Critical care specialist Roger Seheult, MD illustrates a concise review of the essential skills of mechanical ventilation. We’ve made this video series free at https://www.medcram.com/courses/COVID19-ventilator-mechanical-ventilation
As communities across the world are facing or preparing for increasing numbers of patients in respiratory distress from COVID-19, MedCram has packaged this video series for clinicians and hospitals on the frontlines.
We understand that medical professionals (and students) that don’t have significant experience with mechanical ventilation may be called upon to help ventilator management teams in critical care settings. And clinicians with extensive ventilator experience may want a refresher or a tool to aid in teaching mechanical ventilation strategies to other clinicians.
This video series is a collection of previously recorded MedCram videos on mechanical ventilation with the addition of some COVID-19 specific videos.
This course will remain free, please share it with anyone you think may be interested. We hope you find it helpful, and we welcome feedback.
We appreciate you – medical professionals, students, and volunteers around the world. We are in this fight together.
Speaker: Roger Seheult, MD
Co-Founder of MedCram.com
Clinical and Exam Preparation Instructor
Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine.
Produced by Kyle Allred, PA
Media Contact: [email protected]
Please Note: MedCram medical videos, medical lectures, medical illustrations, and medical animations are for medical education and exam preparation purposes, and not intended to replace recommendations by your doctor or health care provider.
Visit our Website! https://www.MedCram.com
Facebook: https://www.facebook.com/MedCram
#COVID19 #mechanicalventilation #coronavirus
This video series on mechanical ventilation was produced for medical professionals, and free for all to view: https://www.medcram.com/courses/COVID19-ventilator-mechanical-ventilation
I wonder if they’re harvesting organs with these ventilators since most people die using them.
@Orco Kiwo If find unable to afford a ventilator, appyling “hot formations (towels, not so hot to burn the skin)” large enough to cover lungs, “front and back,” will give relief of discomfort. Must be done in series (not sure how many, so, since the bible uses the number “7” frequently, administer that many times) than give patient a break (say an hour), than repeat. I got this information out of a health book called “Back To Eden, by Jethro Kloss. Do try to order the book online. The “herbs” Golden Seal and or Echinacea will kill the infection (also can be purchased online). As well you can learn about those herbs online. Good luck in helping your ppl and “share your knowledge” with them. As well, as a bonus, give patient NyQuil. This will relax the body and help the patient sleep as “it heals itself.” Also can be purchased online.
Thank you for the tutoral. Very easy to follow (except for me, the math). My reason for watching this vid was to learn if the oxygen was distributed by mask or tubing to the lungs.
@Helena Funny Thank you for the links.
@Bonniebaby Boo I perhaps should modify my approaches in order to avoid hurting some sensible souls. Nevertheless, frankly speaking I wouldn’t learn the way you do online though.
Anyway, I have sent you some links about Ventilator. Hope you find helpful. Best wishes.
Could they use cans of air to stand in for ventilators that they don’t have. Pressurized cans of air used for hiking and diving with millions of cans already made…. but how to use them in place of the machines. If they can figure that part out, it may solve the whole problem of not having enough breathing machines…..
What about ECMO?
Thank you Dr. Sehelut. There is a severe shortage of Respiratory Therapists. Respiratory therapist have been well trained in all care of mechanical ventilator patients. Respiratory therapists can do your intubations so that the doctors are free to do use their skills in other patient needs.
Thank you for all your videos, Covid and beyond. You have been a source of reliable, easily understood information in the midst of chaos. This ED doc is very glad you are taking the time to put out these videos
Heading to NY to a setting where I may need to be assisting in more vent management than what I am typically used to. Thank you for this.
~20% survival rate for those put on a ventilator whom have covid-19. Hydroxychloroquine has an ~80% cure rate in early trials. Use the drug first (preferable when you are moderately ill when it is most effective) and then if it doesn’t work go to ventilator if necessary. Increases your chances to 84% of cheating death (beats 20% IMHO). Discuss this with your doctor in you are moderated ill with covid-19. (Note: I’m not a doctor so take this for what it is worth.) I will discuss this with my doctor if I’m unlucky enough to get this nasty disease. The actual best advice is not to get sick in the first place.
GREAT Videos – I’m not in the medical profession but an engineer and your videos clearly define Ventilators – thank you for that . . .
Had a question . . . .the COVID -19 virus causes swelling in the lungs – one treatment for swelling is adding ice or cooling down the affected area – would it be beneficial to cool the air going into the patient’s lungs to a point to help reduce the swelling? . . . if so have we tried doing this to help people infected with COVID – 19?
Thanks again!!!
Thank you .
Thank you.
The site can’t be reached 😔
I’ve done 4 things to greatly improve my lung function and overall wellness. My sleep, energy, and life outlook are greatly improved:
1. I started using the BreatheEasy Lung Exerciser about 5 years ago and still use it,
2. I stopped mouth breathing unless absolutely necessary, even when exercising, nose breathing is part of the immune system,
3. I did light mouth taping at night in order to ensure nose breathing all night,
4. I do a simple exercise to reset my CO2 levels for triggering breathing so I don’t breathe so much. See Patrick McKeown’s work for more about this. Voila!
That’s why they cost 25 thousand dollars wow
So this basically do not help to cure the disease. It’s only help the paints to breathe until he or she dies or live! In another word, good luck. If u are lucky this machine with save you. If not . God bless your soul.
Truly amazing how many Chinese Bots in the comments!
i miss more info on oxygen treatment (manuel/automatic ex. O2matic) for covid-19 – which potential can lower the need for use of a ventilator as explained nicely in this video
What pressure range in mBar should the device give out ??? Tell me please.
Ventilators are the key resource to saving lives in the fight against the coronavirus , but they are useless without physicians, respiratory therapists and nurses. Thank you !
Are you kidding, I child drawing
Thanks Doc! Great info for those out there kicking Corona’s Ass and saving lives!
