Guidelines for Puritan Bennett 980 Ventilator

Hello, I am Staff Sergeant Mitchell. I'm a Restorative Therapist at Long Beach Children's Medical Center. In this video I'm going to be showing you how to properly set up, perform the short self-test, and initiate ventilation on a patient using the Puritan Bennett 980 Ventilator. The things you'll need to grab in order to do this is the RT380 package. It comes with the dual heated inspiratory and expiratory limbs, a humidifier canister, and an inspiratory filter. You'll also need to grab the Puritan Bennett 980 specific. Expiratory filter, as well as your heater humidifier cables, which I have here. So to start things off, make sure that you have the power cable, the air source, and the oxygen source properly plugged in so you can do your SST after completing the setup. I start with the expiratory filter. Take the export filter with the filter portion side up. You'll see the pull to open the door by pressing the little blue tab. The door opens and you can press it and set it inside of the toilet. Just like that. Close the door, lock it, and you'll feel it's snug and in place when you have it corrected. Next grab your humidifier canister. On the actual heater, there's a blue tab that you can press down and slide it in. Here it's snapped, and it's in place correctly. The IV line for the sterile water, when it's new, it'll have a plastic holder that you can keep it in for storage. This is a training aid that we've used many times, so I can use it like this. Next, take your inspiratory filter. It has a thick side and a thin side on the end. The thick side goes towards the actual ventilator, right here on the introductory side. Take your short piece of tubing. Remember, blue is for inspiration. It doesn't matter which side of the humidifier you attach it to. Take your actual circuit itself and place it against the inventory. circuit side onto the humidifier and the expiratory attach it to the filter on the other side. You should be wearing gloves when you're doing this. Except, well, I'm not. I'm just in a training simulation room. Your next step is to take your humidifier cables. Start with the blue. See that's the blue side, it's color coded. There is a single prong and a dual prong. And the dual prong has a small triangular wedge that fits very specifically into the inspiratory side next to the humidifier. You plug these in. The blue port is on the bottom of the heater on the right hand side. To show you, wipe these down with alcohol before you put them into the actual circuit. But the hole for it has a small wedge taken out of it. That is where you place this in. Directly as so. Press it down. and you'll actually see it correctly. Take the single prong end and put it towards the end of your side. There's a hole specifically for it. Just press it in. You're good to go. Take your other cable, it should be color coded yellow. It has a sort of a clover, a tri-prong, like a dual prong end to it. On the right hand side of the heater, yellow, it's plugged into the top. Again, it's color coded. The triple or a tri-poker connector next to the end of the inspiratory circuit next to the heater. And the dual portion gets connected to the end of the expiratory circuit, which is the expiratory filter. And that is it. That is how you properly set up a circuit for the PB980. So now we're going to go into how to perform the short self-test. In order to do that, the very first thing I should stress to you is that you take the little blue cap off of the circuit itself. If you leave that on there and you start the... The ventilator will sense back pressure on the circuit and it will immediately try to start ventilating. It feels as if there's a patient connected to it. So when you have it all set up and complete, under the blue flap in the front is the power button. Press that on and you will have to wait for it to load. Bring the camera closer. So it'll bring up this screen. It'll say new patient, same patient, and SST. You'll want to choose the SST option. You'll have to choose run all SST. We always set these up for adults because we only have these vents for the ICU for adults up in the ICU. It's a heated expert for a tube. You can set it up for HME, but you'll have to have a dry circuit and HME attached. We don't change the humidification volume because it's already preset for the humidifier that comes in this package. It'll ask you initially to connect circuit with inspiratory filter and without the humidifier. In order to do this, you're simply going to bypass the humidifier with your circuit. Disconnect it from the inspiratory limb and take this off of the humidifier and connect it to the inspiratory side just like that. Press accept on the screen and it will begin its first test. It will ask you to block the Y. So take the little blue cap and put it back onto the end of the circuit. Press accept and wait for it to finish running its test. I'm going to ask you to put the communifier back into the circuit, so put it into its previous configuration before you started the SST. Let's accept Linda. So as you can see we've reconnected the humidifier and it has failed its leak test. If this happens one of the first... places you'll want to look is actually on the humidifier itself and it comes with the small cable that you put into your IV bag for your sterile water. Oftentimes what will happen is this will leak air so if you pinch it off and restart or repeat the test If it does, then you have a leak somewhere else in your system, but more often than not, this is where you'll find it. It's going to ask you to disconnect at the expiratory filter. It's disconnected from there. Press Accept. Reconnect it at the circuit for the expiratory filter. Press Accept again. Unblock the Y as it says there in the instructions. So take the little blue cap off of the end of the circuit and press accept. It's going to measure the circuit resistance. Reblock the Y with the blue cap. Press accept. And if you aren't pinching off the IV line, you