Mechanical Ventilation Explained - Ventilator Settings & Modes (Respiratory Failure)

[@Medcram]

Thanks for watching. Get CME for this video series, AND see Dr. Seheult's updated vent videos at our website: www.medcram.com/courses/mechanical-ventilation-explained-clearly

[@nazikalamin7732]

MedCram - Medical Lectures Explained CLEARLY

[@amyaksu2137]

Thank you! I'm an ER nurse turned ICU nurse literally overnight. I know nothing about mechanical ventilation and tomorrow I get to work on the machines for the first time so this is a great series!! I couldn't find something like this in German (I work in Germany as well) but hearing it explained so clearly in my mother tongue helps me feel less nervous.

[@Medcram]

Good to hear, thanks for the comment

[@mrfrizzle0782]

I have used your lectures to help prepare myself for Nurse Anesthesia school interviews, and to obtain a better grasp of certain subjects. I have been accepted into the 2015 class and I want to take this time to thank you for all the great instruction you have given me through your lectures.

[@CANAYAMD]

mrfrizzle0782 I thought volume control and pressure control are modes of assist control. You are equating assist control to volume control. Know what I mean?

[@mannyhernandez9991]

CANAYAMD VC and PC are two different modes. They do have variations which add assist control for example ACVC+, ACPC, VOL/AF(seen on my anesthesia machine). But strict VC or PC have set values that do not assist a spontaneous breath. There is no pressure support setting on strict VC or PC. However you can assist with modes like SIMV, ACVC+, and of course pressure support. ACVC+ is essentially pressure regulated volume control, so you can deliver a set tidal volume with variable inspiratory pressure to account for changes in lung compliance thus hopefully minimizing your peak inspiratory pressures..hope I answered your question:)

[@rdseheult]

That's awesome! Never stop. So great to be part of your education!

[@bellefeu4933]

How did it go?

[@raffyibanez9653]

Who is here because they are the new nurse to the ICU unit.. 🥹

[@jacobtaylor4258]

i was a patient on this treatment, i would just like to thank all doctors and nurses, and cleaners, they all do a fantastic job, god bless you all.

[@annettefordyce875]

I am an RN who may be called back to the hospital to care for patients...awesome to be able refresh on this while waiting for the call... it has been a lot of years since ICU for me. Thank you

[@susanwetmore4822]

I'm in the same boat!

[@jamesbrown-vi6og]

Respiratory Therapist Run Ventilators Period. especially in critical care patients.. if you want to start to kill patients a painful death by all means take a 10 minuet video tutorial and have at it ... we have only gone to school for 2-4 years to learn about hemodynamics.. i not deminishing the job of our RN we love and need them.. but we need to stay in our own lane. or we will see masive crashes..

[@CyclePat]

Just asking... would a CPAP Machine be sufficient ventilation (possibly) duirng this outbreak/pandemic?

[@Jeremiah2911HOPE]

In Australia, we don't have a lot of respiratory therapists. Critical Care trained nurses are very capable in looking after ventilated patients :)

[@bernardofitzpatrick5403]

@@CyclePat good question

[@Grahmahshanz]

Where have you been all of my nursing life! I work in a pediatric vent facility with amazing RT's who try their best to explain settings/modes/ functions to me, but since I have them, I never found it necessary to 'know it all'. Now that I care for a baby at home on mechanical ventilation, although my education/experience has taught me everything that I need to know care for him, I just want to 'know it all' !! You explained mechanical ventilation in such a way that, now, my RT's smile in amazement when we converse ;-) thank you so much!

[@Medcram]

+Linda Ellis Thank you for the great feedback!

[@radcow]

Who's betting this video becomes even more popular

[@Purashwin6defOWNZ]

Can I leverage my bet 100*

[@amia1220]

Am

[@irenetraum6904]

I am leaving a huge "Thank you" here, I am working currently in Germany and this series of videos really help me to understand those differents modes of a ventilator! Congratulations for your nicely done and excellent work!

[@asifali-tr9tc]

Same here

[@tgreaux5027]

MedCram is gonna blow up over the next 3 months.

[@URCStJamessNewcastlehymns]

love the no nonsense terminology - as someone once said - the more you know about a subject the simpler you can make it sound

[@shimankumaheshwari6904]

Golden words-The more you know about the subject, the simpler you can make it sound.