Wow, this is so great to learn from . I am an optometrist and my mother is now on a vent from COVID19 in Michigan right now. I feel that I have a far greater understanding of what is going on now.
I’l would do like to know if a simple project will be efective in a emergency scenario. I have a project using just soleids valves and no contol PEEP.
Hello medcram, I am a medical officer of Nepal I am very much interested in this course. But I couldn’t find for sign up.
what is the value of the compliance that we need ?
which mode of ventilator most useful with covid 19 patient ???
You mean the CHINESE FLU dont you.
Thank you for the valuable lesson
thank you for the clearly explained lectures
God bless you guys! I am an RN without vent experience but I want to help – excited to learn ASAP
Hi Sydney, im an RN too. Are you working with vent patients yet? If so, how have you found the ease of which to operate machines, and deliver care to these complex patients? Thanks, I’m wanting to help as well, I just submitted app to volunteer in NYC. Thanks in advance!
Doctor, can you show an actual ventilator, possibly several examples of it and how it operates? I have sleep apnea and my main worry is that if I, or someone with a similar respiratory condition contract Coronavirus, it may be a death sentence. I am also contemplating purchasing a cpap machine.
I’ll never work in ICU but it’s good to know about it
Great course! However link to download cme certificate did not work. Any suggestions?
So in my mind it’s possible for patients to be grouped together according to lung compliance and pressure to potentially share a ventilator in a severe shortage. I watched the video of the doctor in Detroit? Or Chicago— somewhere in the Midwest . How would you potentially improve on the multiple patient set up?
Can you survive after being on a ventilator? People tend to stop breathing and die soon after a ventilator shuts off, though some do start breathing again on their own. If he is not taking in any fluids, he will usually die within several days of a feeding tube removal, though he may survive for as long as a week or two.Jul 21, 2019
Can you get brain damage from being on a ventilator? Researchers find why ICU ventilation can cause brain damage. Patients who have been mechanically ventilated in intensive care units have long been known to suffer some form of mental impairment as a result. … They note that the incidence of delirium in patients who are mechanically ventilated is around 80%.Sep 26, 2013
Sorry, is this the first of a series? Where can I find the next?
Could you rig cpap Machines to help with shortage?
Thank you Dr. Roger Seheult😊
About to cop one these homie
Love it. Great job for fellow medics and nursing staff across globe.
Vet techs and vets intubate animals of course, but could they also be useful during this time? Just thinking.
I’m so bummed. I just finished RT school and I have to wait to take my board exam because of the virus. I wish I could be in the hospitals helping. Thanks for this video.
Personally I think we need to be increasing production of ECMO machines. To blow air into lungs that have aveoli full of fluid is a waste of time. There is still no oxygenation happening. We need to oxygenate the blood & return to person as if they were fetus’ in the womb. Babies live for 9 months with lungs full of fluid…because the mother is operating as an ECMO machine. Their blood is oxygenated & returned to them all while they do not use their lungs. The covid sufferer has lungs full of fluid…so you can blow air in all day until the cows come home but the oxygenation is not happening! The air is not coming in contact with the blood at the aveoli level. Every time I hear them on TV talking about needing ventilators I want to shout at the screen that what they need are ECMO machines
Thank you so much for that information. I heard you loud and clear. Your comment explains “why” a person said the ventilators makes patients feel as if drowning. Of course it would if air is blowing in atop of congestion. Can you tell me where I can find more information on the equiptment you mentioned as more reliable for certain conditiions (lungs filled)? Again, thank you
@Clint E If the blood was being oxygenated & then returned to the body,,,,then maybe yes we could dry out the lungs, antihistamines might work better than sawdust…:)
I’ve been wondering same thing. Can’t they just use something to help thicken it to cough up like mucinex? Breath in some sawdust or something lol.
Your are correct.
n 3 Months..14,612 Dead…World Population = 7,700,000,000 = .00000189766 NOPE. Still *NOT a Pandemic. Put another way..if 14,612 people died *EVERY DAY from COVID-19 from now on it would take 14 1/2 years to reach just 1% of the World Population.. yet so many celebs have it. lets call it the celebrity virus haha. there was more chance of tom hanks being struck by lightning twice in australia than catching corona. in the medical encyclopedia from 1980 it stats plane and simple the corona virus is the common cold. they are hoaxing the public bad and purposely causing fear. trumps adviser even stated it was a hoax. look at these fools when confronted… @
thank you for these videos. am in icu and each day we are getting more and more covid patients, in ards and vented. this is a helpful review esp since i started in icu less than a year ago! thanks!
Thank you for sharing your knowledge so perfectly doctor! I’m in with this series as well! 🙂
I have been watching these videos for over a year, when I stumbled across the series accidentally. I love the information. I am reminded of things forgotten and introduced on levels I hadn’t experienced yet. Love this.
How is the patients panic response controlled? Are they conscious, twilight or our cold? I am speaking as a 60 year old lifelong asthmatic with anxiety and panic disorder and I am sure you deal with people like myself when the need to intubate arises, One of the most alarming aspects I have read is diaphragmatic paralyzation I could not imagine not being in control of my own breath without the panic running rampant although the physical o2|co2 exchanges would be met and proven by oximetry or blood gas if the fight or flight response kicks in doesn’t the heart rate elevate and respiration increase even to the point of hyperventilation? Or is one being pumped full of benzo’s and beta blockers to let the body fight it out with the cortisol and adrenaline?
Thanks for all your work both at your hospital and here in YouTube land we are all Lucky to have you.
