This how-to video will show you how to monitor your patients during ventilation with the Hamilton T1. In this module, you'll learn about the numerical and graphical parameters available on the Hamilton T1 and how to select the information you want to display. You should be able to complete this whole module in less than 10 minutes.
During active ventilation, You can see all the available patient data. The biggest part of the display is dedicated to patient monitoring. In the center, you can see two primary graphic areas.
One is reserved for the pressure-time waveform and is always displayed. Right underneath that, there's another part that you can customize to suit yourself. You can select what you would like to be displayed, whether it's other waveforms, loops, trends, or even intelligent graphic panels. On the left, you can see some numerical patient data.
These are the four main monitoring parameters, also known as MMPs. Just above the main monitoring parameters, you'll find the ventilation mode currently selected, as well as the chosen patient group and gender. To access all other monitoring data, including CO2 and SBO2 values, if enabled, open the monitoring window. Now let's have a look in more detail at how to access patient data and configure the screen layout on your Hamilton T1. As already mentioned, the four numerical parameters shown on the left side are the main monitoring parameters.
For each of these parameters, you can see the current value, the name, and the unit. Any of the monitored parameters can be displayed here. You can choose which ones to display, and the order they should appear in. The parameters shown here, peak pressure, expiratory minute volume, tidal volume, and total respiratory rate are our factory defaults. Normally, these numerical parameters are white, but if they are affected by an alarm condition, their color will change.
For a medium priority alarm, you see the parameter displayed in yellow, and for a high priority alarm, it is displayed in red. When the alarm resets, the corresponding MMP turns white again. The pressure-time waveform is always shown, which means you can't configure this area of the main display.
This waveform plots pressure against time and also shows some additional information. The red line represents the high pressure alarm limit, while the blue one corresponds to the maximum safe pressure we can apply, or P limit. This is always 10 centimeters of water below the set high pressure alarm limit. You can change the time scale in the waveform window. Just touch the waveform and select the time scale you want to use.
If needed, you can freeze the graphic and scroll through the points to look at them more closely. The pink triangles below the pressure time waveform tell you that the breath is patient triggered. If the CO2 and SpO2 sensors are enabled, you can even display three additional waveforms. To display an additional waveform, just touch anywhere in the graphic area, then touch the waveforms tab, and choose the parameter you want to plot against time. Alternatively, you can select one of the other available tabs, Trends, Loop, or intelligent graphic panels.
Each of these offers a different view of the data. Sometimes it's more useful to plot one variable against another one as an XY or a loop display. To display loops, touch anywhere in the graphic area. Then touch the loops tab and select one of the parameter combinations available.
The pressure volume loop is displayed with volume as a function of pressure. The red and blue lines have the same meaning as on the pressure. For time waveform, the red line represents the high pressure alarm limit, while the blue one corresponds to the maximum safe pressure we can apply.
The slope of this loop is the respiratory system compliance. With each loop displayed, you'll see some additional information, like the current values for resistance and compliance, and the time constant. If you need to store the current loop curve, just touch the loop reference button and the current loop will be saved along with the current date and time. You can see both loops, the current and the past one, displayed together so you can analyze them. To make it easier to interpret all the different information, we've combined the clinically relevant patient data in dynamic representations to display one of these intelligent panels.
Touch anywhere in the graphic area, then touch the graphics tab and select the panel you want to see. With just one quick look at the dynamic lung panel, you'll get an idea, in real time, about the title volume delivered, the respiratory system compliance, the airway resistance, and patient triggering. Instead of having the different pieces of information presented separately, You can see it all combined in one moving lung graphic. The lungs expand and contract in time with the patient's actual breaths.
And when all the values are in a normal range, the panel will be framed in green. You can also use the vent status panel to see how dependent the patient is on the ventilator. Six parameters relating to oxygenation, CO2 elimination, and the patient's breathing activity are displayed next to one another.
Each parameter has a floating indicator that moves up and down as the value for that parameter changes. Both panels are available in all ventilation modes. If you select the ASV mode, there's another intelligent panel you can display, the ASV graph. Touch the graphic area of the display, then touch the graphics tab and select the ASV graph.
The ASV graph shows you the patient's current minute ventilation target, together with the target and real-time values for tidal volume and frequency. You can see how the adaptive lung controller moves towards its desired targets. The graph also has a red safety frame.
showing the limits within which the target point should move. This panel includes real-time values for the applied pressure and the total and spontaneous respiratory rates. From the time you switched on the ventilator, all the monitored parameters are being stored in its memory.
So, if you want to analyze any of this data at a later stage, you can use trend graphs. To display trends, touch anywhere in the graphic area, touch the Trends tab, and select the parameter, or a combination of parameters you would like to analyze. Then, select the desired trend time, and confirm it. You can analyze a specific point or points on a trend waveform using the Freeze, and Cursor Measurement function. The Time axis shows you the elapsed time relative to the present and the corresponding value of the parameter you've selected.
To access all the monitoring parameters, touch the Monitoring window. To access different windows, touch 2 and 3. Each window displays a different set of parameters. The Hamilton T1 automatically measures resistance, compliance, and auto-peep using a statistical technique called the Least Squares Fitting, or LSF method.
This method can be used in all modes without interrupting ventilation because it doesn't require special inspiratory flow patterns or occlusion maneuvers. The LSF method works well if the patient is partly or fully relaxed. If you've enabled the optional CO2 and SpO2 sensors, additional tabs will give you direct access to all related parameters. Now you know which monitored patient parameters are available on your ventilator and how to access them.
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