RT Clinic: Setting up the VAR - Vortran Automatic Resuscitator - Go2Vent

[@lizbarcena602]

We received over 150 of them after 9/11 from FEMA funds. They are pressure vents but will do the work for a while ARDS patients need additional modalities as their Pao2 crashes. Good luck fellow RT's, tough times, glad that I am retired after 32yrs in the field. Al B.

[@justlivemyway]

Liz Barcena, Can you explain Pao2 crashes in detail? I believe it means when lungs close completely and the ventilator has to increase inspiratory pressure for couple of breaths until it normalises.

[@CheerleaderBody]

Wow! Amazing how you added when to use it! Now we need them more than ever!

[@dannydinh3244]

I'd like to hear comments from hospitals if this device is being used on patients.

[@domingue4god]

What kind of flow meter goes to 25 l/m? The highest I’ve seen flowmeters go is 15 l/m.

[@rtclinic]

Usually as standard flowmeter flushes at 40 LPM, but you can purchase flowmeters the increase by increments of 10lpm to 70. I've always called the anesthesia flow meters,but I'm not sure way.

[@shahadatpolash7144]

how it works in a spontaneously breathing patient? how it senses trigger or changes cycle?

[@rtclinic]

A flexible diaphragm moves with pressure changes (patient taking a breath or pip reached). This cause the vent to open a valve and change to the expiratory phase for a set amount of time. The valve then closes and allows pressure to build again in the lungs. It is a very cool device.

[@chelysgarage1457]

Does ventilation change if you increase the length of the flow line. If not, does Westmed have the option for a longer line. If you want better recoil , place a rubber band in the middle of the test lung. Best bands are the red ones for the vacuum cleaner filters. Does the vortran still work as prescribed if you add a peep valve. Is it MRI safe?

[@rtclinic]

The flow line length wouldn't change ventilation because it doesn't affect deadspace. I like the question though...😁 I have not tried it with a PEEP valve..but that is a good thought. I'll try it today. I believe it is MRI compatible, only one very thin spring inside. You may want to check the Vortran medical website for an exact answer.

[@alexbachman-williams9814]

Thanks for the video! My site is looking at these as a last resort. Did you happen to get a PEEP valve to work with it? Appreciate the info!

[@shouq1335]

It is considered set pressure or time or flow or volume?

[@rtclinic]

The vortran is pressure regulated, time cycled.

[@MrMusiq2]

What if flow meter only goes to 15LPM?

[@rtclinic]

The inspiratory time will be longer. Which will mess with your I:E ratio, but will still work in a pinch.

[@iyerkumar]

Hi Jimmy: Got a question that I am unable to get an answer on: where does the expirated gases (exhale) vent out to? is this through a filter or just in open air? How about ventilators.. where do they vent out to? If all the air (with the viruses) vent into the room, then isnt that a bigger issue with spreading the virus? BTW excellent videos .. learnt a lot.

[@rtclinic]

Unfortunately, the air on this device is released from two different areas that could not be filtered. The only option is to filter at the end of the ET tube. Resistance at the ET might cause some changes in the ventilator cycling. Conventional ventilator usually expel air from one port in the expiratory limb. It is much easier to filter. We treat these patients with airborne precautions while on a ventilator. This is an additional layer of protection for the clinical staff. If you have adequate amounts of PPE this process works well.

[@tausifkhan6398]

they did not show oxygen tank. is it air or oxygen taken in?

[@rtclinic]

Oxygen

[@tausifkhan6398]

@@rtclinic thank you Jimmy. If I am right , they are calling it as disposable or discard after one year. Why

[@rtclinic]

The seals inside can become sticky over time that will stop it from cycling.

[@productosalimenticioselarc5732]

How can I buy at least 25 of those? And what would be the price?

[@rtclinic]

I've heard they are around $150 each, but I think they are backordered until summer. Contact Vortran Medical for more info.

[@johnthomas8014]

Quick question: You are using a high flow flow meter then? So if using an E cylinder it would attach to the steel nipple and be run at 25 L? Not the DISS 50 PSI source? Thanks in advance. I'm sure it would be pretty self explanatory if I had one in my hands. Just wondering how they'd run on a tank. I know that running at 50% it can double the time one will last if your facility has that part so you're not always stuck at 100% but in pinch even without that part I can see this would keep up and running while waiting for vents to become available. Also, what about the exhalation. I assume a combo hme/filter could be used at the ett to help prevent the spread of the virus? Assuming more flow would be needed especially as it gets wet. Thanks again.

[@rtclinic]

Yes. I have run it from the steel nipple adapter. I've not tried it from the 50psi diss hookup. It can really run a tank dry quickly on 100%. I would lower the flow to whatever it takes to get an adequate rate and volume.

[@rtclinic]

See Peter B.'s response below.

[@benjiwork4795]

Peter B. I think that answered my question about adding PEEP. We’re finding that with ARDS cases we can’t increase PaO2 with only FiO2. High PEEP is the only option. And if there isn’t an exhalation port, there isn’t a way to add a PEEP valve. Thanks for the info and tutorial.

[@muathamreeen1389]

Is it useful for covid-19 case?

[@rtclinic]

Very short term. Many COVID patients are requiring high PEEP and non-conventional ventilation modes.

[@PapaU81]

How much are these

[@rtclinic]

Around $100 each, but they are on backorder for a couple months right now.

[@justlivemyway]

@@rtclinic News says xerox is going to mass produce them and retail for $120 a piece.

[@rtclinic]

@@justlivemyway That is awesome! A good price too.

[@justlivemyway]

@@rtclinicGood yes, but very expensive for developing nations. We are building mechanical ventilators under $100 a piece and this Go2 is an injection molded component. $120 is right for western countries where inflation and money value are high.

[@hvmulay]

is it a ventilator

[@rtclinic]

Yes. A temporary pneumatic ventilator.