[@cynthiaeugene7803]

Sooooo accurate!!!

[@darylreece7840]

I’m a mechanical engineer and I love your videos. They are very interesting and informative. Thanks!

[@deeparaman1]

Excellent especially for students and doctors from non English speaking countries. The usual video tutorials given by native English speakers is with heavy accent and difficult to comprehend and causes lots of stress trying to make out what the speaker is trying to say. But your accent is so clear, slow, English is so simple and you have done fantastic service to students from third world countries. Even a layman can understand your lectures. If the patient care improves because of your lectures,(I am sure that it will) the credit actually goes t o you.

[@edwigcarol4888]

Of course laypeople might understand. The child blowing up a balloon, how much pressure does it need to get it big, depending of the material the balloon is made of. No equation necessary.. in fact..

[@irisitah77]

Great video, perfect for ICU nurses like me who still struggle with understanding vents. Very easy to understand!

[@pabbate87]

I’m a respiratory therapy student so I’m definitely looking forward to this

[@dailypaywithdeena]

I work in a home care setting and my client is on a ventilator (non-dependent). This series was very helpful to understanding the vent dynamics. Thank you!

[@Medcram]

Deena Foote Glad to hear the series helped with your understanding

[@betfiendish]

this was great! I'm a nurse new to critical care and vents have been confusing the hell out of me, this is making it more clear, thank you!

[@johnkahts7698]

I am a total layman re ventilators. Your calm and well paced explanation is down to earth and I am sure anyone in the field will understand this. Keep up the good work,

[@marisapinto249]

Thank you very much for all of these videos doctor Roger Scheuld.I am an anesthesiologist and I am working in the Amazon Region (Roraima)..I am very thankful .

[@MrsLWilliams]

Thank you so much for this lecture. It raised my Competency in Mechanical Ventilation by 40%. In home health it's very important I not only know how but can explain the rationale

[@vernareeder316]

Tell me you made it through covid.I have followed you for awhile now and I have found comfort in your courage and faith.God bless and keep you.

[@matthewjkele]

even after you helped me through PA school, I still watch videos like this as I practice.

[@Medcram]

+Matthew Kele Good to hear, glad the videos remain helpful

[@nicholaswhs0896]

This helped a lot. I took CCP in the summer and that was the hardest class I've ever taken so far. I still struggled to understand the basics of the vent and so far your video has helped cleared some cob webs lol.

[@tovahromanov7414]

An Ontario🇨🇦Canada🇨🇦 Doc has figured out a way to DOUBLE ventilator capacity! There’s a catch......the patients need to be of similar size and lung capacity. It’s still fantastic and if one vent can help two people, less horribly difficult decisions will have to be made by Docs like what has/is taking place in Italy......who gets a ventilator? Small miracle but still a miracle and heck yeah, any miracle right now is welcome! Way to go Dr. Gauthier!!!

[@999akva]

Thank you so much! Learned a lot, especially as a student, who is thinking to go to the anesthesiology residency and, at the same time, working in ICU, I understand much more with your help!

[@Medcram]

Thanks for your comment! We wish you luck!

[@abar7178]