Responses from anyone reading with experienced medical insight would be most welcome, thanks
Personally I think we need to be increasing production of ECMO machines. To blow air into lungs that have aveoli full of fluid is a waste of time. There is still no oxygenation happening. We need to oxygenate the blood & return to person as if they were fetus’ in the womb. Babies live for 9 months with lungs full of fluid…because the mother is operating as an ECMO machine. Their blood is oxygenated & returned to them all while they do not use their lungs. I realize we don’t have many of these machines & I wouldn’t want to play God here….but personally I think any Doctor who contracts this should get a shot at this. I can’t get the picture out of my mind of the Italian Doctor on the vent. I’m still praying for him.
Who doesn’t love pvnrt
Ex icu nurse going back now to help with crises ! Thank you for refresher course xxx much appreciated !
What kind of ventilators exist? Can you explain please? Are there any diy projects available?
Thank you for all you do!!!! This is much needed to many nurses!!!
There is a way to kill virus in chest through strong UV light only to chest
This is what our government should be doing! Getting knowledgeable volunteers ready to help! Thanks, MedCram!!
Hydroxychloroquine link to Candida Overgrowth? That would explain a lot.
In Denmark other healfcare personal has been trained how to operate ventilators, if we become short in critical personal
We have 20.000 extra previous healfcare personal in reserves… personal who previously worked as doctors, nurses etc. if needed…
Chromecast has a hard time with Medcram video’s, anyone that knows a solution?
As an anesthesiologist, I greatly appreciate what you are doing! Well done!
and we appreciate your work too!!
COVID-19 Chinese Consultation Center Release
@t
Can You please tell us how we can prepare our immune system or boost our immune system???
I believe a ventilator destroyed my lungs. Is it possible? I had a tumor in my abdomen surgically removed the moment I woke up I hard serious trouble breathing. I was on oxygen the first 4 days and still have trouble breathing especially when I lay down. My pulmonary function test was terrible too. No answers.
THANK YOU!!!!!!!!
Thank you for all you do. These are very interesting and informative. I do have a question. With all of the case’s in the US and the length of time it has been, is seems the number recovered for the US is slow. Why and how long does the symptoms last with this virus? Thank you again.
Please post a video about chloroquine if you’ve any further info on the clinical trials .
Been waiting for it since 3 days :/
Thank you, your instruction is so clear and so beneficial. You and your team are amazing.
I usually just use a one way value, tire pump and duct tape, but ok.
Also, the Tidal Volume (Tv) only helps to remove CO2 from the lungs, you oxygenate the pt by increasing FiO2, increasing PEEP, or increasing MAP. You oxygenate pt by increasing MAP as a last resort, although oxygenation and prevention of respiratory distress (which will lead to respiratory failure) are the primary goal, try to not use 100% O2 unless necessary to prevent passive atelectasis, PEEP is good for keeping the lung open to allow oxygenation. I am rusty on knowledge of MV myself, great video, so many more variables not mentioned.
The New England Journal of Medicine recently tested the Coronavirus on surfaces to determine its cellular life. Would a 2 day quarantine of the N95 / P95 mask, since its components are plastic and fabric qualify as safe to re-use ?
I have followed your channel since COVID19 outbreak in China. one word RESPECT 🙏
Do you have any insight into whether to use a mask or not? My friends are going out shopping for groceries and I’m encouraging them to wear an N95 mask but they don’t think it’s important. Do you advise wearing a mask of any kind for regular day to day activities?
Doc you are the best
Dr. Seheult: You said HydroxyChloroquine is a cure. Why aren’t they using it to stop the deaths? Why won’t the pandemic end soon if we have a cure?
I am becoming hooked n these videos. I worked in Healthcare for 20 years but on the Administrative side. It’s great to finally understand what all the technical and mechanical terms mean. I knew in a generalized way but this takes it to a whole new level. Information is presented in a clear, concise way which makes it easy to understand. So glad I found this channel.
Thanks. It has been 30 years since I ran a ventilator as a RRT. As a PA since, in Nephrology, I just glance at the vent while I head to the Dialysis machine. The hospital tells me I may need to dust off old skills.
Why can’t UV C sterilization be used to allow for mask reuse?
Thank you a lot doctor
Medcram, please answer:
Kidneys clean the blood. When people have kidney disease or failure, they go on dialysis.
Lungs oxygenate the blood. When people have ARDS, doctors keep trying to force oxygen into lungs that have nearly stopped working. Why is there no dialysis equivalent – some machine that can oxygenate the blood outside the body?
I assume I’m missing something obvious. What is it? Thanks!
You’re referring to an ECMO Machine.
ECMO stands for extracorporeal membrane oxygenation. The ECMO machine is similar to the heart-lung by-pass machine used in open-heart surgery. It pumps and oxygenates a patient’s blood outside the body, allowing the heart and lungs to rest.
ECMO for heart and lung failure
This channel is amazing! This should be broadcast to the public.
Doc your doing amazing work. The people that really need this information will surely appreciate you.
How do you determine the correct size to inflate balloon so it seals the Trach?
As a non-medical person, I got to say thinks for the education.very interesting and plan to keep watching. hope that I or those I love never need to use this device. I am 65, and can still hold my breath for 4 mins, so I suppose I have a compliant lung, and also take way less than 12 breaths a min. so might be a pain in the butt to get me going on this machine. cheers
We are going to thank Stanford University for the discovery of this combination (hydroxychloroquine + azithromycin) in the treatment of Coronavirus.
I hope that doctors will quickly use this formula that brings very promising results, as President Trump of the USA told us.
That’s nicely explained.
i am an engineer, when i see how this ETT is inserted into the patient, it give me great concern.
When a patient is infected, ALL of his air passages is infected. so the act of inserting the ETT could means scrapping off the virus in massive quantities and when the ventilator turns on, PROJECTILE PUMP the ENTIRE lung full of virus particles, thus accelerating the death of the patient.
Also to pump the balloon, you expect someone to blow up the seal, in an ICU full of virus, OPEN mouth.. OMG which idiot invented this process…. they should just shoot the designer…
also,
in theory there should be liquid removal in front of the balloon[lung side], why?
