Flow rates

Re: Flow rates

pinkfluff15 — Mon, 12 Jul 2010 09:27:47 GMT

Hi,

Do you have the rebreathable circle circuit available? Much less fresh gas required!

Re: Flow rates

Phrin Vernon RVN — Fri, 14 May 2010 22:17:28 GMT

[quote user="Nick 'Batfink' Shackleton DipAVN(Surgical)VN MBVNA"]

[quote user="Phrin SVN"]

[quote user="Nick 'Batfink' Shackleton DipAVN(Surgical)VN MBVNA"]

[quote user="Phrin SVN"]

Oh, and I would now choose a circle or the ADE plus soda lime for the 30kg bilateral enucliation patient, and just turn the flowmeter up a few litres if it needed IPPV - If it looked like it was going to need IPPV more more than a few minutes though, I'd change to the bain.

[/quote]

Or put it on a ventilator

[/quote]

you and your 100% referral ways mr shackleton!

[/quote]

You love em really Phrin

[/quote]

Do not get me started Nick! You know very well that not only do I love your 100% referral ways, but that I may also be a teensy bit jealous of them!

Re: Flow rates

Nick Shackleton — Fri, 14 May 2010 22:10:34 GMT

[quote user="Phrin SVN"]

[quote user="Nick 'Batfink' Shackleton DipAVN(Surgical)VN MBVNA"]

[quote user="Phrin SVN"]

[/quote]

Or put it on a ventilator

[/quote]

you and your 100% referral ways mr shackleton!

[/quote]

You love em really Phrin

Re: Flow rates

Phrin Vernon RVN — Fri, 14 May 2010 22:00:43 GMT

[quote user="Nick 'Batfink' Shackleton DipAVN(Surgical)VN MBVNA"]

[quote user="Phrin SVN"]

[/quote]

Or put it on a ventilator

[/quote]

you and your 100% referral ways mr shackleton!

Re: Flow rates

Nick Shackleton — Fri, 14 May 2010 21:53:59 GMT

[quote user="Phrin SVN"]

[/quote]

Or put it on a ventilator

Re: Flow rates

Phrin Vernon RVN — Fri, 14 May 2010 21:50:39 GMT

Re: Flow rates

Phrin Vernon RVN — Fri, 14 May 2010 21:47:33 GMT

Just wanted to revisit this thread after learning more about circuits etc at college

Apparently, lacks, mini lacks and rebreathing circuits can all be used safely for IPPV (as long as it is not for a prolonged period of time), as long as you increase the flow rate ( to reflect a circuit factor of 2.5-3 in non rebreathing)

Incidentally, we have a humphreys ADE in practice - I never really liked it as I didn't know what to do with it! But after learning about it in college, and how it preserves dead space gases etc, it is my new favourite circuit!

Re: Flow rates

Vicky RVN — Tue, 23 Mar 2010 17:59:40 GMT

[quote user="Sue Cox"]

[quote user="Vicky SVN"]

I've now got round to putting it in the revision thread, ta

[/quote]

No problem! If any more random ways of remembering things come to me, I will let you know!

[/quote]

Thank yooooooooooooooooooou

Re: Flow rates

Sue Cox — Tue, 23 Mar 2010 14:38:02 GMT

[quote user="Vicky SVN"]

I've now got round to putting it in the revision thread, ta

[/quote]

No problem! If any more random ways of remembering things come to me, I will let you know!

Re: Flow rates

Vicky RVN — Mon, 22 Mar 2010 22:16:00 GMT

I've now got round to putting it in the revision thread, ta

Re: Flow rates

Sue Cox — Mon, 22 Mar 2010 21:44:05 GMT

[quote user="Nick Shackleton"]

[quote user="Sue Cox"]

oo its just come to me Phrin! Thermovent!! (i didn't even no we had one!)

[/quote]

Termovent is the trade name! They are heat moisture exchangers!

[/quote]

ohhhh....ok thanks Nick!

Re: Flow rates

Nick Shackleton — Mon, 22 Mar 2010 19:46:45 GMT

[quote user="Sue Cox"]

oo its just come to me Phrin! Thermovent!! (i didn't even no we had one!)

[/quote]

Termovent is the trade name! They are heat moisture exchangers!

Re: Flow rates

Sue Cox — Sun, 21 Mar 2010 14:05:29 GMT

oo its just come to me Phrin! Thermovent!! (i didn't even no we had one!)

Re: Flow rates

Sue Cox — Sun, 21 Mar 2010 14:04:34 GMT

Cheers Vicky, of course you can copy it! Im rubbish at remembering things so stuff like that really helps! (Thanks to tutor Helen from college!)

Phrin I am thrilled!!

We did learn it the 'proper' long winded way too, which you need to know so you can understand what your working out and so you will pass that practical task!! Though the acronym (right word? or even right spelling?) does help in the practical when your mind goes blank with panic!!

PS- you are most welcome Phrin!! your portfolio will be sorted in no time!! x

Re: Flow rates

Nick Shackleton — Sat, 20 Mar 2010 09:10:32 GMT

[quote user="phrin"]

I did use one of those warming/humidifying things (name totally escaped me)

[/quote]

HME: heat moisture exchanger. Dose what it's name suggests

Re: Flow rates

Phrin Vernon RVN — Fri, 19 Mar 2010 23:02:05 GMT

I spent the first 4 years of my working life in a referral practice - they only introduced rebreathing circuits months before i moved on........ so in a potentially risky patient, i reached for the bain - what I was used to!... i am just an svn (lots of exp) but like to check with the rvns.... they agreed with me, so bain it was!

