So far the best video I have seen for bipap setting 💯👏🏻👏🏻

Hey , You have done a great job. Feel proud. You have cleared my basics and made it easy for me. Thanks

Great, ... Brief but Effective explanation. Thank you

thank you so much! this is i really need right now. so happy that i found your video!!!!

Brilliant simple explanations!!

So glad I found this will spend time on it until I get this, your explanation makes more sense. ❤

This was a great explanation!!!! Thank you

Best video on bipap everrrr thanks

Excellent!!! Now I understand thank you 🙏

I needed this video, thanks

THANK U VERY MUCH!!!! NOW I UNDERSTAND ❤️❤️❤️❤️❤️

thanks so much, very helpful and practical,

Thank you. Perfect explanation. 🙏🙏🙏🙏🙏🙏🙏🙏🙏🙏🙏🙏🙏

Amazing video so easy to learn

Thank u Ma'am, loved the video

Nice explanation. Also make vedios on when to wean off BIPAP .

Very helpful thank you

great teaching👌❤️

Watched first video, and subscribed 👍👍

Thank you so much. This was very helpful! Is it possible for you to do another video like that one but for mechanical ventilator settings and another one for the alarm settings please?

Hello. Great input. Please do a video on setting the other parameters like respiratory rate, modes etc

Excellent 🌹

great explanation

Love it❤️❤️❤️❤️

Nicely explained

Omg! Thank you!! I can never find any intervention with the Bipap.

Thank You!

Good job.

Thanks! This makes it easier. I’m pretty sure I’m going through the same program based on the teachers name and the color of your scrubs

@2ndstartrrt844

Жыл бұрын

Maybe I'll see you at your clinicals at some point!

Thanx a lot

Excellent

Really great video to easily understand changing the pressure. Just a question tho, why the baseline fio2 is 60%? Can we not lower 60% fio2 first ,shall i say to room air or 21% instead of lowering Epap for high O2?

Amazing

Thanks for sharing the information.

Thank you mam

Thanks

Too good

What about the initial settings ? Can you guide how to set the initial settings

Is there a link to lore of these problems? My school barely touched on this and I have check offs Wednesday. I need a cram video please!! Your method is solid! Thank you!!

@2ndstartrrt844

2 жыл бұрын

Unfortunately I don't have any specific problems I can share nor do I know of a place you can find some online. Sorry! I hope you do really well on your check off!

How do I find my pH and O2 readings on my ResMed AirCurve biPAP machine?

@2ndstartrrt844

Ай бұрын

PH and PaO2 are only obtainable by lab results from a blood draw. This video is mostly applicable to making changes in a hospital setting.

Ohke There is a patient with Normal ABG parameters on Bi PAP support On PS 12 PEEP 6 And FiO2 of 80% with RR of 30 /minutes What next ?

thankyou mam,lovely class...i have a small doubt mam..how often should we check abg and change the setting...here in our hospital they change every 24hrs...is there any particular protocol

@2ndstartrrt844

3 жыл бұрын

Really depends on the patient and how they are doing. A patient on continuous bipap will need monitoring much more closely than one who is only on it part of the time. At my facility, they often do ABGs in the morning on most vented or continuous bipap patients and patients who are more unstable will have them done more frequently.

Hi, I don't know much about this, in the Cpap I use 13cmh2o how much would that be in a Bipap, THANK YOU.

@2ndstartrrt844

Жыл бұрын

There isn't an equivalent. Cpap is one continuous pressure that doesn't change. Bipap uses different pressures for inspiration and expiration.

@TriggerFull

Жыл бұрын

@@2ndstartrrt844 ok I understand that, 2 pressures, but if I am going to change to bipap. and in the cpap I used 12cmh2o. in the bipad it would be the two pressures then 12cmh2o / 6cmh2o.

@2ndstartrrt844

Жыл бұрын

@Trigger you could start with that, but you would need to adjust based on the volumes the patient gets with those settings. It's not a straight across correlation. 12/6 is often a good starting point.

@TriggerFull

Жыл бұрын

@@2ndstartrrt844 The Bipap has some function of Auto-adjusting to my way of breathing automatically, every night by itself. Independent of the initial adjustment or programming? And what program or app can I use to get a report of my pressures used every night and apneas if any, in pdf or printed, for my personal use or take it with me when visiting my doctor? since he does not have to read the SD card. THANK YOU SO MUCH FOR YOUR TIME AND HELP, BLESSINGS!!!