should be now because it's going to do the certain compliance test next. So if you're not pinching it off, you'll most likely fail. In this portion of the option, if you were putting it in storage and not initiating ventilation, you would press cancel because you won't have any water in the humidifier, which is what it's asking here. If you are doing this right before putting it on a patient and you have already... Spike your IV bag, then go ahead and press accept. I'm going to press cancel because there is no water in the humidifier this morning. Unblock the Y, press reset. We have passed. If you see the green letters up here, it's passed the SST portion. So if you were going to put it in storage, you can go ahead and turn it off, replace the blue cap, put a bag over it, and put it in the storage area. It's very important that you remember that you turn it off first before you replace the blue cap, or it's going to immediately go into ventilation mode, as I stated before. Zoom in. So if you know that you're going to have a patient coming in, we try to get the ventilator set up prior to them actually showing up at the hospital or coming out of the OR or wherever it is that they're coming from. So after you've done your SST, one of the first things you want to do if you know you're going to put it on a patient is to attach an aerogen. It's kind of a general rule here that we have. You can set it up in one of two ways. You can put it... In between the Y and the inspiratory circuit, so if you break this circuit right here, you can place your aerogen between these two. Like so. I do not prefer to do it this way because aerogen nips usually take about 15 to 30 minutes and a lot can happen in 15 to 30 minutes while you're gone. And often times it'll tilt over or the nurse will move the patient and they don't realize what's going on and all the medication won't get nebulized or it will just sit in the cup. My preferred method, which they've done multiple tests on and it works just as well both ways, is if you unhook the wet side of the inspiratory circuit, you can actually place it. Over the humidifier and reattach your inventory circuit as so. Now, this way your medication cup will always remain upright and you won't have to worry about any of the medications spilling out. What are the next things that you're going to want to do? It's set up your suction catheter and your end tidal CO2 monitor. At Launch Tool we require in a standard operating procedure to always have an end tidal CO2 monitor on every patient that is on a vent. So this is the end tidal CO2 sensor and we'll go over later in another video how to use end tidal CO2 monitoring. But this will go between the Y and the suction catheter because you don't want to pass a suction catheter. in between the two, in between the sensor. So it'll go just like that. I'm sorry. Other way. Attach it just like that. And this will attach to your wife, as such. Okay? If you know enough about your patient, you can go ahead and set up your settings now. I'm going to move down here a little closer so this is clear to see. Okay. So you can see the options are for new patient, same patient, and SST. We've already performed the SST, so we're going to go directly into a new patient. It'll ask you initially if you know the predicted or ideal body weight, and if you're a male or female, because this vet will automatically put them at 6 mLs per kilogram from whatever it is that you set. We don't generally do that here at Launch Tool. We like to have a little bit more control, and a lot of times... we end up just mirroring the settings from what it is that they came in on. So I'll just either choose male or female and it'll bring up the rest of your settings that you can choose. We're going to choose an invasive mode obviously because it's an ET2. Assist control, volume control with a flow trigger. We'll go over the rest of the modes, but the 980 has S, I, and B, spontaneous and bi-level. For both volume control, pressure control, and VC plus. We'll go over that later. To change any of these settings, you just click on it and use the rotator knob, which is down below the screen. I'll zoom out so you can see it right here. And then... Instead of start, it'll say accept. Right now it's just start because we haven't actually initiated ventilation yet. And then you choose whatever setting. Usually you keep the flow at 60 liters a minute because the patient's here most comfortable at least in that setting. Free for the flow sensitivity is a good setting for most people. Your oxygen percentage, usually you either mirror it off of the ventilator that they came in on, the transport vent. Or if you don't know, just start them at 100% normally and wean them down. You don't want to go below 30% because 30% is the therapeutic level. Once you have all your settings set up, you can go to apnea parameters and you can set up your apnea parameters. We always choose ACVC for apnea unless it's imperative that they're on a pressure control mode. And then we mirror the settings that we set earlier. For alarms... Set your peak pressures, your frequency total, and then you'll go 10% above and below for the rest of your settings based on what it is measuring when you actually attach the patient. So once you're done with all that, you can press start. And it won't actually start ventilation until it senses it is attached to a patient. The way it does that is it will sense back pressure on the circuit. And when it senses back pressure, it will begin ventilation, which is why it's important that you don't put the blue cap on unless you're actually ready to start ventilation, because that's back pressure on the surgeon. So when you do actually receive your patient, the first thing that I like to do is secure the... ET2, especially since there's going to be an extra set of hands in the room that help you. They'll be bagging the patient most likely if they're coming from the OR. If they're on a transport vent, then you'll easily be able to do this while