Summary of Hamilton T1 Ventilator at Westmead ED

Overview

• Purpose: Replacing Oxylogs with Hamilton T1 for transportation from ICU.
• Support: Training and support provided by manufacturer and local resources.
• Key Features:
  • Turbine ventilator (no oxygen supply required for flow).
  • Oxygen supply range: 21-100%.
  • Suitable for neonatal, pediatric, and adult patients.
  • 9-hour battery life.
  • Automated mode with patient-specific lung protective strategy.

Set-Up

• Essential Checks:
  • Calibration adapter (PTO) connected to flow sensor.
  • General circuit check after setup.
• Circuit Setup:
  • Connect expiratory valve and circuit appropriately on the ventilator.
  • Ensure filter placement is considered to avoid excessive dead space, especially in children.

Operation

• Modes:
  • Multiple modes including Adaptive Support Ventilation (ASV), pressure-controlled, volume-controlled, and noninvasive ventilation.
  • Important traditional modes: SIMV+ and S(CMV)+.
• Practical Points:
  • Set patient height for calculating ideal body weight for ventilation settings.
  • Manual adjustment of I/E ratio required if respiratory rate changes.
  • Basic settings for a 70kg male: TV 490mls, RR 12, PEEP 5cmH2O, Fi02 100%, I:E ratio 1:2.

Troubleshooting

• Common Issues:
  • Pressure alarms: Check for agitation or tube obstruction; ensure plateau pressure is <30cmH2O.
  • In emergencies, disconnect and manually ventilate if needed.

Modes of Ventilation

• Adaptive Support Ventilation (ASV): Adjusts based on patient needs.
• Airway Pressure Release Ventilation (APRV): For critical conditions like ARDS.
• Other Modes:
  • APVcmv / (S)CMV+: Volume-targeted mandatory breaths.
  • PCV+: Pressure-controlled mandatory breaths.
  • PSIMV+: Pressure-controlled mandatory with pressure-supported spontaneous breaths.
  • SPONT: Spontaneous breathing with optional pressure support.

Starting Ventilation

• Six Steps to Start:
  1. Quick Setup.
  2. Select gender.
  3. Adjust patient height (calculates IBW).
  4. Modify ventilation mode if necessary.
  5. Review settings.
  6. Start ventilation.

Additional Resources

• Video Tutorials and Simulators:
  • Induction and setup tutorials available online.
  • Online simulator for practice.

These notes summarize the key points for the Hamilton T1 ventilator operation, setup, and troubleshooting at Westmead ED.