The surface of the air passages have hair that point upwards/outwards. assisting removal of unwanted matter with a cough. When you have the balloon, you prevent the lung from removing the expelling the virus and matter. when the patient is inverted, matter builds up in-front of the balloon[lung side] and when the ventilator pumps, Venturi effect takes over and you pump the lungs full of virus again…so you need to continuously remove all matter in-front of the balloon. Removing material behind the material does absolutely nothing.
bubblers work in wonders.
Can the coronavirus spread through air ventilation in apartment buildings?
Yes it can… China had people infected in the same building through the ducts/pipes. I’ve taped off ALL my drain openings and use HEPA filters for my vents. My apartment is like a jungle, so I get oxygen from them and can open my windows for fresh air. Better safe than sorry!! Hope this helps!
Thanks Doc. Very timely update.
I will jump on for sure!
Unrelated to this video but I need your expert opinion on fever. When should I intervene? Best treatment? Every doctor I’ve dealt with has no concern over a fever. Do you agree?
we would love to see your handsome face whilst giving a lecture on the video 😊😍
Excellent video. RN in ICU 30 years.
Is ther any thing you can do at home with a respirator and medicine to prevent it from turning to pneumonia
Dear medcram I have a question what I maybe being over looked I have heard that chloroquine is used for lupus patients do we know in that data that are people with lupus being affected by Covid-19 to see if it had a sheilding affect ?
Thank you for your content, you are brilliant 😉
With the increase of ventilator patients , will the general care nurses have to learn how to use these machines?
Intensive care nurses are trained to use these machines. It would be smart if the general nurses are trained too.
You illustrations are awesome doctor! Even a lay person like myself can understand your simple instructions. Thank you!
Very well explained, not even a med student and understood everything.
Working with these COVID patients in NYC now. I’ve intubated two. Scary, no reserve. This is a great channel for helping those learn more. Thanks for educating the masses. Now back to work in the ICU.
Woo hoo Sunday video and 200th comment right here baby
Just finished watching all the videos! Also love the integrated quizzes!
Is there a difference in the severity of the COVID-19 disease depending on how many viruses enter the body. Is it easier to recover if only one cell gets infected?
Is it possible to perform some kind of “controlled infection” by infecting a single cell somewhere in a toe, if possible?
Thanks for a great work!
Can a cpap
machine be converted to a ventilator to help the coved 19 crisis ?
P Suds No, but could help with keeping lungs from collapsing/ alveolar filling with fluid. Cpap is basically Peep on a ventilator. However, Cpap does not provide rate. All a cpap would provide is peep in an actively breathing patient.
Thank you for helping our friends battling this outbreak day after day and helping everyone who is ill that may be in need of this level of medical assistance in the future but doesn’t know it as of yet. I am so glad we have someone reaching out to help the way you have. It means the world to us, and it really does mean the world to us!
Just a student respiratory therapist trying to comprehend ventilation and perfusion. Thank you Doc!
Medcram: Be well
*Chubbyemu has entered the chat*
tx
Your the best teacher I have ever had. I understand molecular biology because of you!
Thx
Why would you want to use PC over AC? PC requires an alarm while AC would continue to provide the same volume to ensure oxygenation. It also makes me wonder if there is a hybrid approach, things like provide X volume but stop if the pressure reaches Y (then repeat the cycle say 12 times per min).
wow, doesn’t that show you that the hospitals will not have enough ventilators or staff.
When I got a dry cough and sweats I took 4000 mg of vitamin C every 15 minutes until the symptoms went away, When the cop came back I took more vitamin C and I was fine. Like any virus it takes 10 days or so to work its way through the system no need to panic
@David Musial What is your interest in recomending large amount of vit C? And why did you mention that cop?
@Matija Deretic 2000 mg is not the upper limit. They tell you that, but it’s not true. Your body needs more vitamin c when it’s sick, so you can take more. Did you say get ready for cramps? I did this over a week ago and no cramps so maybe you don’t know what you’re talking about. This works and they wont tell you about it because big pharma would lose money. As far as hiv, its not transmitted the same, it takes semen or blood. Ive heard it kills hiv but I dont have personal experience
2000 mg per day is upper limit for vit C.
If you truly did what you wrote get ready for abdominal pains, cramps, diarrhea, headache, nausea, sleeping problems.
Anyways, you have good intentions, but please be careful what you share with others, people could take your comment as medical advice. And that part about cop I have no idea what are you talking. And not all viruses pass in 10 days. Ever heard of HIV?
*Over the last half decade, this is the EIGHTH video you’ve offered on mechanical ventilation concepts, and just like the other 7, this is quality instruction. Crucial for this year as well. Thank you.*
I can only hope that if I get sick, I’m treated by a nurse who is a fan of this channel. Thank you for your service!
Hello Doc…you can request me…
@Daniel Herrera YOU ARE IGNORANT OF THE FACTS ! YEA, YEA!!!
@fishouttawtr Yea, no
@Daniel Herrera its the ventilators that use 5g that are a death trap!!!
I think only doctors set ventilators
Thank you for your relavant, factual rational info. It really helps me understand better amidst the crazy talk.
I’m an engineer now, but I did study undergraduate and postgraduate physiology. I seem to recall a sigmoidal lung compliance curve. Is it important to monitor where we are on the curve to properly manage pressure?
I am trying to build a prototype
What are the reasons to choose one mode of mechanical ventilation over another one?
I’m a bit concerned. I have lived near sea level and also in the Colorado Rocky mountains. I have delivered babies in both and high elevation labor is harder than low level labor. Every other year or so a healthy college kid would die from acute mountain sickness on spring break or summer vacation. Usually they had never heard of the severe symptoms to watch for after all they weren’t hiking Everest. Anyway it isn’t just cookies that are harder at altitude. What advice do you have for doctors working at 5,000 feet 8,000 feet? What advice for patients sheltering at those elevations with preexisting risk factors? Are ventilator settings different at altitude? Should people move downhill?