they're on a transport vent and then switch to the motor gear vent after. I like to do this when I have an extra set of hands, though, because it frees me up to manipulate the patient's head and get this around. So if you have not seen a Hollister, that is what we use at Longstool in order to secure an ET2 to a patient. The way it works is this portion will go above their upper lip. This will attach their cheeks. There's adhesive on the back side of these brown pads. And then this Velcro strap goes around the back of their head through the loop, and then you attach it down. To attach the ET tube, The ET2 will run along the bottom side of this. You'll wrap the strap around the ET2 inside of the holder and then you'll clip this down over the top of it. You'll see better when I actually show you that with patience. So let me move this and zoom in. Okay, so we have a mannequin here. It already has an 8.0 ET2 placed. So the first thing you want to do is line up this over there, the upper lip. We'll have these adhesive backers right here that you'll already have the tape peeled off, which you'll be able to stick to their face. It sticks fairly well as long as they're shaven, and it only lasts probably a day, and then it starts sliding around. For now it's good to hold it there. And then you can bring the strap around the back of their head and through the loop on the other side and secure it with Velcro. The holster is secured to the patient with an ET tube. You can see that very well. The ET tube will actually be pretty much lined up, centered around underneath that holster area that I was showing you before. So you can wrap the strap around the ET tube. The isoprofile holder will actually here snap down when you press that down. So now the ET tube is secured. And your next step is to place a bite block. Every patient that has an ET tube at law school will get a bite block, regardless if they have teeth or not. I like to have an extra set of hands in here when I do this because of how thin the channel is in the bite block itself that you have to force the ET tube through. So you're going to be manipulating the ET tube somewhat roughly in order to make this work. You'll grab the ET tube and you'll press the channel against it and kind of press it onto the ET tube and it will work itself over. Make sure when you place the bike block that it's actually between their teeth. A lot of times they'll see either in front or behind their teeth and that doesn't do any good. And then also ensure that the pilot tube is also inside of the bike block. If they bite down and the pilot tube is... Between the teeth and the bite block, chances are they'll bite through it and then your ET tube will be rendered useless at one point. Unless you have a pilot to repair kit, which we don't have here at Monster right now. The next part is to zip tie it down. I like to zip tie it down over the exact same area as the strap for the Hollister. This way it keeps it from sliding down the ET tube. A lot of times I've had issues with our previous bite blocks in that when they're on ventilation for an extended period of time, The mucus and saliva will make the ET tube slick and it will slide down towards the back of the throat. And an unattended nurse or an RT might miss it and might end up down further than you would. So just attach it up there next to the Hollister and that way it won't slide down. So this is how you attach the ET tube to the Hollister. It will be coming out of your patient's mouth at around this point. The Hollister will attach to the patient's cheeks and this will strap around the back of their head. Put that there and you're going to wrap the tape that's already here around the ET tube. And get it as tight as you can. There's a clip right here, you press down and you'll hear it snap. It's nice and secure on to the patient. Your next step, a lot of people tend to miss, is to actually check the pressure in the cuff. We all have to have a manometer, which we have on every single one of our beds in the hospital. Make sure it is in a safe zone for the patient. I just put it at 25 centimeters of water. You're now ready to connect the patient to the circuit. You already have your entitled CO2 monitor, your suction catheter, and your aerogen attached to your circuit. Once you attach it on this mannequin, this is a very expensive mannequin, it will actually breathe and simulate everything, but I'll have a computer to turn it on. So when you do attach it to an actual person or if the mannequin is turned on properly, it will immediately start ventilation for you. It will initiate ventilation because it will sense the back pressure and know that there's a patient there. It's not doing that right now because there is... there's not a back pressure inside of it. The other thing I wanted to show you, if you are using a dry circuit with an HME, you can't use an aerogen because the HME will collect up the nebulized particles. So what a lot of people don't know is that you can take this port off right here. There's a small hole. So if you take the canister out of an MDI, there will be a small tube that comes out of it that you can place right in there. You can actually deliver an MDI to your patient. I'm sorry, that hole is on the orange tip that's in the suction cap. So in order to start ventilation, you'll have to, for the mannequin since there is no back pressure, it'll be sitting there on its screen waiting for you to initiate ventilation. All you have to do is press confirm and it will immediately initiate the settings that you have set inside the ventilator. I'm not going to press confirm because it's either going to alarm and make a bunch of noise or not. That is it. That is how you initiate ventilation on a patient. Using this ventilator. In other videos we'll show you how to manage the patient, troubleshoot how to use different modes in the Bennett 980, but for now this is just the basic how to get them on a ventilator when they come to the hospital. So thank you for watching.

