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Calculating Tidal Volume


hammerpcp

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ml/kg?

Usually 5-7ml/kg is what is cited. I have seen 7-10ml/kg as well...

Since tidal volume is almost always quoted at 500ml for an adult (70kg?) it would appear to be 6-8ml/kg.

EDIT - Just looked in the Walls book, and he quotes 10-15ml/kg...Meh...

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I too use 5 - 10 ml/kg of the ideal weight of the patient, not the true weight of the patient. Yes, many use 10 ml/kg but lately, many have found out that that is too much. As well I too use just enough to make the chest rise and adequately filling lungs with ventilation per auscultation as well. Many make the assumption, to base it upon sat.'s which should not be confused with Fi0[sub:cec05f215b]2[/sub:cec05f215b]..

R/r 911

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Rid was right to mention the IDEAL body weight. You don't want to be using 10cc/kg based on a 120 kg patient. But if you use 10cc/kg of the ideal body weight for patient gender and age, regardless of what s/he weights, you're on the right track.

My service uses 8-10 cc/kg. Unless, that is, we're bagging. Then it's like AZCEP mentioned and just enough to get the chest to rise.

-be safe.

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Many make the assumption, to base it upon sat.'s which should not be confused with Fi0[sub:e3a80c2747]2[/sub:e3a80c2747]...

...which should not be confused with STATS.

I had a corpsman this morning tell me my patients O[sub:e3a80c2747]2[/sub:e3a80c2747] "stats." :lol:

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...which should not be confused with STATS.

I had a corpsman this morning tell me my patients O[sub:33f719824e]2[/sub:33f719824e] "stats." :lol:

Don't know about his O2 stats, but Jeeter is batting .339, go Yankees! :occasion5:

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ml/kg?

Usually 5-7ml/kg is what is cited. I have seen 7-10ml/kg as well...

Since tidal volume is almost always quoted at 500ml for an adult (70kg?) it would appear to be 6-8ml/kg.

EDIT - Just looked in the Walls book, and he quotes 10-15ml/kg...Meh...

GENTS:

The 5 to 7 ml/kg. based on ideal body weight is now the accepted NORM, a very large study worldwide found (NEJM Sept. 14, 2000 Vol. 343, No, 11) That "VOLUTRAUMA" was indeed a large factor contributing to ARDs, in fact prior to end of the study (approximately 75% of results in) was so conclusive that the study was concluded....oh.... I "MUST" add that the baseline PEEP level of + 5 cmh20 was used in this study as it it is a protective mechanism to prevent (micro) atelectasis.....EVEN in those in the "head injury" category. OMG, totally radical eh what? this does not inadvertently affect ICP which was a thoroughly evaluated in an other study (can't find that one, oops)

As a rule of thumb, the concept is: Keep plateau pressures (static compliance) less than 32 cmh20, this can be difficult to calculate on most transport ventilators. This based on the assumption that (on average) 8 cmh2o pressures is the result of (dynamic compliance) on a clean # 8 mm ETT with flows in average 40 t0 60 lpm. hope you are following so far.

Soooo in the back of the truck/bird....if one eyeball's the PIP (Peak Inspiratory Pressures) try to keep PIP less than 40 cmH2o then this can be accomplished without too much difficulty. If one encounters ETCO2 levels rising then pick up the rates not the Vt's. Targets shoud be ETCO2 of around 35 to 38....this accounts for "Norms" granted the pathophyiology of the acute lung injury can be affect these reading but lets keep it as simple as possible.

The concept of ventilation is that CO2 is dependant on Minute Volumes Rate x Vts....lets stay away from VD/VT for now...k?

It is also mentioned that in the asthmatic patient or the very difficult to ventilate crowd that 3 to 5 mls per kg is acceptable, note these values and suggested guidelines are buried somewhere in the guidelines of the "OLD" 2000 American Heart Foundation International Consensus on Science #239 Part 8 Advanced Challenges in Resus: page #239 as is permissive hypocapnic ventilation... in fact if PH of less than 7.25 then bicarb can be added, numerous on going studies are pointing towards acidosis at the cellular level 'could be" protective homeostatic mechanism yet to be determined.

While your at it a great brief on Auto PEEP as well, not really indepth but and just my 2 cents would be that this unrecognized condition if far more prevalent than first believed in EMS.... a relative mechanical hypovolemia...leading to PEA. A very common point observed when a rookie is told to squeese the BVM.....slow down dude, its not a ballon! I digress...sorry got on a roll there, look back in the SOB OBS thread (or something like) a GUEST? made a post there that was quite interesting a "medics" explanation of Auto PEEP. :lol:

General rule is that Hypoxia kills yah way quicker than Acid base imbalances.

Oxygenation as stated by "ERDOC" when a patient is this acute ABGs should be used as the "Golden Standard" as the evaluation tool.

Oh Dust...if my SATS were less than 85% I would call it "STATS" too.....LMFAO.

Do I get points deducted for rambling?

cheers

oxygen boy...... aka squint.

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...which should not be confused with STATS.

I had a corpsman this morning tell me my patients O[sub:bda4f994f4]2[/sub:bda4f994f4] "stats." :lol:

Hopefully his O2 stats is a diatomic molecule of 2 oxygen molecules that are connected by a double bond leaving 2 sets of lone pairs on each oxygen molecule. There should be 1 Pi bond set with the s bond hybridized to an sp2 configuration.

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