Initial Ventilator Settings | Starting Mechanical Ventilation on a New Patient

What are the best initial ventilator settings? Which ones to use when starting a new patient on mechanical ventilation?
💥Ventilator Settings [Full Guide] ➜ ➜ ➜ https://bit.ly/2KMrNle
💥Initiation of Mechanical Ventilation [Full Guide] ➜ ➜ ➜ https://bit.ly/2yfQtjE

➡️ Initial Ventilator Settings
Once it has been determined that mechanical ventilation is indicated for a patient who needs help with oxygenation and/or ventilation, then you must know how to properly input the initial ventilator settings. Keep in mind that each mechanical ventilator machine is different, so be sure to abide by the guidelines provided by the manufacturer of that machine. However, here are some of the general guidelines that you can use when determining the initial ventilator settings for a new patient.

🟦 Mode
Any operational mode will work when setting up the initial ventilator settings! You should not get too caught up deciding on the right mode, especially for the questions that will be on the TMC Exam. With that said, just as a reminder, you can select A/C if the patient needs full ventilatory support or SIMV if they only need partial support.

🟦 Tidal Volume
The initial tidal volume setting should be 5 – 10 mL/kg of the patient’s ideal body weight (IBW). So if a patient weighs 70 kg, their initial tidal volume setting should be between 350 – 700 mL. Now I realize that many of you guys were probably taught to use 6 – 8 mL/kg as the range for initial tidal volume.

Yes, that one technically is correct as well and it's even more precise. But through my experience, using 5 – 10 mL/kg will still help you come up with the correct answer and it makes the calculation much easier. You can quickly do it in your head. But like I said, it's up to you. Use whichever one you feel more comfortable with.

🟦 Frequency
The initial frequency setting should be 10 – 20 breaths/min.

🟦 FiO2
The initial FiO2 setting should be 30 – 60% unless the patient was previously receiving a higher percentage of oxygen before intubation. If that's the case, then you would simply use that previous FiO2. But in general, you should strive to provide the lowest concentration of oxygen that’s possible to maintain a normal PaO2. An FiO2 up to 100% as an initial setting is appropriate for patients with severe oxygenation issues. But keep in mind that you'll want to try to titrate and wean them down below 60% as soon as possible.

🟦 Flow Rate
The initial flow setting should be 40 – 60 L/min.

🟦I:E Ratio
The initial I:E ratio setting should be between 1:2 – 1:4.

🟦 Sensitivity
The initial sensitivity setting should be between -1 and -2 cmH2O. 

🟦 PEEP
The initial PEEP setting should be set at 4 – 6 cmH2O.

💥Ventilator Settings [Full Guide] ➜ ➜ ➜ https://bit.ly/2KMrNle
💥Initiation of Mechanical Ventilation [Full Guide] ➜ ➜ ➜ https://bit.ly/2yfQtjE

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🚑MEDICAL DISCLAIMER
Medicine and Respiratory Therapy are continuously changing practices. The information in this video is for educational and entertainment purposes only. For medical advice, please consult with a physician or qualified medical professional.

💡AFFILIATE DISCLAIMER
This description contains affiliate links. If you decide to purchase a product through one of them, we receive a small commission at no cost to you.

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⏰TIMESTAMPS
0:00 - Intro
0:06 - Initial Ventilator Settings
0:48 - Mode
1:18 - Tidal Volume
2:06 - Frequency
2:11 - FiO2
2:53 - Flow Rate
2:59 - I:E Ratio
3:04 - Sensitivity
3:12 - PEEP

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#MechanicalVentilation #VentilatorModes #VentilatorSettings