M4. This is EXACTLY what I was hoping for from this channel. Thank you 🙏🏼 🙏🏼
Thank you for putting out these videos.
Thank You so much- I’ve been vent trained since the start of my career. Any instructional videos are desperately needed. You are one of our healthcare heroes- You and Dr. John Campbell have been spot on.
I’ve been following you since the beginning of Cov 2. Just wanted to say thanks for keeping us educated and up to date. Be safe!
Could a CPAP machine be used as an emergency ventilator for Covid-19 patients?
thank you doctor
Thx for the lesson. Can’t wait to listen to the rest of the videos. It’s been a long time since I practiced as a Respiratory Therapist (30 years).
Dont you think the auto makers should start producing the old bellows type machines with no computerized components so we can have them Now, as to buy time until we can get the modern type?
Hey Doc, don’t you find it fascinating to view the macro scale of human response to biological crises and the micro scale of the actual antigens themselves. The human response is to mount a defense and surround, isolate and eliminate the antigen from society; just as the body’s immunological response is to do this on a smaller scale. Everything large is a reflection of the successes and failures of everything small.
Case in point, when the system — on the macro level, the societal structure (healthcare for example) is overwhelmed, the structure is more prone to collapse during a response. This is just like the micro scale of biological threats on our systems on a micro level.
The exponential scale of biological life and worldly / universal structure is so amazingly intertwined!
So grateful for your work. thank you
In Taiwan, the government assembled a national machinery team to have 92 production lines to make medical equipment and gear since January because they know they cannot depend on Chinese shipments.. They are ramping up production to make 15 million masks per day. How many months does the government need to figure this out? How many months do these health professional need to get themselves prepared?
Each and every person that I knew that was intubated ended up having damage whereby they could no longer eat via their throat afterwards and then were in a state of needing to be fed via a feeding tube , making them a permanent patient. It was the END for EVERY one that I knew who was intubated. . Im of the belief that either these people are poorly trained or this is being done on purpose. In my area , if you need this you may as well just forget it as your going to be dead in a few weeks from what they do to you. And im living in an area that has world famous hospitals.
@Bobsblues I can’t comment on that, as I don’t know current procedures and individual cases. There are many methods to provide oxygen to the patients, ranging from Nasal Cannula, Mask, to incubation ventilation and Tracheotomy. The methods adopted were depending upon the Conditions of patients.
For the critical cases of Covid-19, incubation ventilation would help patients to get rid of the secreation accumulated in the lung which was caused by pneumonia.
Frankly, I don’t like anything intrusive myself unless absolutely necessary. The situation you described was real. There have been patients suffering eating difficulties afterwards..
@Helena Funny They are receiving damage by this procedure that renders them unable to swallow correctly ever again which then requires them to be forever fed via a feeding tube which makes the person a permanent patient in a nursing home. A very clever Boomer remover.
@Bobsblues : Dr. Seheult is working in Intensive care unit. The patients there are all critically ill. Intubated ventilation is intrusive, which is used for patients whose conditions make NIV NOT applicable… You are quite right that many people wouldn’t be able to survival even if with the helps of Incubated Ventilation.
Thankyou, such a great resource
Thank you
Do you think APRV would be better for covid patients?
Yes possibly. I like conventional ventilation first then I would go there next if oxygenation becomes an issue.
Awesome!!!! I’m a CRNA and was an ICU RN for 10 years and think we are forgetting the PERSONNEL ELEMENT while concentrating on masks and ventilators. There is already a critical shortage of ICU RNs (and intubated vented patients require EXTREME VIGILANCE) and this crisis may require HUNDREDS of THOUSANDS OF ICU RNs. Not every nurse can do this, nor can every physician or PA or AA or respiratory therapist. I’m encouraging my fellow CRNAs to be an ICU RN now (I’m doing it!) but there’s only 50,000 CRNAs in the USA. We are going to be in a CRISIS when we realize the intense need for critical care nurses and this whole time we should’ve been focusing on STAFF and not just masks and vents. We have a lull, idle time now with nurses sitting around unemployed when we could be organizing them and educating them to anticipate this huge need.
TRAINED PERSONNEL STAT NEED! : CORONAVIRUS EMERGENCY VENTILATOR TRAINING OF NURSES TO MANAGE VENTILATORS IN THE ICU
There are 350,000,000 million Americans and if only 10% of the population get the coronavirus (COVID-19) that equals 3,500,000 people. If only 2% of that 3.5 million infected require mechanical ventilation that means we need 70,000 ventilators. We need TRAINED PERSONNEL TO MANAGE THESE VENTILATORS!
One critical care registered nurse (RN) can manage 2 ventilators during one 12 hour shift. The shifts are 7am-7pm and 7pm-7am. Therefore that’s 2 VENTILATOR-TRAINED NURSES that can manage only 2 ventilator-dependent patients for a 24 hour shift. Usual shifts are 3 a week, during a crisis we may be able to up that to 4 shifts a week.
We currently have around 3 million nurses. We have around 500,000 critical care RNs. We will need hundreds of thousands of critical care RNs to care for the minimum projection of 70,000 intubated, ventilated patients. That’s assuming none of the precious critical care RNs get infected themselves with the coronavirus and end up in quarantine.
We have a limited window of time and opportunity to rapidly train preferably nursing personnel and even other healthcare professions on ventilator usage. We need to mobilize our current nursing staff in logical departments like telemetry, emergency room, operating rooms, medical surgical and start training them NOW on VENTILATOR MANAGEMENT BEFORE IT BECOMES A CRISIS!
