We have a lot of patients transported to our long term care facility by ACLS amubulance. In the past they would just use an ambu for our ventilator patients. Now however they are using small transport vents. I'm not sure of their competency in this. Last month they brought a patient in who had 6ft of deadspace tubing on his circuit, when I asked them why the deadspace their answer was "Whats deadspace"? Do paramedics get any training on vents and has anybody else had similar problems?
Do they? That is a good question. I had a paramedic pick up a ARDS patient for transport out and back for a procedure recently. The individual was cocky while demonstrating a serious lack of basic knowledge. The ECG and pulse ox and that intrinsic to the vent were all that was used to monitor the adequacy of breath delivery. It must be safe, the patient returned alive, but I was nervous the whole time they were out. It seems wrong, and I feel your pain. I think this will be a trend for adult ground transports, it is in my area of the country, unless some really serious events occur or settlements have to be paid out. It seems only a matter of time considering your 6 ft of dead space issue.
It depends on the area and the Paramedic Coordinator.
I would speak to the PC first and maybe offer to help train the Paramedics, I have done that in the past and it does make a difference.
It's not just a matter of mechanical ventilation either. I've watched more e-cylinders fall unprotected under their utilization. Locally paramedics placed a non-rebreathing mask on a restrained, pronated subject who had just battled 6 policemen and had been tasered multiple times. He was hog tied and pronated to restrain his actions. The mask was placed only to stop him from spitting. Too bad they did not supply any oxygen to the mask. He went into cardio respiratory failure 3 minutes after the mask was put on and ultimately died. These paramedics did not understand deadspace.