Mechanical ventilation saved millions of lives, this is one of the main medical procedures. In each intensive care unit or intensive care unit , more than one ventilator operates, helping a person overcome critical moments of the disease.
Breath is life
Try to hold your breath while looking at the stopwatch. An untrained person can not breathe for more than 1 minute, then a deep breath comes. The champions stand for 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 - while we are alive, of course. Carbon dioxide is constantly accumulating and needs to be removed. Oxygen is constantly required, life itself is impossible without it.
What were the first breathing apparatus?
The first ventilator simulated the movement of the chest, lifting the ribs and expanding the chest. It was called a "cuirass" and was worn over the chest. A negative air pressure was created, that is, the air was involuntarily sucked into the airways. Statistical data on how effective it was was not preserved.
Then for centuries, devices like blacksmith furs have been used. Atmospheric air was blown in, pressure was regulated "by eye". There were frequent cases of lung rupture due to excessive pressure of the supplied air.
Modern medical devices work differently.
A mixture of oxygen and atmospheric air is blown into the lungs. The pressure of the mixture is not much higher than 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. The devices of earlier models are simpler, there is a simple transparent tube inside which the cannula moves. Cannula movements display the frequency of respiratory movements. There is also a manometer, which shows the pressure of the injected mixture.
An executive unit is a collection 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 cylinder. A centralized supply of oxygen is arranged in large clinics where there are oxygen stations. All others are satisfied with the cylinders, but the quality of artificial respiration does not change from this.
Be sure to have a speed controller for the gas mixture. This is a screw that changes the diameter of the oxygen supply tube.
In good devices there is also a chamber for mixing and heating gases. A bacterial filter and humidifier are also available.
A breathing circuit is designed for the patient, supplying an oxygen-enriched gas mixture and venting carbon dioxide.
How does the device connect to the patient?
It depends on the condition of the person. Patients who retain swallowing and speech can receive life-giving oxygen through a mask. The device can temporarily “breathe” instead of a person with a heart attack, trauma or malignant tumor.
People in an unconscious state receive a tube into the trachea - they intubate or perform a tracheostomy. The same thing is done to people who are conscious, but having bulbar paralysis, such patients cannot swallow and speak on their own. In all these cases, the ventilator is the only way to survive.
Additional medical devices
Various medical devices are used to perform intubation: a laryngoscope with autonomous lighting and an endotracheal tube. Manipulation is performed only by a doctor with sufficient experience. First, a laryngoscope is introduced - a device that pushes the epiglottis and spreads the vocal cords. When the doctor clearly sees what is in the trachea, the tube itself is inserted through a laryngoscope. To fix the tube, the cuff at its end is inflated with air.
The tube is inserted through the mouth or nose, but through the mouth it is more convenient.
Life-saving medical technology
To save life and maintain health, artificial lung 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 heart rate and effective blood circulation. They are obligatory equipped with cardiological emergency teams and intensive care units.
An objective assessment of the health status of an organism is impossible without a variety of analyzers: hematological, biochemical, homeostasis analyzers and body fluids.
Medical equipment allows you to study all the necessary parameters and choose the appropriate treatment in each case.
Devices for rescue teams
A catastrophe, natural disaster or accident can happen at any time and with anyone. A person in critical condition can be saved if resuscitation equipment is available. In the machines of rescue teams of the Ministry of Emergency Situations, disaster medicine and cardiological ambulances, there is always a portable ventilator, which allows transporting victims alive to inpatient hospitals.
Portable devices differ from stationary ones only in size and number of modes. Pure oxygen is in cylinders, the amount of which can be arbitrarily large.
Modes of use of the portable device necessarily include forced and auxiliary ventilation.
Emergency Medical Equipment
Certain standards have been adopted throughout the world, as well as medical equipment and tools for emergency care. So, the car should be with a high roof so that employees can stand upright to assist. A ventilator, pulse oximeters, infusors for dosed drug administration, catheters for large vessels, kits for conicotomy, intracardiac stimulation, and spinal puncture are needed.
The equipment of the emergency machine and the actions of medical personnel must save a person's life until hospitalization.
A born baby must live
The birth of a person is not only a major and exciting event in the family, but also a dangerous period. During childbirth, the baby is exposed to extreme stress and often requires resuscitation. The revival 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:
- autonomy breathing;
- heart rate;
- independence of movement;
- throbbing of the umbilical cord.
If a child shows at least one sign of life, then the probability of his survival is very high.
Revitalizing newborns
Artificial ventilation of the lungs of newborns has its own characteristics: the frequency of respiratory movements is in the range from 40 to 60 (in an adult at rest, up to 20), diaphragmatic breathing. Unopened 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 to revitalize newborns is impossible. Therefore, the very principle of restoring breathing is different, namely high-frequency jet ventilation.
Any ventilator for newborns is designed so that it delivers from 100 to 200 ml of the respiratory mixture with a frequency of more than 60 cycles / minute into the patient’s airways. The mixture is fed through a mask; intubation is not used in the overwhelming frequency 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 maintained. The flowing arterial blood is enriched with oxygen as much as possible, which increases survival.
Modern devices are highly sensitive, they carry out the function of synchronization and constant adaptation. So, spontaneous breathing and the best ventilation mode are supported by the ventilator. The instructions for the device teach you to measure the smallest tidal volume so as not to suppress the spontaneous breathing of the newborn. This makes it possible to adjust the operation of the device for a specific child, to catch his own rhythm of life and help him adapt to the external environment.