Hi this is a quick video to show you how to set up CPAP on the the V60 NIV ventilator that we have here in Addenbrookes Emergency Department. Before I get started though I have to say this video is intended for doctors and nurses who are already competent in managing patients in respiratory failure and who only need a reminder in how to set up this device. First lets take a look at the hardware. On button here, and battery indicator light beside it. The battery does last several hours but you are going to need it to transfer the patient to the ward, so please keep the V60 plugged in whenever its in use in resus. Power cabling here Oxygen tubing here goes in the main port in the wall There is an oxygen cylinder on the base but that’s only for patient transfers. Patient circuit goes here and pressure monitoring tubing attaches here. The V60 is a touchscreen but just in case you can’t use it there is the dial pad as a backup. The circuit that is used with the V60 isn’t compatible with any other ventilator in the department. It comes with a bacterial filter in the packaging. When you turn the V60 on it’ll start working straight away using the settings it was in the last time it was used. You can temporarily stop it by pressing ‘standby’ Then, to put it into CPAP mode press ‘modes’ and select CPAP If it’s already in CPAP mode this button will be blue and it will have had Batch written above it That takes you to the CPAP settings screen To enter the pressure that you want press CPAP and use these arrows to select the pressure you want to deliver Typically we start it at 5 cmH20 and then press accept. To select the FiO2 that you want to deliver press O2 and then use the same arrows to select the FiO2 And press accept. And then C-flex. C-flex is a setting designed to help the patient who is finding it difficult to breathe out against the pressure the machine is delivering What it does is it briefly drops the delivered pressure at the start of each exhalation the patient makes and then restores it to the pressure that you set by the end of each exhalation. What I’d recommend is when you are starting off CPAP in the patient with acute respiratory failure leave C-flex off and accept it and then go back into the settings later if you find the patient is finding it difficult and increase the level of c-flex. If you max out the level of c-flex and the patient is still finding it difficult you may have to drop the level of CPAP altogether. Once you have the settings that you want, press activate to start delivering CPAP There is two ways to get the machine out of standby mode One is, just connect the circuit to the patient’s mask and it will disengage itself when it detects patients breaths The other way is simply to press restart CPAP up here. Next steps: Once you’ve got the patient settled on CPAP Gradually, over the next half an hour or so try to increase the level of pressure delivered up to a maximum of 10cmH20 as the patient will tolerate While the patient is in the Emergency Department on CPAP They need to remain on continuous monitoring. Do check the Trust’s respiratory failure policy because, of course, there is an awful lot
more to the management of a patient in respiratory failure than I have discussed here. OK that’s it, really. All the best.