The things you'll need to grab in order to do this is the RT380 package. It comes with the dual heated inspiratory and expiratory limbs, a humidifier canister, and an inspiratory filter. You'll also need to grab the Puritan Bennett 980 specific.

Expiratory filter, as well as your heater humidifier cables, which I have here. So to start things off, make sure that you have the power cable, the air source, and the oxygen source properly plugged in so you can do your SST after completing the setup. I start with the expiratory filter.

Take the export filter with the filter portion side up. You'll see the pull to open the door by pressing the little blue tab. The door opens and you can press it and set it inside of the toilet. Just like that.

Close the door, lock it, and you'll feel it's snug and in place when you have it corrected. Next grab your humidifier canister. On the actual heater, there's a blue tab that you can press down and slide it in.

Here it's snapped, and it's in place correctly. The IV line for the sterile water, when it's new, it'll have a plastic holder that you can keep it in for storage. This is a training aid that we've used many times, so I can use it like this.

Next, take your inspiratory filter. It has a thick side and a thin side on the end. The thick side goes towards the actual ventilator, right here on the introductory side. Take your short piece of tubing. Remember, blue is for inspiration.

It doesn't matter which side of the humidifier you attach it to. Take your actual circuit itself and place it against the inventory. circuit side onto the humidifier and the expiratory attach it to the filter on the other side.

You should be wearing gloves when you're doing this. Except, well, I'm not. I'm just in a training simulation room.

Your next step is to take your humidifier cables. Start with the blue. See that's the blue side, it's color coded. There is a single prong and a dual prong.

And the dual prong has a small triangular wedge that fits very specifically into the inspiratory side next to the humidifier. You plug these in. The blue port is on the bottom of the heater on the right hand side. To show you, wipe these down with alcohol before you put them into the actual circuit.

But the hole for it has a small wedge taken out of it. That is where you place this in. Directly as so. Press it down. and you'll actually see it correctly.

Take the single prong end and put it towards the end of your side. There's a hole specifically for it. Just press it in. You're good to go.

