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Effective: Summer 2015

Prerequisites: Prerequisites: RSPT 50C and 51C.
Grade Type: Letter Grade Only
Not Repeatable.
FHGE: Non-GE Transferable: CSU
3 hours lecture, 3 hours laboratory. (72 hours total per quarter)

Student Learning Outcomes -
  • Apply the principles of oxygen delivery and arterial blood gas analysis to patient case scenarios to determine appropriate ventilator therapy.
  • Identifies ventilator waveforms and suggests ventilator setting modifications.
Description -
Develops and enhances the concepts and skills essential to meet the needs of patients placed on invasive and non-invasive ventilation. Overview of modes of ventilation, humidification and medication delivery. Includes laboratory exercises of commonly used ventilators and patient-ventilator simulations. For continuing education purposes, new ventilators and state-of-the-art theories on ventilation will be presented based upon current research. Intended for students in the Respiratory Therapy Program; enrollment is limited to students accepted in the program.

Course Objectives -
The student will be able to:
  1. Apply the principles of oxygen delivery and arterial blood gas analysis to patient case scenarios to determine appropriate ventilator therapy.
  2. Set up a mechanical ventilator (PB 7200, PB 840, Servo i, Pulmonetics LTV1200 and Drager XL).
  3. Check ventilator settings on a mechanical ventilator.
  4. Suggest changes in ventilator parameters based on patient data.
  5. Recognize ventilator malfunction given patient simulations.
  6. Change ventilator circuits.
  7. Explain when to use the various modes of ventilation.
  8. Perform calculations, i.e. Raw, Cst, Ti, I:E, Flow, Vt, ventilator settings.
  9. Compare and contrast Pressure Control and Volume Control Ventilation.
  10. Identify ventilator waveforms and suggest ventilator setting modifications.
  11. Identify capnographic waveforms and suggest appropriate treatment.
  12. Using spontaneous breathing trials, recommend weaning techniques.
  13. Suggest ventilator settings to decrease work of breathing.
Special Facilities and/or Equipment -
Calculator, watch with second hand, scissors. Ventilators; compressed gas source. PC computer and projection monitor.

Course Content (Body of knowledge) -
  1. Recommend initial ventilator settings
    1. FiO2
    2. Mode
    3. Tidal Volume
    4. Rate
    5. I Time
    6. Peep
    7. Pressure support
    8. Flow
    9. Back up Apnea parameters
  2. Correctly set up and initiate mechanical ventilators
    1. PB7200
    2. PB840
    3. Servo i
    4. Drager XL
    5. Pulmonetics LTV1200
  3. Perform a routine ventilator system check
    1. Record
      1. Mode
      2. FiO2
      3. Tidal volume set and spontaneous
      4. Set and total rate
      5. Minute volume
      6. Peak Inspiratory Pressure
      7. Plateau pressure
      8. Mean airway pressure
      9. Peep
      10. Pressure support
      11. Flow
      12. I time
      13. I:E ratio
      14. Mechanics
      15. Alarm settings
      16. Back up apnea parameters
      17. humidification
  4. Suggest changes based on:
    1. ABG results
    2. Waveforms
    3. Mechanics
    4. Patient dyssynchrony
    5. Parameter changes
  5. Troubleshoot ventilator
    1. Leak recognition
    2. kinked tubing
    3. Disconnection
  6. Change ventilator circuits
    1. 2 person method
    2. Criteria for changing circuit
  7. Modes of ventilation
    1. Weaning modes
    2. Volume modes
    3. Pressure control modes
    4. APRV
    5. HFOV
    6. IRV
  8. Calculations
    1. Cs
    2. I:E ratio
    3. Raw
  9. Compare and contrast between:
    1. Pressure control
    2. Assist control
    3. SIMV
  10. Waveform interpretation
    1. Scalars
    2. Loops
  11. Capnography
    1. Waveforms
    2. Troubleshooting
  12. Spontaneous weaning trials
    1. RSBI
    2. MIF/VC
    3. PF ratio
    4. T-piece trials
  13. Adjustments to decreas WOB
    1. Sensitivity
    2. Ramp
    3. Flow adjustments
    4. Mode changes
    5. ATC
Methods of Evaluation -
Methods of evaluation may include the following:
  1. Exams.
  2. Laboratory Competency Check-offs.
  3. Comprehensive Final Exam.
  4. Laboratory Final Exam.
Representative Text(s) -
Wilkins, Stoller, Kacmarek. Egan's Fundamentals of Respiratory Care.9th ed., Mosby. 2009. 9780323036573
Pilbeam, Cairo. Mechanical Ventilation: Physiology and Clinical Application, 4th ed., Mosby. 2006 ISBN: 9780323032360

Disciplines -
Respiratory Therapy
Method of Instruction -
  1. Lecture presentations and classroom discussion on the topic of mechanical ventilation.
  2. In class demonstration and practical application of the different modes of ventilation.
Lab Content -
  1. Ventilator set up
    1. Initial settings
    2. Completion of a ventilator check
  2. Management of ventilator settings
    1. Troubleshooting according to different patient scenarios
  3. Set: Alarms and Sensitivity accordingly
Types and/or Examples of Required Reading, Writing and Outside of Class Assignments -
Reading assignments in the required texts.