We are going to be purchasing new ventilators. It appears that the RCP's at this institution like the Avea. My experience has not been very good with the Avea. We did trial the Avea at another hospital and it shut down. We pushed it aside and had the rep pick it up. Can anybody out there tell me how their experiences with Avea have been?
Hi Jan: I like many things about the Avea. It has a convienient platform, good menus, lots of data, useful for a wide patient population, has neoflow, can do esoph. press. monitoring, P flex, tube comp, fancy shamncy new modes which are ideallic for comfort, can run effectively a heliox system and much more.
It leaves me wanting in a few areas. We had a few issues with flow. Patients on more than one occassion demonstrated a sort of flow starved response. The rise % seemed very ineffective and patients in general seemed to have little difficulty sort of outstripping the particular vent we tried. May have just been the vent havent yet determined that. There is a discussion below on the topic. The graphics are useful especially on P flex but the resolution leaves something to be desired. With all the new modes on the market something like PAV would have been a neat adjunct as well which it lacks. It think with the esophageal pressure monitoring it would be a great area for further developement. I dunno I had a few other thoughts but Im just shooting from the hip so Ill save that for later.
So functionally useful but I am still unsettled with the whole thing based on what I witnessed with regard to patient comfort and safety. It sounds like an isolated site though because I also asked and no one else seemed to have these issues.
Looking at the FDA website, there isn't much in regards to safety alerts. Being a newer vent, it probably had several upgrades by now. It has had some pretty decent pub in the AARC rooms.
Our facility is going to replace our old servo 300's. If you guys had a choice between servo i and the avea which one would you choose? also is the avea flow termination in PRVC similar to what servo i calls auto mode in the prvc mode? what are your experiences using the servo i?
No automode is just a monkey in the vent that changes it from PRVC to VS and back if the patient goes apneic it has nothing to do with termination sensitivity.
As far as pick a vent, I would suggest brining both in and which ever the staff is more comfortable with choose that one. Both are good vents.
I work with the Avea currently. We just brought the i in for a study. I think that the Avea is a lot more user friendly and has many options that the i does not. I think there is a little bit of a safety risk with the i in that the control knobs are an instant change control. More so if the RN's at your facility are able to increase FiO2 for suctioning ect. The FiO2 knob is next to the PEEP, so if someone isn't paying attention and increases the PEEP vs. the FiO2... Also, I like to see what my PS is without having to dig for it. These are just my opinions though.
Intersting comments, but bothersome. What bugs me about the comments is not that you don't find the vent user friendly, but your concern of someone changing peep instead of FIO2. Don't we trust our RN counterparts to administer life saving medications via IV pumps? If they were that inept wouldn't they be making mistakes left and right in that arena as well? EVERY nurse I have worked with, once properly trained, has easily discerned the difference between the FIO2 and Peep knob. I have observed far more errors by lazy RT's when it comes to vent changes and documentation. I would also hope when people are making vent changes that they would 'pay attention'.
Also, what makes turning a knob and it illiciting an instant change unsafe? Let's look at the history before we had the newer generation vents. We had the likes of the MA-1, Bear Cub, Infant Star, Bear 1 and 2, Monahagn, Sv 900 and 300, Bird VIP, 3100A and B to name a few. Many of these vents are still being used in ICU's. All are, turn the knob, the change is made. Nobody complained that it was 'unsafe'. Now all of a sudden it is? If there were countless adverse reactions from this the FDA would disallow it. It's just not the case.
We all have our likes and dislikes about one product or another. Not having PS displayed to your liking may be a valid reason not to choose that particular product. However, I think there is more to consider than something so trivial than that.
In regards to 'safety' we have allowed ourselves to teach to the lowest common denominator. We blame the equipment if something goes wrong when usually it's user error. If a health care professional (RT or RN) cannot figure out how to use the equipment correctly they should go flip burgers.This message has been edited. Last edited by: seatac,
There seems to be an unwaivering passion for the Servo I that gets energized with negative comments about the I. We have used the I for quite some time and not had any issues with the proximity of the PEEP knob to the O2 setting. We press the button for an increased O2 concentration for suctioning on the I and it works very well. The instant change of the buttons is very useful when the is a critical situation and immediate intervention is needed. The idea of a "enter" step slowed us down or sometimes caused confusion for some clinicians. The immediate change selection buttons are covered so this has not been an issue. The biggest concern of the I is the exhalation moisture. The Avea does not solve this because it used a pressure differential pneumotach (I believe) and we have these on our other long term care vents and the Evita.They need more maintenance than the I. Your earlier comment that the Avea has more options is the one to explore. Are these options changing and improving the conditions of your ventilated patients? The process should look for these issues to demonstrate the value of the Respiratory professional. Ease of use is probably not the best issue to stand on. Both ventilators are good tools so your goal should be to make a difference with whatever ventilator you choose.
Fyi, the Avea uses a Hot wire Anemometer pneumotach at the wye for babies.
peds and adults the flow sensor is optional
Recently were getting hard time defending the performance of Avea vs the I. I work with pediatrics and post cardiac surgery peds patients and the physicians prefers the I more than the avea. Many times due to vent shortage, (we got more avea than I) We would recommend avea pointing out its plus points. But as per their observation they would insist on the I. Usual settings for their patients would be PRVC or SimvPRVC+ps. Usually they love looking at the leak% and u know how they hate high digits. Circuit occlusion is frequent too. We would change the exhalation (with Filter)assembly. Another thing that they would insist is the ability of the I:E ratio being constant 1:2 even changing the rate. Lastly, we do have more than 100 aveas and i dont think we purchased the hotwire sensor, would it make the difference?
ric mandanas jr
c/o rt dept.
hamad medical corp.
p.o. box 3050