Take your other cable, it should be color coded yellow. It has a sort of a clover, a tri-prong, like a dual prong end to it. On the right hand side of the heater, yellow, it's plugged into the top.

Again, it's color coded. The triple or a tri-poker connector next to the end of the inspiratory circuit next to the heater. And the dual portion gets connected to the end of the expiratory circuit, which is the expiratory filter.

And that is it. That is how you properly set up a circuit for the PB980. So now we're going to go into how to perform the short self-test.

In order to do that, the very first thing I should stress to you is that you take the little blue cap off of the circuit itself. If you leave that on there and you start the... The ventilator will sense back pressure on the circuit and it will immediately try to start ventilating. It feels as if there's a patient connected to it.

So when you have it all set up and complete, under the blue flap in the front is the power button. Press that on and you will have to wait for it to load. Bring the camera closer. So it'll bring up this screen. It'll say new patient, same patient, and SST.

You'll want to choose the SST option. You'll have to choose run all SST. We always set these up for adults because we only have these vents for the ICU for adults up in the ICU. It's a heated expert for a tube. You can set it up for HME, but you'll have to have a dry circuit and HME attached.

We don't change the humidification volume because it's already preset for the humidifier that comes in this package. It'll ask you initially to connect circuit with inspiratory filter and without the humidifier. In order to do this, you're simply going to bypass the humidifier with your circuit. Disconnect it from the inspiratory limb and take this off of the humidifier and connect it to the inspiratory side just like that. Press accept on the screen and it will begin its first test.

It will ask you to block the Y. So take the little blue cap and put it back onto the end of the circuit. Press accept and wait for it to finish running its test. I'm going to ask you to put the communifier back into the circuit, so put it into its previous configuration before you started the SST.

Let's accept Linda. So as you can see we've reconnected the humidifier and it has failed its leak test. If this happens one of the first... places you'll want to look is actually on the humidifier itself and it comes with the small cable that you put into your IV bag for your sterile water. Oftentimes what will happen is this will leak air so if you pinch it off and restart or repeat the test If it does, then you have a leak somewhere else in your system, but more often than not, this is where you'll find it.

It's going to ask you to disconnect at the expiratory filter. It's disconnected from there. Press Accept.

Reconnect it at the circuit for the expiratory filter. Press Accept again. Unblock the Y as it says there in the instructions.

So take the little blue cap off of the end of the circuit and press accept. It's going to measure the circuit resistance. Reblock the Y with the blue cap.

Press accept. And if you aren't pinching off the IV line, you should be now because it's going to do the certain compliance test next. So if you're not pinching it off, you'll most likely fail. In this portion of the option, if you were putting it in storage and not initiating ventilation, you would press cancel because you won't have any water in the humidifier, which is what it's asking here.

If you are doing this right before putting it on a patient and you have already... Spike your IV bag, then go ahead and press accept. I'm going to press cancel because there is no water in the humidifier this morning.

Unblock the Y, press reset. We have passed. If you see the green letters up here, it's passed the SST portion.

So if you were going to put it in storage, you can go ahead and turn it off, replace the blue cap, put a bag over it, and put it in the storage area. It's very important that you remember that you turn it off first before you replace the blue cap, or it's going to immediately go into ventilation mode, as I stated before. Zoom in. So if you know that you're going to have a patient coming in, we try to get the ventilator set up prior to them actually showing up at the hospital or coming out of the OR or wherever it is that they're coming from. So after you've done your SST, one of the first things you want to do if you know you're going to put it on a patient is to attach an aerogen.

It's kind of a general rule here that we have. You can set it up in one of two ways. You can put it...

In between the Y and the inspiratory circuit, so if you break this circuit right here, you can place your aerogen between these two. Like so. I do not prefer to do it this way because aerogen nips usually take about 15 to 30 minutes and a lot can happen in 15 to 30 minutes while you're gone. And often times it'll tilt over or the nurse will move the patient and they don't realize what's going on and all the medication won't get nebulized or it will just sit in the cup.