This was great. I wish I had this available back in the day. Thank you for your time. I started out as an Oxygen orderly back in 1973 after I was discharged from The Marine Corps in New York City. Wheeling H tanks on a dolly with an adjustable wrench to the patients bedside and changing them out when they reached 500 PSI. No piped in Oxygen back then and only open patient Wards. with 10 to 15 patients in a room separated by a draw curtain.Part of my arsenal was a No smoking sign. It was not uncommon. to see patients smoking while lying in their beds as well as a doctor examining a patient with a cigarette dangling from the sides of his mouth. Oh how we long for the good old days LOL. I eventually became a certified inhalation therapy tech. Via The AARC later it became the NBRC or vice Versa. I stopped practicing in 1999 when I came to Massachusetts only to discover Massachusetts was a commonwealth and reciprocity of my licenses were never granted. I like to believe, I was a respiratory therapist and have been around since the Infancy of our profession. That makes me the original OG of respiratory therapy. Back in the days. We ran to codes with a Bird Mark 5 or mark 8 pressure ventilators ( the little green Box ) attached to an E-cylinder of Oxygen. The ideal settings on the Bird were 15, 15, 15. It was actually a great little machine to run to codes with. Easy to maneuver through patients wards and great during transports. Back then the big fear with the Bird was the infrequent incidence of Barotrauma as well as all the negatives associated with Positive pressure ventilators. However, if you knew what you were doing, You were golden. later in my career I became a clinical instructor and that became part of my introduction to my students. I would introduce myself and begin with these words ( Keep in mind. I am a United States Marine ) I would begin, If you are here to press buttons and turn Knobs. This is not a class for you. I can teach a Monkey to do that. However, if you want to know what happens mechanically and physiologically after you have pressed that button and turned that knob. Please have a seat. ( By the way, my students had the highest passing rate on certs and registry ) Back to the past. Back then, we had Engstrom and Emerson Volume ventilators with a heating plate at the bottom and a steel pot similar to a pressure cooker that sat on atop of the heating plate. The tubing ( AKA Manifold) contained steel wool lining the inside of the tubing to increase and help maintain the humidity of a dry gas. It had a huge mechanical spirometer. It sat on top with a large needle that move per cycle of respiration . One day, the workhorse came onto the scene. We all gathered around and received an Inservice on the latest and the greatest. The Puritan Bennet MA-1. followed by the 7200, the bear respirator, Etc. I could go on forever, so I will end here with these two memories. When PEEP was in its Infancy. Hell, it felt like we invented it. We would take a large bottle filled with water, placed alongside the respirator on the floor. We would submerge the tubings of the manifold into the bottle below the water level we would adjust the amount of PEEP by adding more water to the bottle or elevating or decreasing the height of the submerged tubing into the water. This is how PEEP. started out. ( Positive End Expiratory Pressure. prolongs exhalation. Thereby allowing the Alveoli to remain open longer and allowing for a prolonged period of Diffusion along the Alveolar Capillary membrane ) Somethings you never forget LOL If you took the time to read this. Thank you for allowing me to share with you a trip down memory lane. Trust me there is a lot more to share as my career span was well over 35 years working in diverse clinical settings and adult critical care. To include having the honor of being part of Mount Sinai's School of medicine and working as a pulmonary research technician alongside Dr. Irving Sellikoff ( asbestosis and Sarcoidosis studies) Dr.Alvin Tierstien and Dr. L.K Brown. Traveling the country back in the 80's as part of a research team to predominately gay communities and seeing well over 100 patients a day and performing PFT's and Perfusion studies when patients at that time were expiring in NYC and the diagnosis at that time was " Fever Of Unknown Origin " ( AIDS) Going into the Tunnels of the NYC Subway system with a team to locate and perform sputum inductions on the homeless. At that time, we had a strain of drug resistant TB. Then I moved to Mass and my carrier came to an abrupt halt because of Bureaucracy. "Sie La Vie" . I am a U.S. Marine. We are trained to adapt and overcome. I fell back on the trades. In the Marine Corps, I was formally trained as a Lineman and electrician as well as an Avionics tech.( Aircraft electrician ) At Marine Corps engineer school. Courthouse Bay N.C. My mechanical aptitude I believe was why I was able to teach my students and reach them in a mechanical way. I would equate the human body in its purist form. A machine and in a mechanical way. The neuron pathways are no more than a glorified electrical conductor ( wire ) picture the wiring in your home. It has copper and the insulation that surrounds the copper coil is made of a rubber non conductive material. A neuron for all intents and purposes is a wire and it's insulation it is the Myelin sheath. The heart, a four chamber pump. Positive and negative pressure outputs with valves that open and close and seal etc. I miss my career, I miss my patients, I miss being able to have that feeling after all is said and done. Watching that patient and his family go home together. However, I was able to vicariously share with you a very small part of the evolution of Respiratory Therapy from a first hand eye witness. This is the OG of Respiratory therapy saying Thank you again and Semper Fi.

[@chelseaberry4639]

Thank you for the videos, they are so helpful in understanding ventilators! It would be great to see a video on SIMV, and VC + (PRVC) in the future!

[@RavishingSailor]

Great info. I'm gonna have to use you form of explaining (which is fantastic) when during MICU rounds for my medical students and new interns rotating through our service.

[@hosam.eldin.bebars]

very informative, i am starting my IM residency and these lectures made a great difference to my knowledge , thanks

[@Medcram]

Hosam Eldin Bebars Good to hear. Hope your residency gets off to a good start

[@bing259]

This is the exact explanation and step by steps instructions I was looking for. Please continued to do more blogs. Thank you

[@Medcram]

Thank you for your feedback

[@broganhogan3469]

Amazing how impactful this is in the wake of Covid19 and seeing comments from practitioners years ago to present. Thank you, Dr !!

