let me see the individuals and subject matter in which I have an interest while minimizing down time that can't count toward CMEs. This became an almost monumental effort since I would invariably want to visit presentations that were seemingly miles apart while the first one ended at the same time as the next one started. Of course I found I needed to double my caloric intake to maintain my weight under these challenges of miles of ambulation and there are few better places for spiking up your calories than good ole San Antone. Well my first trade off came my first morning. I worked Friday and drove down from Ft. Worth to San Antonio Saturday Morning and wasn't able to get to the Convention Center until after lunch. So I missed the awards ceremonies and the Saturday keynote address by Joe Flower "The End of Healthcare as We Know It". Mr. Flower is a futurist and if what he has to say on his web site is any indication I am sure his presentation was really good.

For my first CEs of the Congress I attended "Open Forum #1-Monitoring" Some cool posters and presentations. Several grabbed my interest, which is usually related primarily to vent management, weaning and airway clearance then broadens widely from there. There was some interesting info about TCO2 monitoring. A couple ofpresenters discussed the new V-Sign probe that collects SpO2 and TCO2 from a small ear probe. David Rowley et al from the University Virginia Health System seem to have found them quite accurate and reliable with good correlation to arterial. Ronald Dolbec representing the group from Spaulding Rehab Hospital discussed using these sensors. They describe using the technology to monitor their patients during bronchs, post vent adjustments and during SBTs. Dolbec presented in discussion that followed that he was seeing the shift in the TCO2 indicating intolerance a significant period of time before the other measurements of vitals and SpO2 shifted giving them advantages such as greater safety, and being able to use the technology to assist in the decision on the best time to end weans. There were some other great presentations at Open Forum #1 including a couple that provided me with a new awareness that some people are way into their stethoscopes.

I will attempt to come back soon as an addition to this thread or in another and cover some more of my experiences at the 51st Congress. BIG kudos to AARC on an awesome 51st Congress. To bring this to the point, the theme there was RTs on a mission. For me this really took. One of the last presenters I was able to see was Richard Manlove from Texas Specialty Hospital in Denton Texas. His topic was "Expanding the Role of RT in LTAC. Currently based at an LTAC myself, I was intrigued by the title. Jon mentioned my having many ideas for VentWorld. One of them is to be able to interview some of the people who intrigue, interest or excite me in our industry/community. I hope some time I can sit down with Mr. Manlove. He lit my candle with this presentation. He used the term "audacious" a couple of dozen times. Opportunities are everywhere for us to expand our roles in every environment we enter. Then my last presentation, which I raced to and caught about 90% of, but couldn't claim for CE's since the end and start times overlapped from Mr. Manlove's, but who cares it was another one that got me charged up. Kenneth Thigpin from St. Dominic Hospital in Jackson MS presented "The Impact of Having the Heart of a Leader". Mr. Thigpin's description of some of the progress he and his department in MS has made was absolutely inspiring. He gives so much credit to his staff. His presentation clearly demonstrates that an engaged RT staff and a responsive manager can effect powerful positive improvements and pull through any difficulty.

I returned from the 51st Congress re-invigorated about my profession. I am pretty upbeat about RT anyway, but my head was spinning. I hope to soon relate to you some of the things that we have implemented at the facility where I am based out of since returning from San Antonio. I am not the director at my hospital, but our director was there, and he came back with the same enthusiasm. It doesn't take long to start seeing the benefit of improvement efforts when you feel you are on a mission.

I came back determined that if Jon still had the opportunity available I would take it on. So I contacted him. To my surprise Jon remembered me. I had done a video several years ago on vent management for HSTN which featured VentWorld. Without much more knowledge of me than that and perhaps my tone of enthusiasm in my communications (that's what happens when you are on a mission), he is allowing me this opportunity. From the bottom of my heart THANKS Jon. Jon Kaye is amazing to me. This site and what he and his colleagues have built here and with Amethyst Research is absolutely amazing to me. Jon is so good at what he does and he is in such demand with Amethyst Research that he was not able to work with this site as much as he would like to. It is obvious when you talk to Jon that he is very fond of what he has built here and he wants it to be vital and to contribute strongly to the knowledge in its area of focus, ventilators. I too am very fond of this site. It has been my favorite site on the WWW ever since I discovered it years ago. I have had a couple of handles on here and have posted only a couple of times, but the discussions that are here I have followed, returning often to see what the group of care givers and interested parties here have had to say. I plan to learn far more from you than I can ever offer. Many excellent and thoughtful posts that when I go back and look through have got me thinking and acting to effect improvements in my practice. There have been so many great contributions, but I want to single one poster out as my favorite. I may not have always had time to read everything, but if Jeff Whitnack had posted I had to read. Jeff please keep giving us the benefit of your wisdom and amazing understanding of how these complex devices impact the results we are all after. You changed my perspective of weaning with your "fledging" concept.