There are already programs, powerpoints, videos out there on training nurses how to use ventilators. We must organize our 3 million nurses NOW and train them NOW on ventilator management. I am urging all decision-makers to form a mobile NURSE VENTILATOR TRAINING COURSE NOW (videos, text messaging, emails) so we can be PROACTIVE in this future need.
that’s a leadership counting all numbers and telling, maybe it’s good to tell to the staff that is in charge of the country for this pandemic.
always concise, relevant, and much needed.
Man, after the pandemic ends, i want to hug Roger, i was starting to worry on why he wasnt uploading the COVID-19 update #42
I’ve been following his COVID-19 updates. He only uploads the updates during week days. These videos are extras.
me too
Can a ventilator function if the lung is out of commission?
God bless you Dr. Seheult
Can we reuse the masks after its kept isolated or unused for 10days
Thanks for another great video! Awesome content, per usual!
I’m a Registered Respiratory therapist looking to help but can’t find a site to sign up
@Sarah Stone give me a number to call
New York needs help
Somewhere in your state there should be a hospital at full capacity they may need help. Try calling the human resource department at that hospital. I know New York definitely need some help. The drs and nurses are tiring themselves out over there.
try emailing a local hospital
I have no idea where you are, but San Francisco General Hospital was fast tracking the hiring of nurses recently, eliminating some of the normal steps and criteria
I posted your old video to all my friends 3 days ago.. Thanks for the new update!
i am not a medical professional I just watched it to send you some youtube cents to support your good cause.
Liberals who promote deindustrialization deserve what they face now! No mask No viral testing drug No equipment, they should be used as human factory to produce vaccines, it is ironic US need import rather than manufacture the medical stuff on her own effort
Could cpap machines help? There would be quite a few available I’d imagine.
This was my question as well. My wife and I both have sleep apnea and we each use a Resmed S9 which continuously adjusts pressure throughout the night to match the pressure we need. I’ve been watching the Doctor’s coronavirus updates since late January so around the first week of February I started lining up our medical preps for the event we get this after the hospitals are overwhelmed. I’ve got flu meds, vitamins and minerals especially C, D3, Zinc and I recently got some Quercetin, which is a zinc ionophore, assuming I won’t be able to lay hands on hydroxychloroquine. The one thing I haven’t solved for is if somebody in my family needs a ventilator. Hopefully it won’t get that far with the quercetin and zinc but I’m hoping our CPAP machines would do something.
No formal medical training, but I know quite a bit about medicine for a lay person. Familiar with CPAPs from family members and friends. Here’s my take:
I’m pretty sure CPAP machines don’t exert enough pressure to inflate lungs on their own, only to push back on soft-tissues in the head and neck enough to keep the airway from collapsing. And the pressure is continuous, which means that while they make inhaling a _little_ bit easier, they also make exhaling a little bit _harder_ . They’re completely reliant on the patient to manage their own breathing rate, too. So perhaps they could be of some benefit to patients on the very edge of those who would be given a ventilator under normal circumstances (but wouldn’t given short supply).
There’s also the infection risk to consider in having someone breath through a machine that might not have been cleaned as recently or thoroughly as it should’ve been and isn’t made to be (easily) sterilizable in any case. If someone’s pneumonia were bad enough that the little bit of help breathing that a CPAP might offer would be important, I’m guessing it’s probably also bad enough that their lungs are very vulnerable to additional infection. And any additional infection could easily push them into _needing_ a real ventilator. So infection risk might outweigh the already iffy mechanical usefulness.
Keep up the excellent work, Doctor!
Would you use a ventilator built in a closed down chevrolet plant?
Thank you all for the prayers and the wonderful messages,my heart is full..thank u Dr Seheult for your lectures, i am grateful.
Thank you!!
I am from China, my experience is if you implement lockdown , it will be contained within 2 months , I upload the experience I have in China on this channel of I
How things going are you all doing all right.
Thankyou again, Dr.! Please keep the videos coming. We really appreciate what youdo. I can see for years you have been doing this and finally you have our undivided attention. You are getting the views and attention too, that you deserve from us after all of your efforts in making the good videos. I hope the hundreds of thousands of viewers will multiply for you more than even this horrible virus affecting us…. you are a hero to many of us who wish to learn about this virus rather than waste our time making horrible jokes and memes. Thankyou, again, for guidance and proper knowledge. *huggles*
not sure if you noticed that everyone on youtube become a Doctor or for reviews to make expensive online classes, its nothing wrong with that, but people start to lose trusts with these websites, but what I like about your videos, that you show your passion of spreading acknowledge, and you simplified for everyone, and I like that, so thanks for all these videos, I definitely learned a lot and hope someday I can help others and save lives, Keep the good work. ,,,,and I know I mean what I say cause I never typed three lines comment before lol.
Has everybody heard about ZINC and CHLOROQUINE for the VIRUS are also called HYDROXY CHLOROQUINE along with Z pak its all over the youtube channels
@Hamal Jay thank you for sharing that story God bless you
This guy talked about it weeks ago look up his videos you will find he was ahead of the game.
I remembered watching this video when I was a new RT student. Your videos really help me understand the mechanical ventilation concepts. Thank you!
The data is clear you don’t want to be put on any type of ventilator your chances of dying is 67% if put on mechanical ventilator and 70% 12 months out…. This data is certainly not discussed enough. A disease like COVID-19 these patients have no reserve capacity. If you can’t be around 12–13 METs normally you are totally screwed. because it you are normally 8 METs and this illness takes 5, you are going to die.
did the chinese use uv light to kill the virus ?
@Mr Brown does that mean warm weather will stop or slow it down
@steve mooney m kidding you. You should Google it or YT it. Maybe
@Mr Brown thanks for your reply are us hospitals ramping up uv light use and is it effective ?
Yes LED too. And some used microwave ovens
Yesterday I saw a facebook post that multiple patients can be hooked up to one vent.
But I don’t use Facebook
Thank you you to the entire medical community for all they are and will do.
Heroes.
So clearly explained…I like your other videos as well.