[@tvphealth9889]

Thank you for sharing this educational resource! The creation of low-cost ventilators is incredibly crucial, now more than ever. Understanding how a ventilator works and why it is needed is a necessary step towards solving the global ventilator shortage.

[@davidwalker8124]

Excellent - just learning about ventilators as we are working on a new lower cost design for hospital / home use for patients just needing a little assist - physicist Dave

[@kaankalem2666]

Are you planning to do it amateurly and how many people are there working with you ? I am also interested.

[@jazzbluesify]

Im in wt you frm winnipeg

[@gardeniabee]

My cat loves the doctor's voice, and though usually very active, is sleeping nearby.

[@stevecolton4714]

Me too - zzzz

[@zewraja009]

☺

[@washimakram141]

doc..ur understanding of the science and the way u made me understand it.. is marvellous..bow down to u sir...

[@Nitinchowdhary211]

The concepts are explained so beautifully and in such simple terms! It takes a genius to explain such complex things to a layman so Medcram guys - you are geniuses! Else any medical technician/doctor can pepper the entire talk with jargon and screw up one's interest in learning the concepts.

[@antoninadomino5508]

I was intubated a month ago due to multiple pneumothoraces as a complication from Wedge resection of my lungs. It’s a very traumatic experience but thankfully was able to survive.

[@Heynursee]

I have no reason to know this this in depth. I never want to work in the ICU or anything. But what I don’t understand - I wish to figure out. And you made this very easy to understand. I really thrive off things being “dumbed down”and you did great

[@TheCrossa]

Yep. Here for Corona. I'm a neurologist. Haven't dealt with ventilator settings in over 2 decades.

[@doctora3262]

Damn as a psychiatrist it hits me in the feels.

[@ggaggagga4]

I'm a retired radiographer who mostly worked in MRI. I have a new level of respect for Respiratory Techs.

[@pipasfacundo890]

I'm just a pharmacist trying to refresh physiology and understand the ICU jargon in these uncertain times. Hats to all of you if you are trying to re-train or just for having taken care of others. Stay safe.

[@Eugene019]

Clear and simple introduction to mechanical ventilator dynamics. Well done.

[@raghavendrabethamcharla3103]

A Consultant Psychiatrist in UK -here in preparation to help patients if needed by supporting them on ventilator

[@stephgami]

Very helpful as I am currently rotating in ICU.Thanks

[@abdurahmanandijani1593]

Your way of explaining difficult things with simple words is really gorgeous .. I love it ..

[@didi7680]

Gorgeous LOL

[@maheshjhunjhunwala44]

Explained in a very simple comprehensible way to any beginner

[@heikelphoto]

I really enjoy your videos, Roger. Thanks for sharing and making so many things easier to understand!

[@jessicatamayo1041]

Thank you for sharing your knowlegde in such a simple and concret matter, please continue to add on value on healthcare education. Keep it up !🤗👏👏👏

[@DenHenson]

Who else is here because of Corona Virus?

[@subhadipghosh4265]

i am

[@mullerpierre-louis2129]

😂 u got me

[@RichaRat]

Me. I just realized this video was created in 2014.

[@hamzalel]

​@@RichaRat me engage in a war

[@maggiewhiteside4463]

I just want to know what to expect…

[@briannaaa____1]

God bless science ❤️ this is saving my dads life right now recovering from covid on the path to a healthy recovery

[@enckidoofalling4519]

Thanks for the review! Just picked up a home vent patient. 🤙

[@meloyellow6488]

Best video on KZbin !!! Very informative

[@Medcram]

+Melody Aribuabo Good to hear- thank you

[@neil17z]

You guys are awesome! I'm so glad I found this channel! Cheers from Israel

[@Medcram]

Thanks for the support from Israel!

[@maryanneelmi6697]

*Palestine

[@nargiznargiz4907]

as always your lectures makes the subjects easy to understand and of course to remember.

[@rodhoover9158]

Another outstanding period of instruction.

[@prezadent1]

Who else is reading the comments in 2020?

[@geoindian5467]

I am here becoz of covid 19. Thank you doctor , immensely for the valuable video.

