The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts


ASSESSING RN AND RCP INITIATION AND USE OF AN UNFAMILIAR VENTILATOR FOR POSSIBLE EMERGENCY SURGE CAPACITY USE

F. M. Freihaut1, M. J. Luethge1


Background: Hospitals and Emergency Management Agencies are planning to handle surge capacity incidents. We were asked to help evaluate a ventilator that a local government agency might purchase to utilize in mass casualty situations. A surge capacity incident would not only require extra ventilators but extra care providers. A shortage of RCPs may necessitate the use of nurses to initially help cover a surge of ventilator patients. Care providers may have difficulty with an unfamiliar ventilator.

Method: For ease of set-up we observed participants initiate ventilation on a mock patient. For ease of use we had the ventilator running on a test lung and asked the participants to tell us the parameters that were in use.
Participants were a random selection of RCPs and critical care RNs in our teaching hospital. No participants had experience with the ventilator, Versamed iVent 201, prior to our observation.

Results: Listed in table below.

Conclusion: All participants were able to initiate ventilation but the RCPs were quicker than the RNs. The RCPs seldom utilized the manual or built in tutorials. The limited use of the built in tutorial may have been due to the difficulty in accessing this function. RNs and RCPs utilized a similar average Vt but this may have been a factor of the default settings on the ventilator. Both RCPs and RNs participating were able to assess the parameters in use but a clear difference was observed in pressure support use and alarm functions. The observation that few participants took the opportunity to utilize the ventilator manual emphisizes the importance of an easy to operate ventilator. The inability of participants to correctly assess the alarm settings may be due to the location of the alarm controls on the ventilator. These results also highlight the importance of training care providers on the equipment they will be using. Conducting these observations on a larger number of participants is needed to confirm these findings.

Results:
EASE of SET-UP
Title Number Average years experience Attach Circuit Set Parameters Average Vt utilized Utilized Manual or Tutorial
RN 6 15.8 2.2 minutes 10.2 minutes 608 ml 50%
RCP 9 8.9 1.7 minutes 3.4 minutes 589 ml 22%
EASE of USE, (Percent that assessed correct parameters)
Title Number Average years experience Mode Rate Vt PIP PEEP PS Disconnect Alarm High PIP Alarm Low Vol. alarm
RN 8 10 100% 100% 88% 100% 100% 13% 25% 50% 13%
RCP 6 17 100% 100% 100% 100% 100% 100% 83% 67% 67%



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ASSESSING RN AND RCP INITIATION AND USE OF AN UNFAMILIAR VENTILATOR FOR POSSIBLE EMERGENCY SURGE CAPACITY USE