BXBX NOVEL Chapter 1182: 【1182】It is very important to do your homework
First explain what is invasive and what is non-invasive. The difference lies in one word, trauma. Invasive and non-invasive ventilators correspond to invasive mechanical ventilation and non-invasive mechanical ventilation, respectively.
Mechanical ventilation, simply put, refers to the connection between the machine and the patient. Invasive, it is to connect the ventilator in the case of intubation of the patient. Non-invasive, it is to connect the ventilator and the patient in a harmless way such as a mask.
Non-invasive ventilation, which is broadly defined, not only refers to the use of ventilators, but also includes diaphragm pacing. The latter are rarely used clinically and are hard to see. There is always only one reason for the technology that is rarely used clinically, and the cost and effect of treatment are not matched.
Non-invasive ventilator can be used more in respiratory medicine. For the same reason, the cost is less, and patients are more affordable than invasive ventilation, and the effect is good. Early administration of non-invasive ventilation can reduce the possibility of further deterioration of the disease to the need for invasive ventilation.
Invasive ventilator can also be used for non-invasive ventilation. So in icu, you can see that some patients may need non-invasive ventilation after extubation, and use invasive ventilator directly. Anyway, there are many ventilators like icu. However, it is impossible for a non-invasive ventilator to become invasive ventilation. Because non-invasive ventilators are cheap, indicators such as compressor power are destined to fall far short of the requirements of invasive ventilation.
The ventilator is precious, especially if it is invasive, and must be managed by a dedicated person, usually a designated nurse. It is also a nurse who usually performs maintenance and management such as disinfection of the ventilator.
Nurses can adjust some simple parameters through ventilator training, but it is only doctors who can adjust ventilator parameters for critically ill patients, because only doctors can understand the patient's monitoring indicators.
How to adjust the parameters of the ventilator can be said to be the skill of professional doctors who study human respiration.
I had time this morning, and the enthusiastic teacher Xin Yanjun stood next to the ventilator and gave a lecture to the new students: "Do you know what we adjust the ventilator parameters according to?"
"The most commonly used and most useful monitoring indicator should be the patient's blood gas analysis." Xie Wanying said.
Hearing her answer quickly, Xin Yanjun was stunned, she didn't expect her to say so accurately. Ventilator management has always been the focus of internal medicine. It is not easy for a surgical student to come to the department of respiratory medicine on the first day to learn and answer this question.
Xie Wanying's answer does not seem to be purely from books, but has some clinical experience. Xin Yanjun wondered if she had learned relevant knowledge clinically.
Teacher Xin's suspicion is right, Xie Wanying is not easy to confess, she is reborn. I used to work in the laboratory department, and it was most common for icu to perform blood gas analysis on ventilator patients every three days, or even in the middle of the night. With the work experience she has accumulated over the years, it is entirely possible that she understands the monitoring indicators of ventilators better than general physicians.
The work of the laboratory should be connected with the clinical work, and the content of these work will follow the clinical study and research.
"The mode of the ventilator seems to be many, but the principle of the ventilator is like this. At the beginning, there is no sensor, and the machine directly fills the patient's airway. With the sensor, the machine can sense the patient's breathing and adjust accordingly. Make the breathing situation of the machine and the patient more coordinated. The adjustment can be controlled by the computer of the machine, or it can be operated by the medical staff. In this principle, there are various computer modes."
(end of this chapter)