You should have been my instructor, Lord, you are good! I know and I believe I will pass my TMC this time around just watching your videos.

@RespiratoryCoach

4 жыл бұрын

Hey, Hawa. I wish I would've been. Best wishes on your upcoming TMC exam!

You are such unbelievable. Excellent lecture sir. Keep it up , you helped me a lot.

@RespiratoryCoach

4 жыл бұрын

Hello, Amare. Glad the video helped you. I appreciate you watching and kindly commenting.

I’ve been a RT for a little over a year. I always try to keep myself updated and review concepts. Your videos are AWESOME for review!!! Thank you! I just texted my professor and recommended your channel as a resource for students.

This is epic I am just starting out on my pathway in critical care in Ireland and these sessions are epic to understand what's going on miles really supplementing what I have learned so far cheers

This is AWESOME! I love learning about the physiology of my profession. Thank you

@RespiratoryCoach

3 жыл бұрын

Glad you enjoyed it!

Super....just awesome ... I like your confidence ...Sir

You are very great instructor thank you 🙏

you are the best!

Great breakdown!! Thank you for sharing

@RespiratoryCoach

4 жыл бұрын

Hey Jay. Thank you for watching. Let me know what you think of part 3. Just released.

@RespiratoryCoach

4 жыл бұрын

Nevermind...thought this was the PEEP series.

I love your videos, thank you 🙏

@RespiratoryCoach

4 жыл бұрын

I love that you watch and comment. Thank you!!!!

Thank you 🙏🏻🧡🧡

Thank you

Will the end tidal co2 still decrease for a patient in the o.r under general anaesthesia if a PE happens? Thanks in advance, amazing breaking down concepts.

Superb

@RespiratoryCoach

4 жыл бұрын

Thank you, Ishan. I appreciate the kind comment and you watching!

Thank You

@RespiratoryCoach

4 жыл бұрын

No, thank you for watching and commenting!

With low Vt in a PE is it best to increase RR to compensate with the patient like cv-19 pna to prevent barotrauma but still maintain minute volume? I have been it work with this severe pna if we keep the minute volume maintained to life sustaining.

Awesome lecture! Thank you!!!!!

@RespiratoryCoach

2 жыл бұрын

What's up, Carlos! Glad to see you in the comments again. As always, thanks for watching and commenting!!

@greensahuaro2834

2 жыл бұрын

@@RespiratoryCoach you are the Best!

@greensahuaro2834

2 жыл бұрын

@@RespiratoryCoach I recently worked at an acute long termed facility with post covid posted on vents, on HFNCs, and BIPAPS. I feel the approach to ventilate is not to well. I'll explain myself!

@greensahuaro2834

2 жыл бұрын

@@RespiratoryCoach I found pts on BIPAP , rate, O2, full face mask but no humidity, pts on NRM 100% and no humidity. The lungs need humidity to work. So, covid gives stiff lungs with little perfusion, low O2 sats, and people are given 100% , that's toxic, and no humidity washing nitrogen out! Continues BIPAP with or no rate ought to have humidity or the membrane will dry. We need to Invent humidity on a NRM. Humidity is very important! Best regards!

@greensahuaro2834

2 жыл бұрын

@@RespiratoryCoach youshould get an award from the dept of Education, you are an awesome teacher! Kudos a million!

Between 15-16 you mention that exhaled Oxygen dilutes the etCO2 causing the readings to drop. Would there be a similar effect with over oxygenating or refractory hypoxia? I’ve not seen this happen. However if oxygen isn’t passing thru the lungs into the blood causes etCO2 to drop, then every situation that causes excessive exhaled O2 would make the same effect (etCO2 drop), right? Taking away from an acute change. This could also mean a higher gradient could be hyper oxygenating verses increase deadspace? Can you clarify, I might be twisting this up.

Great video! I have a question: Do you think it is a good idea for a new grad (RT student) to start working a full-time RT job and PRN at another hospital fresh out of school? I am thinking about doing this (if possible) because I feel this can help me advance in this field at a faster pace. Please let me know what you think. The hospital I plan to apply PRN at is my externship site & that is what is available at the moment.

@RespiratoryCoach

4 жыл бұрын

You've probably figured this out by now, but I do think the more exposure you can get at various facilities does aid the progression of a new grad. Just be careful not to get focused on doing too much too fast. You'll get burned out and quickly regret your decision. There's a fine line between increased experience leading to progression, and too much experience too fast leading to bad habits and burn out.

Hi, is there a difference between PECO and PETCO? Im not sure where to find PECO. If we know the percentage of the impaired air exchange, can we go higher with our TV, what about for ARDS? sorry too many questions as Im not an Rt. Thanks! Appreciate your teachings, made a huge difference in my practice.