I have seen success stories, and scientific explanations about Chloroqvine and Remdesivir with added Zinc. Don’t take over 100 MG of zinc. The ratio needs to be 2 MG of copper to 15 MG of zinc. All need to get what is in my comment.
@Jonathan Hughes what about Quercetin ?
@Karen Gabrielsen Then the nutritional almanac, is wrong. “Superloading zinc by taking up to 100mg zinc a day is confirmed to be safe in the short term (2-4 months), “
@Mr Brown Fauci said no. “The information that you’re referring to specifically is anecdotal,” Fauci added firmly. “It was not done in a controlled clinical trial, so you really can’t make any definitive statement about it.”
He went on to explain that the Food and Drug Administration is looking for a way to make the drug available for emergency use, but in a manner that gives the government data about whether it’s safe and effective.”
Jonathan Hughes 40mg of Zn per day is upper tolerable level !!
@Mr Brown There are studies that are investigating this. No results yet.
Don’t take it without speaking to a health professional. The side effects are considerable.
great idea! God bless you and your family.
This is why we love Pulmonologists. We are so busy on the floor and we get hit with refresh with added info. We need crash course fast track on Restrictive ventilation on the spot when MD says here you go do your thing and leaves. Initial settings for restrictive base off ht. Thank you!
Is there any truth to the story I’ve heard that there are manifolds available for allowing one machine to ventilate multiple patients at the same time? Thanks
Poland already producing machines that can vent 2 people at once
I saw somewhere that Italy was putting two people on each one. I have seen too much to tell you where.
I saw him state this in a video a few videos back, he also stated that ventilation companies were coming out with components that you could purchase to make doing this possible
For anyone who doesn’t know. Being on a intubated ventilator is NOT pleasant. It’s a horrible uncomfortable and or painful. Having a tube in your throat is not something you want. This virus is not a joke. Don’t go to work, stay inside.
👍💯
I work in a neuro Icu where we don’tsee too many ARDS patient but I think that is going to change quickly. Great video to brush up on the knowlege! I will share with my fellow nurses!
Good to hear, thank you for sharing
Greetings from ARGENTINA. I always watch your videos. Always with the right data and clear. Thank you for your time and work on this.
The patient has to be sedated before you intubate them right?
@Love Relationship Talk yes of course not having enough oxygen is another scenario. And world needs alot of venteez
@Mr Brown not necessarily, the patient may be alert and struggling to breath, so you have to sedate them and place the tube in for ventilation
It is for those who are unconscious and can’t depend on their own regular breathing even with okay lungs.
Yes, but you can still feel it. It’s horrible lying in bed with a tube in your throat. Seeing patients in their bed moving because they are uncomfortable and trouble breathing sucks.
Thank you for this! Can’t wait for the next course!
Roger you are doing God’s work. Thank you. You are amazing man. Keep on trucking. Our appreciation of you is off the clinical charts 👍🏼
Thank you for staying away from politics. I appreciate so much.
Thanks for your fantastic job! I appreciate that.
Maybe this could be a good aid!? “Loperamide demonstrated anti-MERS-CoV, anti-SARS, and anti-HCoV229E activity in an in vitro screen of approved drugs [36], although the mechanism of action is unknown. Interestingly, loperamide was suggested for limiting gastrointestinal fluid and electrolyte losses in patients with Ebola virus disease (EVD) [37].”
@Magnus Barnabus 36/37
@Mr Brown ?
John 38
Thanks for this video. If I am unlucky enough to get intubated I will now be less scared, since I know more about what’s going on.
@Pat Pierce Yeah, same. I want to know what happens if worst come to worst. Good luck to you and your family. Don’t forget to share the video. We all need to know these things now.
Ni An That’s why I am watching….my sister, her 2 sons, and husband all in Los Angeles, started showing symptoms 2 days ago. I figure learning what to expect, helps me explain this to others.
Not a doctor but this is interesting
You guys have always been like 2 months ahead of the news cycle. Stuff that I hear on the MSM today, was already explained more thoroughly in early February.
I think it’s because they are out in the field going through the crisis in live time.
Yws, the pros knew, this was coming or it is a possibility.
Thank you for being purely scientific and zero amount political.
How do you place a tube down your throat without experiencing a major gag reflex?!
@MedCram – Medical Lectures Explained CLEARLY Thank you! Keep up the good work doctor.
Sedation
Hello Doctor Seheult , I would like to ask whether Clarithromycin can be combined with hydroxychloroquine for covid-19 treatment ? Or is azithromycin a better option ?
Is azithromycin helping with secondary infections which are bacterial infections from covid 19? Yes I understand that covid19 is a virus.
That’s a great question. It depends on exactly what is it that Azithromycin is doing. I’m not clear exactly what it’s doing but it seems to work therefore I don’t know if clarithromycin would be beneficial or not.
when do we get to start writing scripts?
The world needs more doctors like you, thank you 🙏
Your information are very clean and easy to understand. could you please comment on DIY masks that are around the internet please? will that mask help? if so, what is the proper material we can use? please help with this.
Thank you very much. Keep doing this. it is alway a pleasure to refresh and learn new things
Every country needs to produce their own medicine and medical equipment.
Let’s learn from our mistakes.
How about the Vatican, Monaco, Benin, Luxembourg, etc.
Iran is already doing that.
Totally agree with that. Drugs ahould be open source but the researcher should get percentage of drug manufactured and sold. Every country should manufacture their own medicine and equipment.
@David Burgin Seeing as the socialized medicine(China, Italy, UK) countries are the ones getting FUUUCCCKKEEDD, you’re right
@Nicki Snyder Yeah there was 8 million before the famine so they were a big country back then in those times which is why they still have a disproportionately big influence on world culture today. They are alive and well on the east coast of the US.
