Artificial ventilation has saved millions of lives, it is one of the main medical procedures. In each intensive care unit or intensive care unit, more than one ventilator works, helping a person overcome the critical moments of the disease.
Breath is life
Try holding your breath while looking at the stopwatch. An untrained person will not be able to breathe for more than 1 minute, then a deep breath comes. Record holders can withstand more than 15 minutes, but this is the result of ten years of training.
We cannot hold our breath because the oxidative processes in our body never stop – as long as we are alive, of course. Carbon dioxide is constantly accumulating and needs to be removed. Oxygen is constantly required, without it life itself is impossible.
What were the first breathing machines?
The first ventilator simulated chest movements by lifting the ribs and expanding the chest. It was called "cuirass" and was worn over the chest. Negative air pressure was created, that is, air was involuntarily sucked into the respiratory tract. There are no statistics on how effective he was.
Then for centuries, devices like bellows were used. Atmospheric air was blown in, the pressure was adjusted "by eye". There were frequent cases of ruptured lungs due to excessive air pressure.
Modern medical devices work differently.
A mixture of oxygen and atmospheric air is blown into the lungs. The pressure of the mixture is slightly higher than the pulmonary. This method is somewhat contrary to physiology, but its effectiveness is very high: all people connected to the device breathe - therefore, they live.
How are modern devices arranged?
Each ventilator has control and execution units. The control unit is a keyboard and a screen on which all indicators are visible. Earlier models are simpler, they have a simple transparent tube inside which the cannula moves. The movement of the cannula reflects the respiratory rate. There is also a pressure gauge that shows the pressure of the injected mixture.
Execution unit is a set of devices. First of all, it is a high pressure chamber for mixing pure oxygen with other gases. Oxygen can be supplied to the chamber from a central gas pipeline or a cylinder. Centralized oxygen supply is arranged in large clinics where there are oxygen stations. Everyone else is content with cylinders, but the quality of artificial respiration does not change in any way.
Be sure to have a gas mixture feed rate regulator. It's a screw that changesdiameter of the oxygen supply tube.
In good devices there is also a chamber for mixing and heating gases. There is also a bacterial filter and a humidifier.
The patient is provided with a breathing circuit that supplies an oxygen-enriched gas mixture and removes carbon dioxide.
How is the machine attached to the patient?
It depends on the condition of the person. Patients who have preserved swallowing and speech can receive life-giving oxygen through a mask. The device can temporarily “breathe” instead of a person in case of a heart attack, injury or malignant tumor.
People who are unconscious are inserted into the trachea - intubated or performed tracheostomy. The same is done to people who are conscious, but have bulbar palsy, such patients cannot swallow and speak on their own. In all these cases, the ventilator is the only way to survive.
Additional Medical Devices
To perform intubation, various medical devices are used: a laryngoscope with autonomous lighting and an endotracheal tube. Manipulation is performed only by a doctor with sufficient experience. First, a laryngoscope is inserted - a device that pushes back the epiglottis and pushes the vocal cords apart. When the doctor clearly sees what is in the trachea, the tube itself is inserted through the laryngoscope. To fix the tube, the cuff at its end is inflated with air.
The tube is inserted through the mouth or nose, but the mouth is more convenient.
Medical equipment forlife support
To save lives and maintain he alth, mechanical ventilation alone is not enough. We need a variety of medical equipment: defibrillators, endoscopes, laboratory equipment, ultrasound machines and much more.
Defibrillator allows you to restore the heart rhythm and efficient circulation. They are mandatory equipped with cardiological ambulance teams and intensive care units.
An objective assessment of the state of he alth of the body is impossible without a variety of analyzers: hematological, biochemical, homeostasis analyzers and biological fluids.
Medical technology allows you to study all the necessary parameters and select the appropriate treatment in each case.
Apparatus for rescue teams
Catastrophe, natural disaster or accident can happen at any moment and to anyone. A critically ill person can be saved if resuscitation equipment is available. The vehicles of the rescue teams of the Ministry of Emergency Situations, disaster medicine and cardiological ambulances must have a portable ventilator that allows the injured to be transported alive to inpatient hospitals.
Portable devices differ from stationary ones only in size and number of modes. Pure oxygen is in cylinders, the number of which can be arbitrarily large.
Portable machine usage modes necessarily include forced and assistedventilation.
Emergency Medical Equipment
Specific standards have been adopted around the world, as well as medical equipment and tools for emergency care. So, the car must be with a high roof so that the employees can stand up to their full height to provide assistance. We need a transport ventilator, pulse oximeters, infusors for dosed administration of drugs, catheters for large vessels, kits for conicotomy, intracardiac stimulation and lumbar puncture.
The equipment of the emergency vehicle and the actions of medical personnel should save a person's life until hospitalization.
A baby born must live
The birth of a person is not only the main and exciting event in the family, but also a dangerous period. During childbirth, the baby is exposed to extreme stress, and resuscitation is often required. Resuscitation of newborns is only possible for an experienced neonatologist, since the body of a newly born child has specific features.
Immediately after birth, the doctor evaluates 4 criteria:
- independence breathing;
- heart rate;
- independence of movement;
- pulsation of the umbilical cord.
If a child shows at least one sign of life, then the probability of his survival is very high.
Newborn Resuscitation
Artificial ventilation of the lungs of newborns has its own characteristics: the frequency of respiratory movements is inrange from 40 to 60 (in an adult at rest up to 20), diaphragmatic breathing. Unexpanded areas may remain in the lungs, and the vital capacity of the lungs is only 120-140 ml.
Because of these features, the use of adult devices for neonatal resuscitation is not possible. Therefore, the very principle of restoring breathing is different, namely high-frequency jet ventilation.
Any neonatal ventilator is designed to deliver between 100 and 200 ml of respiratory mixture into the patient's airway at a rate greater than 60 cycles/minute. The mixture is delivered through a mask, intubation is not used in the vast majority of cases.
The advantage of this method is that negative pressure is maintained in the chest. This is very important for later life, because the normal physiology of all respiratory organs is preserved. Inflowing arterial blood is maximally enriched with oxygen, which increases survival.
Modern devices are highly sensitive, they perform the function of synchronization and constant adaptation. So, spontaneous breathing and the best ventilation mode is supported by the ventilator. The instruction to the device teaches to measure the slightest tidal volume, so as not to suppress the independent breathing of the newborn. This makes it possible to adjust the operation of the device to a particular child, to catch his own rhythm of life and help him adapt to the external environment.