There are many many things I want to bring up and discuss here. I am very excited about where we are at this point in time with vents and ventilation. I am very passionate about the positive effect focused provision of care to ventilator patients can have. These are as a group one of the most expensive patients we care for. Changes that improve the results for this group of patients improve our ability to provide for all patients. The cost of a day in ICU or each day on the vent is off the charts. One of my visions for this site is to continue to provide a forum for exchange of ideas that will result in empowering everyone exposed to the ideas here to effect this positive change globally. Yes globally. This is VentWorld. There have been quite a few international posts here. We have no corner on the market of excellence in vent care here in the US. I have a great deal of respect for my international colleagues and a curiosity about how the tasks I carry out as an RT caring for vent patients are accomplished in other places outside the US. If you are doing something really cool with vents or vent care, where ever you are, let us know about it.

You will find more and more as you get to know me that I have a real soft spot in my heart for the folks attached to the terminal end of the circuit. I have worked with them in every imaginable environment. I have worked adult, neo, some pedi, transport, long term, long term acute, home care, etc as I am sure many of you who have an interest here have. I will make no claims to know all the answers. I do bring a passion and excitement for the subject. There is a real soft spot in my heart for the long–term vent user. The "unweanable" few who have to find some way in a society who doesn't really seem to feel the need to consider the unbelievable challenges these people face. Another of my visions for this site is to assist this group of really inspiring people in more tangible ways than a discussion board dedicated to them. I do invite LT vent patients and their families to continue to come to us for info and assistance. We will do all we can within our limits, but I hope to increase our ability to provide better and better solutions for these folks who are really no different at the heart and mind level than you or I.

As you can see I don't have much to saySmile. I will conclude here by saying "It's not the tool, but the workman that makes the difference." I firmly believe that I can meet the mechanical ventilation needs of around 90% of those needing it with diligence, a Wrights respirometer and a Bird Mk 7, PB MA1, etc., etc. The basic concept is very simple, air goes in, and air goes out. I don't hold with this vent or that vent is better in the majority of situations. Increase your understanding of your equipment until you know it as well as or better than any one that you know and develop your standing with the decision makers until you have the autonomy you will deserve at that point. Then you can make the needed adjustments to fit almost any modern equipment to almost any clinical situation. Don't blame the equipment for your inability to cover the situation as your first response. Are the settings really appropriate to the patient and situation? If you have a vent management protocol then set it up the best for the patient. If you do not, as you increase in your knowledge of technical and clinical aspects of the care you provide as well as develop your standing with those decision makers, you will find you have less and less problems with the brand and model of equipment with which you have been provided. Don't forget to lobby constantly for protocols until you have a good one in place as good effective protocols combined with care givers prepared and willing to use them make more difference than just about anything else with these patients. Heck yes we all have our favorite machines, but don't discard all of the rest. It seems odd to me that even though I am of the opinion expressed above, stating that I can manage with the simplest equipment, that I am a huge fan of "bells and whistles" and "the latest and greatest". I firmly believe that outcomes are improved when our equipment is the best available and precisely suited to its application. I realize also there are snafus and idiosyncrasies with these complex devices and I ask you to come here to find answers and if there are commonalities to what you are finding with your equipment. However, I want this site to be a place where this equipment is one of the main features. When you post regarding specific equipment, please try to do so with respect to the fact that many great minds went into the R&D and development of the clinical application with these devices. If it is just your opinion that one vent or the other just stinks, and you cannot support that opinion with specifics, find another forum for that kind of post.

In the coming weeks I hope to provide more about myself, and my current situation to let this community know where I am coming from, and why. I then hope to describe a vision for VentWorld and bring this community along as I seek to improve the landscape of healthcare in my own small way. VentWorld community, this is your site. Where do you see needs for improvement and updates. Tell us about yourself, where you work and what you are doing that gets you charged up.

Thank you again Jon.

It is really all about the outcomes!
Gary Mefford
Director VentWorld
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VentWorld Director
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Just a quick update on this thread. We have a plan together and are awaiting certain foundational items to be set before we start making any major changes. Thanks to the many posters and viewers who keep VentWorld discussions so vital. Please stay tuned.
Posts: 147 | Location: Buckeye Az | Registered: January 27, 2006Reply With QuoteReport This Post
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