My preferred method, which they've done multiple tests on and it works just as well both ways, is if you unhook the wet side of the inspiratory circuit, you can actually place it. Over the humidifier and reattach your inventory circuit as so. Now, this way your medication cup will always remain upright and you won't have to worry about any of the medications spilling out.

What are the next things that you're going to want to do? It's set up your suction catheter and your end tidal CO2 monitor. At Launch Tool we require in a standard operating procedure to always have an end tidal CO2 monitor on every patient that is on a vent.

So this is the end tidal CO2 sensor and we'll go over later in another video how to use end tidal CO2 monitoring. But this will go between the Y and the suction catheter because you don't want to pass a suction catheter. in between the two, in between the sensor.

So it'll go just like that. I'm sorry. Other way.

Attach it just like that. And this will attach to your wife, as such. Okay?

If you know enough about your patient, you can go ahead and set up your settings now. I'm going to move down here a little closer so this is clear to see. Okay.

So you can see the options are for new patient, same patient, and SST. We've already performed the SST, so we're going to go directly into a new patient. It'll ask you initially if you know the predicted or ideal body weight, and if you're a male or female, because this vet will automatically put them at 6 mLs per kilogram from whatever it is that you set.

We don't generally do that here at Launch Tool. We like to have a little bit more control, and a lot of times... we end up just mirroring the settings from what it is that they came in on.

So I'll just either choose male or female and it'll bring up the rest of your settings that you can choose. We're going to choose an invasive mode obviously because it's an ET2. Assist control, volume control with a flow trigger.

We'll go over the rest of the modes, but the 980 has S, I, and B, spontaneous and bi-level. For both volume control, pressure control, and VC plus. We'll go over that later. To change any of these settings, you just click on it and use the rotator knob, which is down below the screen.

I'll zoom out so you can see it right here. And then... Instead of start, it'll say accept.

Right now it's just start because we haven't actually initiated ventilation yet. And then you choose whatever setting. Usually you keep the flow at 60 liters a minute because the patient's here most comfortable at least in that setting.

Free for the flow sensitivity is a good setting for most people. Your oxygen percentage, usually you either mirror it off of the ventilator that they came in on, the transport vent. Or if you don't know, just start them at 100% normally and wean them down.

You don't want to go below 30% because 30% is the therapeutic level. Once you have all your settings set up, you can go to apnea parameters and you can set up your apnea parameters. We always choose ACVC for apnea unless it's imperative that they're on a pressure control mode.

And then we mirror the settings that we set earlier. For alarms... Set your peak pressures, your frequency total, and then you'll go 10% above and below for the rest of your settings based on what it is measuring when you actually attach the patient.

So once you're done with all that, you can press start. And it won't actually start ventilation until it senses it is attached to a patient. The way it does that is it will sense back pressure on the circuit.

And when it senses back pressure, it will begin ventilation, which is why it's important that you don't put the blue cap on unless you're actually ready to start ventilation, because that's back pressure on the surgeon. So when you do actually receive your patient, the first thing that I like to do is secure the... ET2, especially since there's going to be an extra set of hands in the room that help you.

They'll be bagging the patient most likely if they're coming from the OR. If they're on a transport vent, then you'll easily be able to do this while they're on a transport vent and then switch to the motor gear vent after. I like to do this when I have an extra set of hands, though, because it frees me up to manipulate the patient's head and get this around.

So if you have not seen a Hollister, that is what we use at Longstool in order to secure an ET2 to a patient. The way it works is this portion will go above their upper lip. This will attach their cheeks.

There's adhesive on the back side of these brown pads. And then this Velcro strap goes around the back of their head through the loop, and then you attach it down. To attach the ET tube, The ET2 will run along the bottom side of this. You'll wrap the strap around the ET2 inside of the holder and then you'll clip this down over the top of it. You'll see better when I actually show you that with patience.

So let me move this and zoom in. Okay, so we have a mannequin here. It already has an 8.0 ET2 placed.