Back to the start of the thread tho - even in said referral practice, I would have put patient on about 5-6L/m - much less than their actual requirement! Eeek!

Now I know better and calculated patients flow rate - more like 10-11L/min (checked with RVN)

Re: Flow rates

dinkyd — Fri, 19 Mar 2010 22:50:59 GMT

To be honest at the end of the day it comes down to experience with these cases and what circuit you are happy with for using with these types of cases and what to expect- if your happy with using the circuit its a hell of a lot safer than using something your unfamiliar with-no matter what the situation.

Re: Flow rates

Phrin Vernon RVN — Fri, 19 Mar 2010 22:49:20 GMT

BTW - we did a bilateral eye enucliation! Upset me a bit from the clients point of view - I know my pooches eyes say so much!

It was advised by a cert opthalmic vet, and pooch is doing really well post op, but still - both eyes - at once

Re: Flow rates

Phrin Vernon RVN — Fri, 19 Mar 2010 22:46:16 GMT

[quote user="dinkyd"]

Hmmm-now I can see both sides of debate.I can understand exactly why svn/VN has chosen a non rebreathing circuit for a high risk patient ie IF that patient was to crash a rebreathing circuit would not be suitable to attempt to resus said patient as you would have no idea if said patient was recieving pure 02 or having traces of volatile anaesthetic being breathed into it while attempting to resus it..

But from economical benefit a circle is def a better choice than Bain for 40kg patient.But if i had a high risk patient,personally I would choose a non rebreathing circuit as i wouldnt want to be the one faffing about changing circuits in an emergency - all be it they dont happen often!

[/quote]

I was the one who mentioned a 40kg patient on a bain - I was being a lil dramatic! The bilateral eye enucliation was about 30kg. Still a lot of gas though!

I wanted to use a bain for the reasons I / Soo posted above, and I checked with the head RVN beforehand and she agreed with me

I did use one of those warming/humidifying things (name totally escaped me)

I have loved this thread - every day is a school day! I'm not sure what circuit I would choose for the same patient after reading this... prob a circle though, but with another nurse within yelling distance if apnoea developed = change of circuit....

Re: Flow rates

dinkyd — Fri, 19 Mar 2010 22:29:57 GMT

Re: Flow rates

Phrin Vernon RVN — Fri, 19 Mar 2010 22:19:46 GMT

[quote user="Vicky SVN"]

If you could post it here that would be fab

[/quote]

As I said - Soos way is much easier! I am sure she will not mind if you copy and paste her post to that thread! She can delegate the enemas and eags to me on monday at work if she disagrees LOL

Re: Flow rates

Phrin Vernon RVN — Fri, 19 Mar 2010 22:16:57 GMT

Erm OK!

SOO'S WAY IS EASIER! PLEASE BYPASS THIS POST COS I FIND IT EASY TO CONFUSE PEOPLE FOR NO GOOD REASON!

Basically

Minute Volume [MV] (per min) =

Tidal Volume[TV] (animals lung cap) x resp rate per min [RR]

So, Minute volume = animals lung capacity x their resp rate

Lung capacity is guesstimates at 10mls/kg for 10kg+, and 15mls/kg for <10kg

So;

MV = TV x RR

Example

15kg dog, RR 10bpm - what is the MV?

MV = (10ml/kg) x RR

= (10mls x 15kg) x 10bpm

= 150mls x 10bpm

= 1500mls

Now multiply by circuit factor

For example, a bain circuit (prob not ideal for 15kg routine patient, but I is the only circuit factor I can remember) factor is 2.5-3

For 2.5

Mv x circuit factor(CF)

so 1500mls/min (MV) x 2.5 (CF)

= 3750 mls/mim

= 3.75 litres per min

= approx 4L/min

I told you Sues way way easier! I did a OU science certificate, so I need to know the breakdown of every calculation!

To put it simply though

Tidal volume estimate(mls/kg) x weight(kg) x resp rate(per min) x circuit factor =

FLOW RATE

Re: Flow rates

Vicky RVN — Fri, 19 Mar 2010 22:09:21 GMT

If you could post it here that would be fab

Re: Flow rates

Vicky RVN — Fri, 19 Mar 2010 21:59:50 GMT

Please do post they way you've learnt it, cos others might find it sticks more

Re: Flow rates

Phrin Vernon RVN — Fri, 19 Mar 2010 21:56:56 GMT

[quote user="Vicky SVN"]

Sue, that is a fab way to remember it!

Do you mind if i copy it into the revision thread i started with useful things like this?

[/quote]

As Sue's colleague - she will be thrilled that it has been helpful

Sue & I went to different colleges, so learnt different ways - I prefer the way I learnt, but I am odd like that - If a tutor repeats it a few times, I'm happy!

Can post the way I learnt, but don't want to confuse peeps...

PS - Sue! Thankyou for all the portfolio help! It is soooooooo very much appreciated! And I haven't even had a drink (yet!) x