I don’t work in the medical field, but as someone with asthma who may, with poor luck, need a ventilator during this crisis, I appreciate the clear explanations here. It makes things a little less scary.
I’m an older at risk person to COVID-19 and I hope if have to be ventilated I’ll be kept heavily sedated for the duration. Doing all I can to self-isolate in the meanwhile and feeling a little anxiety.
Until you see it though then it’s horrifying. It’s not pleasant having a tube down your throat.
After this, I’ll be able to do it. Kidding.
Critical care is unbelievably complex. I just started to feel comfortable doing it and then I retired. LOL.
Looks horrifying. I appreciate this because on the news they keep throwing around the word, making it sound so simple. But it’s horrific and people die on vents, too. Not like a shot or something.
@SolSere Jeremy trust me you still feel it. It’s not pain. It’s uncomfortable and you can’t move.
@Umbrella Corporation Well, usually if you’re intubated you’re sedated. You wont feel a thing.
Nope, this is serious.
Yeah a lot of people don’t know that being intubated with a ventilator is NOT pleasant. Having a tube down your throat breathing for you and not being able to move is extremely uncomfortable.
Wow thanks 🙏🏽
Will a CPAP Machine help some one with CV19 at all, IF a ventilator is not available?? I know in Spain they are giving the ventilators to the young, and giving sedatives to the old to ease their death. Maybe this idea will help some More LIVE~!
@Ni An Great question.
@Joe Uehlein Thanks for the explanation.
In Italy it looked like they made something that looked like a CPAP. They had a plastic bubble around head and looked like they were forcing oxygen in there.
Yes, (from an anesthesiologist) in the hospitals we rarely used CPAP except for those who already used it at home and didn’t need additional lung support. BUT if someone has a respiratory issue such as a pneumonia but isn’t making it on nasal oxygen but still isn’t critical enough for a ventilator. In that case we try a machine called a BiPap. With the BiPap we can adjust the oxygen concentration (which is also possible with CPAP – I’ve done it on patients myself a few times) and it is delivered with essentially the same mask setup. The CPAP just delivers the air at one pressure. The BiPap has adjustable pressures for both inspiration and expiration. BiPap is a bit more efficient with damaged lungs such as Covid pneumonia. CPAP would certainly work better than just plain oxygen on the nose – especially if extra oxygen is bled into the tubing. Monitoring the patient’s oxygen levels and other vital signs is very important – to see improvement or decline in condition. If the hospitals start to get overwhelmed I bet CPAP will be used as a last resort on these patients.
You are doing an amazing job. Playing your role in helping several thousands of newly inducted medical staff. hats off to your efforts. I hope this helps everyone who is new in this field.
” . . . it goes into their mouth, passed their vocal cords specifically, and down into the trachea . . .”
. . . unless it goes into their stomach, but that’s another lecture.
Hi Nnmi Hiseddeo U look so pretty , pray for your Good health .
past, not passed
we immediately check ET placement with a CO2 indicator (exhaled CO2 from the stomach?) and auscultating breath sounds while bagging prior to connecting to the vent.
Simple, well done Doc.
Does this work like the iron lungs from the past?
Okay. I tweeted it to @realdonaldtrump. Follow me @DominaJustitia
You’re doing great job sir❤. May God bless you. Love from Bangladesh.
Thank you
I remember seeing my deceased dad, while he was on a ventilator. It was a freaky site. I hope I do not die, while using one.
@TrumpIsToBlame you wont; I understand fear well enough to tell that it only exist in your head, focus on why you should be prepared, fear is good its your best friend, too much fear is not, you are always stronger than yesterday if you aknowledge this fact
I’m sorry about your father; but we all perish, the question should always be “how”, not “when”, strip yourself from life but don’t give up on it; you owe it to yourself
@Lynda yes, good point Lynda. I just do not want to suffer.
Lynda there’s peaceful deaths like dying in your sleep. There’s also fast deaths where you’re gone before pain kicks in like gunshots to the head. Not everything is as painful as death by fire or asphyxiation.
You are stronger, no more talk about dying, you’ll make it, no other options exist!
Hometheaterguy now that I think about dying I don’t see an easy way . I guess we came in with our mothers screaming of pain and we exist the same way
Warching you makes me fell safer lol
Love that formula one in the business of making them now. God bless.
Thank you for this and all that you do. We never covered this in PA school unless we had an elective ICU rotation.
Antti Kokko let me guess: you’re still pre-med?
Hey Talia 👋
I’m sure you never went to a PA school. I learned about this in pre-med college courses.
Thank-you
In MedCram We Trust
P.S. I was worried that you didn’t upload for awhile
Truth! And i hope the good Doctor gets his rest like he deserves. 🙂
Better trust God.
He doesnt upload on Sat/Sun
Team MedCram usually takes the weekends off 🙂
You’re the best! Thank you so much for the most informative videos. I know these are a tremendous amount of work! May God bless you and keep you, Dr. Seheult!
It’s the End of the World as we know it !
@Umbrella Corporation after this is over there going to be a huge change in the world in this new decade
My daughter & I were just singing that song, yesterday…
@Cody Anderson not just the media. And technically he’s right. When it’s all over we are not going back to How normal life used to be.
Says the media
Thank you for helping us who are concerned about the proper use of this important tool !!
Thank you. This is wonderful
Thank you for being a source without sensationalism. I appreciate that.
First! Love you Medcram! Please do video on Germany and why their mortality rate so low? What is their preferred treatment method?
Yes!
Registered Respiratory Therapist here. Thank you for your videos spreading knowledge
Thank you for ALL your efforts. All your years of study and training is helping us all to this day. Blessings.
Thank you for your life saving skills!!
Thank YOU for the work that you do, especially now ( ◡‿◡ *)
Thank you for your support, we love RRTs!
First❤️❤️❤️ thank you med cram your fan from Philippines
First Comment, Thank You 😇 Like and Pin me 🙏🙏