[@minimedlessons]

Great video! I LOVE MedCram content! I've been making similar videos, inspired by you guys. Keep up the great work, MedCram!

[@jamiebarclay3693]

These are just brilliant. Excellent teacher, great level of detail. Thanks!

[@TOPV49]

Great stuff, I am an ICU RN and am always learning new concepts, procedures and perspectives...still, the face pace to the ICU leaves me little time to quietly ponder and dissect all the information, and that's were these short videos really help me grasp the concepts fully. Bottom line, many thanks!

[@apidraiceboy305]

Hello there. I have question. If a patient with a mechanical ventilator crashes, do you switch to hand oxygen (ambubaging) or just let the respiratory therapist do some adjustments with the MV?

[@shadiahniaz2954]

wonderful.Simple and easy to understand.God Bless

[@limeykl]

Great presentation! Simple explanation of a serious situation

[@robertberthiaume7301]

Great explanation dr. Thanks

[@ronsouther]

I've done 4 things to greatly improve my lung function and overall wellness. My sleep, energy, and life outlook are greatly improved: 1. I started using the BreatheEasy Lung Exerciser about 5 years ago and still use it, 2. I stopped mouth breathing unless absolutely necessary, even when exercising, 3. I did light mouth taping at night in order to ensure nose breathing all night, 4. I do an simple exercise to reset my CO2 levels for triggering breathing so I don't breathe so much. See Patrick McKeown's work for more about this.

[@jonpierson559]

Is your goal to get pulmonary hypertension?

[@grntara78]

Your videos are always helping me a lot to understand every kind of topic....thank you very much....

[@cnitevedi4832]

Sir, I am not a medical professional...but with coronavirus disaster going on...i got curious. Question: do we have to go via lungs. Can we not divert blood out of some major veins like abdominal vena cava, that carry larger volumes, analyze o2, co2 levels, and based on result, add oxygen ( i don't know if we can just mix o2 in blood) and then reroute to the vein? Let lung do what it is doing..and blood pressure is maintained by heart anyway. This will bypass the compliance code etc. I don't even know if this makes sense..

[@gunncessna9359]

excellent presentation Doctor.

[@grethelbayro5710]

Thanks for the very clear, didactic presentation!

[@gingingsisangag]

Thanks Dr for this video as it helped me face my fear (THE VENTILATOR). Transitioning from Neuroscience to ICU RN :)

[@Ot-ej5gi]

Nice and simple; thank you so much for making a difference in our practice and hence, the lives of many grateful patients!

[@akhilanslectures3748]

As good and as simple as it gets!!

[@humbleblessed3955]

excellent presentation for beginners

[@imdawolfman2698]

The high resolution graphics are reassuring. Why is the patient standing up? Is s/he hung from the ceiling or is it their responsibility? And how do the bells work and when blow a whistle, is it sterile?

[@BB-sm8ey]

Thank you for these excellent and informative videos.

[@Medicknowhow]

Awesome buddy...liked the simple methodology of teaching ..didn't cram it up like the docs do it while explaining the paramedics..thanx again...concept is crystal clear

[@Medcram]

Johnson Irudayasamy Thanks for the feedback. Glad to hear it helped

[@mohd.shabbir6510]

thanku sir....a lot of help...we ll remember u till life...

[@drsrikumarB]

modes explained lucidly. thanks.

[@dorao.a3698]

Great teaching. Very simple to understand. Thank you.

[@Medcram]

Thank you for the feedback!

[@johnedwards785]

I was told by a Doctor and many ICU nurses that putting a patient on a ventilator was fraught with many dangers especially for the elderly patient. Not that the equipment would fail to sustain homeostasis, but while ventilated it provides many a patient with a path way for a pseudomonas infection which usually requires both a gram positive antimicrobial and a gram negative antimicrobial, e.g. Imipenem and Amikacin given together in the right amounts. However, if they survive that; I was told the biggest hurdle was successfully getting them off the ventilator to sustain breathing on their own once off of the machine. I can recall where a family had to make the decision whether or not to ventilate their elderly Grandmother. Their Doctor who was also my Mother's Doctor was recommending that they don't do it and take their chances for the survival of their Grandmother without its use. However, they chose to ventilate her. At first after she got off the ventilator she appeared to be in good health and it looked as though she was going to make it. But without any warnings she took a sudden turn for the worse had very labored breathing and died. This happened about 36 hours after she had been taken off the ventilator. The family was stunned and was in shock. However, their Doctor reminded them he warned them not to ventilate her due to what he predicted could have a high percentage of occuring. So my question is why is the mortality rate so high for the elderly; subsequent to being removed from a ventilator?

