Respiratory Therapy - What is Flow?

[@fullofgracehomestead]

This has really been needed with the past three years. So many had such high pressures with this pneumonia and needed what I call pedi settings on the vent. It’s not the high rates and low volumes that were the problem, it was the barotrauma occurring from too much pressure with sick lungs.

[@Iamdiggity22]

Well explained. In class they always talk about flow but just assume everyone knows what it means. I’m a second year RT student and finally just understood it now. Thanks RT coach.

[@RespiratoryCoach]

Yes, we talk alot about volume and pressure and just expect flow to be understood. Glad it helped and thanks for watching!

[@Suzi_P]

I learn from you more than I learn from school. Thanks so much for teaching.

[@tomcruise9317]

Hi sir i m that same guy asking idot doubts after seeing some more video of ypurs regarding flow ...i am getting to understand something...... just GOAT sir.......

[@Kassa633]

Thank you, you are wonderful instructor, I easily understood your explnation without any complication.

[@heartyshor]

man...you re amazing. nobody knew how to explain flow to me. thanks a million times

[@RespiratoryCoach]

Hey Adrian. You are a million times welcome! Glad you found the video and thanks for watching!!!

[@josheniajohnson252]

Yes thank you I had to watch more than one to grasp been out of school for whole but this vigor broke it all down exceptionally well! Thank you for your time and patience

[@LolitasCrafts]

Great video as always. You always answer and clarify questions I didn’t even know I had! Thank you! 🙂

[@RespiratoryCoach]

Hi Lolita, unexpected learning is always the best!!! Thanks for watching!

[@kassygunn3217]

Thank you for taking the time to teach on youtube! Your videos have helped me a lot throughout my respiratory program! I have a question about understanding some flow principles. From the equation, gas flow= delta p / resistance, I understand that airway resistance decreases as the diameter of the airway increases resulting in an increased flow. I recently started to think about the air entrainment mask and how we use decreasing orifice sizes to increase the velocity of flow. The example I was taught was to think of a water hose and how when you occlude the hose a higher velocity of flow is created. These principles seem to conflict to me and I'm trying to understand what is the key piece of information I am missing to understand how these principles do not contradict one another.

[@jeckellstallworth]

The end of the video questions are a great add in! Thank you Respiratory Coach!

[@RespiratoryCoach]

Hey, Jay! Thanks for the feedback.

[@groovealong]

I really appreciate the way you make ur lectures so simple and yet informative. I would like to request you to make a video on weaning protocol and procedure please.

[@RespiratoryCoach]

Sure thing. I can do that. I think I have one already. I'll look for it and send it your way. If not, I'll get one out. Thanks for watching and for leaving the comments.

[@jimmyrandy8251]

You prolly dont give a damn but does any of you know a trick to get back into an Instagram account?? I was stupid lost the password. I appreciate any help you can give me!

[@giannidecker2790]

@Jimmy Randy instablaster ;)

[@jimmyrandy8251]

@Gianni Decker thanks for your reply. I found the site through google and Im waiting for the hacking stuff now. Looks like it's gonna take a while so I will reply here later with my results.

[@jimmyrandy8251]

@Gianni Decker it did the trick and I now got access to my account again. Im so happy:D Thanks so much, you really help me out!

[@osamasalah5623]

Thank you very much, you're such intelligent man how make things easier to be understood

[@RespiratoryCoach]

You're very welcome, Osama! Thank you for watching sharing your kind comment!!! I appreciate that!

[@ericarosales7727]

this is excellent, thank you for taking the time to make this!

[@naseemakanase9395]

Very nicely simplified. Thank You

[@RespiratoryCoach]

Cool, glad you found it helpful. Thank you for watching!

[@tamalesytortitas]

Great job coach!

[@RespiratoryCoach]

Appreciate it, Rick!

[@josheniajohnson252]

I pray to go into the hospital and be truly exemplify what I’m learning plus more!

[@RespiratoryCoach]

Got your email. Stay tuned!

[@CB-ob5vh]

I had a pneumoseptic patient who was flow hungry(terrible flow waveforms with dips) in APVcmv. Patient was well sedated with propofol. Triggered the ventilator only every 20 or 30th breath or so. Gases all metabolic due to sepsis. I tried PCMV, same thing, waveforms indicated she wanted more flow. I tried the pt on ASV and BOOM! perfect pressure and flow waveforms but I cannot figure out why asv fixed her flow hunger

[@winniemuhemba5943]

Tx u for for the lecture, this may sound stupid but I didn’t get how to increase the flow on this therapy mode of VC - what to use?

[@karenmitchell6654]

Thank you Respiratory Coach, i appreciate the Lecture. The question at the end was great, it had me thinking. Can we start getting questions at the end of your Lectures please and thank you. Blessings to you and your family!

[@RespiratoryCoach]

Hi Karen! More end of video questions to come. Thanks for watching and commenting, as usual.

[@mihretmichael9700]

Great 👍 I like the way you explain 👍

[@lizl.6874]

I love you for this explanation!

[@RespiratoryCoach]

Hey Liz! I love you for watching and commenting!!

[@zachariahmathewmanalil8361]

Could you please explain what's autoflow and its significance in ventilation strategies?

[@poliklolik]

Does Bernoulli applys to med air 21 %,would it suck air in?PT on collar 10lpm humidified med air what setting can I do on Venturi to accommodate his set up,does it means he still needs higher total flow even when on 21%?