@RespiratoryCoach

4 жыл бұрын

PECO and PETCO are the same. In theory, yes increasing tidal volume would lead to a more effective tidal volume, but we know plateau pressures and other issues come in to play when we start talking about increasing tidal volume, especially above 8 ml/kg. Same concerns with ARDS. Never too many questions. Keep em coming and keep learning!

Do you have familiarity with transcuteaneous CO2 monitoring tools like Sentec? If you could know the realtime PaCO2 easily, would it be worthwhile to track EtCO2? Am I understanding you correctly that without knowing the PaCO2, and therefore the gradient, the EtCO2 is not useful? Is the PaC02 always greater than the EtCO2?

How about exhaled Vt on the vent? How does that compare to EtCO2 when looking at dead space?

@RespiratoryCoach

3 жыл бұрын

Exhaled Vt doesn't change in regards to dead space. The exhaled volume remains constant while the assessment of effective tidal volume changes.

Hey coach. Thank you so much for a wonderful explanation. I have a question on a %EtCO2. Some monitors display EtCO2 in %. I don't quite get, % from what? Google MD is not helpful this time. After playing with numbers I assume it is a percent of a barometric pressure, am I right? And if so, does MAP from mechanical ventilation should be added to barometric pressure when I try to convert %EtCO2 to mmHg, like we do in case of calculating A-a gradient? So, to make my question more general: how to convert %EtCO2 to EtCO2 in mm Hg?

@RespiratoryCoach

4 жыл бұрын

You're very welcome, Nikita. You are also correct. The percentage is percent of co2 of barometric pressure. Normal is 5-7%. I am not aware of incorporating MAP into this conversion. Doesn't mean we shouldn't, I'm just not aware. So basically, 760-47 = 713 X .05 = 35. If your etco2 was reading 10%, then 713 X .10 = 71. Of course this varies with pressure differences. I'm not a fan of the percentage, except for use during intubation. Great question. Hope this helped, and thank you for watching.

@nikitasavenkov1466

4 жыл бұрын

@@RespiratoryCoach Thank you so much for clarification. Top notch as always )

Hi, thanks for your videos, i have question could we calculate the pressure support for the patient before we put him on PSV mode?

@RespiratoryCoach

4 жыл бұрын

No, you start with a minimum level (5-8) and then monitor and adjust according to spontaneous tidal volume, work of breathing and patient tolerance.

@munyrahxz1540

4 жыл бұрын

Respiratory Coach because i saw formula that we could calculate Pressure Support when we put pt on SIMV PS mode .. so I thought we can use it for PSV mode

@RespiratoryCoach

4 жыл бұрын

@@munyrahxz1540 send me that formula so I can look at it. I'm not familiar with any associated with setting PS, even in SIMV. You got me curious.

@munyrahxz1540

4 жыл бұрын

Respiratory Coach PSV= (PIP-Pplat)/set insp flow * peak insp flow

@munyrahxz1540

4 жыл бұрын

Respiratory Coach i saw the formula from this video kzread.info/dash/bejne/fYii0amFpsS7iqQ.html

Sir etco2 tell co2 in expired air venous co2 is 46 mmhg atrial co2 is 40mmhg ... at alveolar level 46 equate to 40mmg hence in atrial blood and expired air we have same 40mmhg .....what is the gradient you are saying sir cant understand it as there is no gradient ..

If you’re using EtCO2 for an SBT, you’re still getting a blood gas to measure the gradient. Sounds like a waste of time if you stick the pt the first few mins of the trial just for them to fail, due to tachypnia. Wouldn’t have to monitor their end tidal. Am I correct? lol

@RespiratoryCoach

3 жыл бұрын

So if ETCO2 monitoring is in place prior to the weaning then a gradient should already by established. Another ABG shouldn't be needed. Monitor ETCO2 changes, RSBI, VS, SpO2, along with other weaning parameters, and readiness for extubation should be able to be assessed without the need for another ABG.

what if the number is reversed? etco2>paco2?

i want to know how Arterial Co2 is greater than (ETco2) ........ arterial co2 is (35-45) and tissues give vein more co2 So veinous Co2 is (40-50) ----- and then vein gives alveoli co2 to remove it so End tidal Co2 should be greater becouse it carries more co2 from tissues ..IS That just becouse dead space diluted Exhaled CO2 ? or what .....

@RespiratoryCoach

3 жыл бұрын

Bingo.... deadspace! Sounds like you're trying to take my job. Great understanding and critical thinking about the subject matter. Thanks for watching and commenting!

@rtalaa2304

3 жыл бұрын

Oh Thanks,I appreciate you and thanks for your kind comment .always i learn from you .. you realy help me alot .

@tomcruise9317

4 ай бұрын

​@@rtalaa2304bro plz help me i cang under stand where is exaled air diluting bro it close system how can it dilute

ah ha moment re "effective" ...

@RespiratoryCoach

3 жыл бұрын

BINGO!!!