@2ndstartrrt844

Жыл бұрын

@TriggerFull some bipap machines have settings that will change based on patient effort, but I don't know if they all do. Your questions would need to be addressed to the company that makes or services your machine. I don't have experience with these machines in a home use setting so I don't know how your doctor would get information about your personal use.

As you mentioned in the rules, when PaO2 is high and FiO2 is equal or less than 60% we need to decrease EPAP by 2. This doesn't sound right to me because decreasing EPAP while IPAP doesn't change leads to increasing PS, thus increasing tidal volume. More oxygen will be available to be absorbed and PaO2 will be higher which we don't want.

@2ndstartrrt844

3 жыл бұрын

You have to take the pressure support number into account as well. If you watch the explanation of the individual problems I go through, it also explains how you deal with changing IPAP to keep or change your PS. Increasing tidal volume can affect oxygenation to some extent but its main impact is on ventilation, not oxygenation. However, you do want to make sure that you are not changing pressure support unless it is needed. This may mean adjusting your IPAP along with EPAP when you are making changes only for oxygenation purposes.

Why in the second example you didn’t change the iPAP? The the CO2 is too high and the problem is ventilation

@2ndstartrrt844

Жыл бұрын

Because we decreased the EPAP to adjust oxygenation, that meant the pressure support was increased (pressure support is the difference between IPAP and EPAP) without needing to increase IPAP. That means the patient will blow off more CO2 despite not changing the IPAP. The change to the EPAP will address both the high O2 and the high CO2 without needing to adjust IPAP in this instance.

How to start bipap ? Ipap and epap setting

@2ndstartrrt844

7 ай бұрын

It depends on the patient and their needs. For an adult, I will often start with ipap of 12, epap of 5 or 6, i-time of 0.9, and fio2 to match whatever they are currently on. Then I watch their tidal volume and adjust as needed.

Lets assume one covid patient, saturation 75 %, respiratory distress, when we go in NIV mode of ventilator, PEEP 5, PSV 9, I:E = 1: 2.5 approx. But his monitored/ delivered parameter in ventilator showing RR greater than 30, and minute ventilation is also very high. How we should manage it, plz guide, madam.

@2ndstartrrt844

3 жыл бұрын

I am not well versed in caring for covid patients. As students, we were not allowed in covid rooms so I have only gotten second-hand information about their care when listening to discussions from other therapists. Unfortunately my lack of experience with these patients means that I do not have any advice to give for this situation. Most of our struggling covid patients end up on PC mode and often get nitric or veletri to try to help since they frequently have very restricted/fibrotic lungs.

I don’t get it

@2ndstartrrt844

3 жыл бұрын

Other programs might have different guidelines about how much to go up and down at a time, but basically, you want to adjust settings based on how your patient is doing. If their CO2 (ventilation) is off, you want to adjust pressure support (the difference between IPAP and EPAP). If their O2 is off, you want to adjust PEEP (EPAP) or FiO2. If both are off, you may need to adjust both pressure support and PEEP or FiO2. IPAP is the amount of pressure the patient gets on inspiration, EPAP is what is delivered on exhalation (which is why it is also referred to as PEEP, positive end-expiratory pressure). If you subtract your EPAP number from your IPAP number, that is your pressure support. To reduce pressure support for a patient that doesn't have enough CO2, you want the difference between IPAP and EPAP to be less. To increase pressure support for a patient with too much CO2, you want to increase the difference between IPAP and EPAP. For oxygenation, can adjust EPAP or FiO2, depending on what the patient is currently getting. EPAP should never go below 4 and it is preferable to keep FiO2 less than 60.

@tobiasa94

3 жыл бұрын

What do you do with respiratory frequency?

@sindhuzsimonz

3 жыл бұрын

@@2ndstartrrt844 could you please mention the normal ABG VALUES

@2ndstartrrt844

3 жыл бұрын

@@tobiasa94 frequency could certainly be adjusted, but remember that these are spontaneously breathing patients. Most people I see on bipap are already breathing over the set rate so changing that rate will not actually change anything for the patient.

@2ndstartrrt844

3 жыл бұрын

@@sindhuzsimonz the basic values you are looking at on an ABG are pH, CO2, and HCO3. The normal ranges for those are: pH 7.35-7.45 CO2 35-45 HCO3 22-26 There are other values reported when doing an ABG but those are the main ones to be concerned with when considering what changes to make on a bipap.

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Thanks 👍🏻👍🏻

Excellent

Excellent