[@asyacotton335]

Thank you! I understand now.

[@RespiratoryCoach]

Hi Asya, make sense? Thanks for watching and commenting!!!

[@KDTRECE]

Makes more sense now Thanks

[@pratyusha..4127]

Thank u very much sir...

[@tomcruise9317]

Sir how can you give 40%fio2 with 10lit per min as 10lit give 60%fio2..

[@dr.teng13]

Thanks

[@booy-jp1qu]

Regarding the question you chose increase flow but the wave form show inspiratory time not enough because not return to baseline if I increase the flow I will have short inspiratory time more than last short?

[@booy-jp1qu]

I can decrease RR to get more TCT and i can increase expiratory time without decrease inspiratory time

[@RespiratoryCoach]

When the flow fails to reach baseline it's coming from beneath the X axis, which is the expiratory phase of the breath. Increasing flow will shorten I time and lengthen E time. Your way works as well, but is typically not the first option because decreasing RR alters minute ventilation which alters CO2 removal and pH.

[@dtmfool789]

A thousand thank yous for your channel!

[@jasmjasmin6449]

Thank you.

[@RespiratoryCoach]

You are so welcome! Thank you for watching and commenting!!

[@SourGrasshopper]

I'm having a hard time differentiating between flow and pressure

[@jennifertorres2423]

Could the itime be changed as another option?

[@RespiratoryCoach]

Yes, which is why increasing flow was the answer. Increasing flow decreases insp time. kzbin.info/www/bejne/gnWyeJmgiLCgqMU

[@jennifertorres2423]

@@RespiratoryCoach thank you!

[@esubalew6222]

Hey! Awesome videos!! Can you do peep maneuver or peep ladder protocol?

[@RespiratoryCoach]

Here you go! kzbin.info/www/bejne/nampZ5yfaNSsoMU

[@susieantencio6415]

I’m sorry respiratory coach, I recently watched a video on how you decrease the minute ventilation, can you tell me which video that was please?

[@dankbreh9013]

Hey RC, Can you do a video on the RSBI? Thank you!

[@RespiratoryCoach]

Sure can! Coming soon!

[@RespiratoryCoach]

Dank....got your video posted. Did you see it? kzbin.info/www/bejne/bJqamoGOjct2jdk

[@dr.swadeshmohanty1925]

Fantastic....

[@drdr3718]

Very good lecture...some questions... 1) do you think that for every device i use to give oxygen we need to know exactly how much flow i am going to delivery in order to calculate FiO2? For example we use ventilogic for NIV PSV and oxygen with flowmeter of 15 lt/min... although i use pressure control i think it's very important to know minute flow in order to calculate FiO2 2) those snorkeling masks adapted as CPAP for ARDS caused by coronavirus.... in order to cover totally patients inspiratory demands... it's important to know minute inspiratory flow? Where does the mask take room air to mix with oxygen?

[@RespiratoryCoach]

Hello, Dr Dr. I can't speak to the "snorkel" masks, as I have not worked with one or looked into the technology behind such. To your first point though, YES, knowing your FiO2 is always best practicing in assessing your patient's oxygenation status. A patient oxygenating effectively on 8 lpm tells me nothing, unless I'm able to precisely equate that to a FiO2. This allows for adequate assessment using the P/F ratio, instead of guessing. Sorry I can't answer your second question. I do thank you for watching and posting these questions. They make very good points.

[@drdr3718]

@@RespiratoryCoach ok thanks...i think snorkel masks don't work because I have only access for oxygen (max 15 lt/min) and no access for room air..I think these patients with a serious respiratory distress have a high inspiratory flow rate, if i can only supply 15 lt/min i don't cover this need...and i haven't any access for room air in order to cover respiratory demands. Do you agree?

[@RespiratoryCoach]

@@drdr3718 I agree 100%. Without room air entrainment we are unable to meet the inspiratory demand of our patients, this that 15 lpm may only be delivering .3-.4 FiO2. Great observation, Dr!

[@drdr3718]

@@RespiratoryCoach If i use PSV for example I think i always should know totally flow supplied in time in order to cover inspiratory demand

[@drdr3718]

@@RespiratoryCoach thank you so much! Better helmet CPAP with an inspiratory flow of 65-70 lt/min or the great AIRVO! They use Venturi system or take directly air from around

[@dotnotes6651]

Sir how the ratio 3:1 came for 40 % fio2

[@RespiratoryCoach]

Because it takes 3 parts room air to everyone 1 part of 100% oxygen to dilute the Fio2 to 40%. .21 + .21 + .21 + 1.0 = 1.63 / 4 = .40 Hope this helps!

[@dotnotes6651]

Sir yes it's very help ...the basic level of ur video helpful to prepare my advanced level of my mechanical ventilation tq sir . LOVE FROM EMERGENCY MEDICINE DEPARTMENT

[@jakebrown6077]

New viewer here 🙋‍♂️ Im having a hard time with differences in I time and Rise time in regards to flow. It seems like flow rate would affect rise time also?

[@RespiratoryCoach]

Hey Jake. Thanks for watching and subscribing. This video may help you with rise time.. kzbin.info/www/bejne/l4q4mXulgNSCetU

[@esubalew6222]

Please and thank you

[@jiaofeng6639]

Electric flow is current = Voltage/ resistance Pressure difference in air equals to voltage in electricity