SPAG Delivery through the Ventilator David R Gibson

SPAG Delivery through the Ventilator David R. Gibson 2016

Gather Parts: Non-disposables • Complete SPAG-2 set-up. • 50 PSI O 2 hose • Blender/hoses set -up

Gather Parts: disposables • 3 filters • 4 -22 mm ID (large) adaptors • 2 – Briggs “T” adaptors • One-way valve • Corrugated tubing • PEEP valve & adapter • Scissors

SPAG Set-up The input should come from a blender, and Blender set same as the ventilators FIO 2%. Drying Flow OFF 1. Set up the SPAG as normal See: Power. Point on RTConnection. org explaining how, with the exception that the drying flow should be left OFF. Wall outlets connections

PEEP Relief Valve Set-up 2. Set-up PEEP valve and adapter: - Set PEEP on valve to same level of PEEP on the ventilator - Bacteria filter between briggs “T” and PEEP valve

Vent Circuit Set-up Patient wye 3. “T” into inspiratory limb about a tidal volume length away y e (two 50 cc sections for each 100 cc tidal volume) 4. Use a one-way valve to avoid loss of tidal volume during inspiration. One-way Valve goes m olu gth n Le l. V a id T this direction To SPAG a aw

Other Considerations • Assess for obstruction frequently! – Suction PRN – Watch for sudden high pressure limits – May need to changes expiratory filters • Discard HME during SPAG delivery, and replace afterward.

Expiratory limb Set-up Q 2 ! 4. Place two filters on the expiratory limb. Change Q 2 hours…with each vent check

Summary view