[@amykay7596]

Pulmonary flashback

[@jary_mane]

I’m about to step into Mechanical Ventilation for Respiratory Therapy. It’s a notorious class & aspect that gets people dropped from my program all the time. It’s a lil less scary at the moment

[@nsar7520]

2024 still im using ur most understandable lectures😍😍😍ㄲㄲ

[@tulsissurfboard6094]

High quality instruction :)

[@sunnytraveler290]

Excellent presentation.

[@finetune1031]

Nice review! Just what I needed after not having written vent orders for 20 years. It's all still in my brain just a bit rusty. God forbid my ICU skills need to be used again. Makes me nervous just thinking about it, not the virus!

[@Paracutie]

Thank you for the easy-down to basics demo!

[@Medcram]

Paracutie thank you for the comment

[@bananabean1977]

I'm here to prep for my last nursing exam (for advanced med surg)

[@drnitupandeyvlogs793]

wow awesome explanation thanks a lot !!!!

[@tonycotto8073]

I'm here to see what's in my near future. I'm high risk. Good health everyone.

[@Kittybarcode]

Tony Cotto build up your immune system , doctors are saying daily vitamin D3 is essential

[@johnettinger4070]

@@Kittybarcode Unfortunately some people have to lower there immune system to stop transplant organ rejection and other reasons.

[@iserved8840]

Tony Cotto GOD bless you!!🙏🏽

[@bernardofitzpatrick5403]

@@Kittybarcode yes!

[@mahatana_r]

Still alive?

[@dayanandav.k.3499]

Awesome explanation.Thanks a lot.

[@marcoantoniogongoleski196]

Thanks, very nice explanaition. - Learning from Brazil !!

[@andybai6544]

Love this lecture. Very clear and it really corrects my wrong perception about ventilation mode. Keep it up!

[@Medcram]

+Andy Bai Thanks for the feedback!

[@aleksasona9376]

+Andy Bai There are a few factors in sleep apnea treatment. One place I discovered which succeeds in merging these is the Stans Slumber Method (google it if you're interested) without a doubt the most useful resource that I've seen.Check out all the amazing info .

[@1412Z]

Thank you, great introduction.

[@gloriaredmon-booth6572]

Great refresher course.

[@jim2980]

Strong work guys! Love you lectures. Trying to get through them all!

[@Medcram]

+Jim Mathey Thanks Jim! Hope you're doing well

[@luzestrada9536]

Thank you so mucho for this information. It was explained really good, and you made it seems easy to understand!

[@workinehtarekegn8150]

wow it is very fantastic and i hvae got alot of knowledges from this lectur video

[@esthermadueke2631]

Great teaching

[@lefuturiste27]

this is really well explained

[@scrapbookedmemories7736]

I was noticing that you include professional nursing. Many docs forget that nursing is a profession that monitors the patients response to treatment and the patient’s experience with that treatment. Some docs don’t even know that nurses have Nurse Diagnosis. Could I work with you to make a video on this?

[@galatea19]

very nicely explained

[@katybrennan8222]

I like the way he says ' ventilator' !

[@sandyhicks1753]

question....my daughter is 23 and was in a motorcycle accident tues 6-28-22 , she's in assist ventilator and breathing on her own. the doc is talkin already about taking her off the vent and putting in a trach this wed 7-6-22 and then a feeding tube into her stomach. they've already mentioned about long term acute care facility. she's yet to wake up and is sedated. today and yesterday she's been shaking alot when disturbed, and they say it's most likely from the cold pad under her that's helping with her temp. she was maintaining her own temp yesterday but her temp went back up last nite, therefore they are now using the temp control pad under her. my question is, should they even be considering takin her off the vent and doin the trach this soon, especially if she's still sedated and not waking on her own? i'm very concerned this will not be a wise idea and she wont fully recover. she has head injury with a little bit of dead cells on both sides at the front, and a fractured nose and left eye bone, a contusion to the spinal cord at the 6th vertabra and some blood spots on the brain.