So the first thing you want to do is line up this over there, the upper lip. We'll have these adhesive backers right here that you'll already have the tape peeled off, which you'll be able to stick to their face. It sticks fairly well as long as they're shaven, and it only lasts probably a day, and then it starts sliding around. For now it's good to hold it there. And then you can bring the strap around the back of their head and through the loop on the other side and secure it with Velcro.

The holster is secured to the patient with an ET tube. You can see that very well. The ET tube will actually be pretty much lined up, centered around underneath that holster area that I was showing you before.

So you can wrap the strap around the ET tube. The isoprofile holder will actually here snap down when you press that down. So now the ET tube is secured. And your next step is to place a bite block.

Every patient that has an ET tube at law school will get a bite block, regardless if they have teeth or not. I like to have an extra set of hands in here when I do this because of how thin the channel is in the bite block itself that you have to force the ET tube through. So you're going to be manipulating the ET tube somewhat roughly in order to make this work. You'll grab the ET tube and you'll press the channel against it and kind of press it onto the ET tube and it will work itself over.

Make sure when you place the bike block that it's actually between their teeth. A lot of times they'll see either in front or behind their teeth and that doesn't do any good. And then also ensure that the pilot tube is also inside of the bike block. If they bite down and the pilot tube is...

Between the teeth and the bite block, chances are they'll bite through it and then your ET tube will be rendered useless at one point. Unless you have a pilot to repair kit, which we don't have here at Monster right now. The next part is to zip tie it down.

I like to zip tie it down over the exact same area as the strap for the Hollister. This way it keeps it from sliding down the ET tube. A lot of times I've had issues with our previous bite blocks in that when they're on ventilation for an extended period of time, The mucus and saliva will make the ET tube slick and it will slide down towards the back of the throat. And an unattended nurse or an RT might miss it and might end up down further than you would.

So just attach it up there next to the Hollister and that way it won't slide down. So this is how you attach the ET tube to the Hollister. It will be coming out of your patient's mouth at around this point. The Hollister will attach to the patient's cheeks and this will strap around the back of their head.

Put that there and you're going to wrap the tape that's already here around the ET tube. And get it as tight as you can. There's a clip right here, you press down and you'll hear it snap. It's nice and secure on to the patient. Your next step, a lot of people tend to miss, is to actually check the pressure in the cuff.

We all have to have a manometer, which we have on every single one of our beds in the hospital. Make sure it is in a safe zone for the patient. I just put it at 25 centimeters of water. You're now ready to connect the patient to the circuit. You already have your entitled CO2 monitor, your suction catheter, and your aerogen attached to your circuit.

Once you attach it on this mannequin, this is a very expensive mannequin, it will actually breathe and simulate everything, but I'll have a computer to turn it on. So when you do attach it to an actual person or if the mannequin is turned on properly, it will immediately start ventilation for you. It will initiate ventilation because it will sense the back pressure and know that there's a patient there. It's not doing that right now because there is...

there's not a back pressure inside of it. The other thing I wanted to show you, if you are using a dry circuit with an HME, you can't use an aerogen because the HME will collect up the nebulized particles. So what a lot of people don't know is that you can take this port off right here. There's a small hole.

So if you take the canister out of an MDI, there will be a small tube that comes out of it that you can place right in there. You can actually deliver an MDI to your patient. I'm sorry, that hole is on the orange tip that's in the suction cap.

So in order to start ventilation, you'll have to, for the mannequin since there is no back pressure, it'll be sitting there on its screen waiting for you to initiate ventilation. All you have to do is press confirm and it will immediately initiate the settings that you have set inside the ventilator. I'm not going to press confirm because it's either going to alarm and make a bunch of noise or not.

That is it. That is how you initiate ventilation on a patient. Using this ventilator. In other videos we'll show you how to manage the patient, troubleshoot how to use different modes in the Bennett 980, but for now this is just the basic how to get them on a ventilator when they come to the hospital. So thank you for watching.

Transcript for:Guidelines for Puritan Bennett 980 Ventilator

Transcript for:
Guidelines for Puritan Bennett 980 Ventilator