The ventilator. Apparatus for artificial ventilation. Medical equipment

Artificial ventilation of the lungs saved millions of lives, this is one of the main medical procedures. In each intensive care unit or intensive care unit, not one ventilator is used, helping a person overcome critical moments of the disease.

Breathing is life

Try to hold your breath while watching the stopwatch. An untrained person can not breathe for more than 1 minute, then comes a deep breath. The record holders stand more than 15 minutes, but this is the result of ten years of training.

We can not hold our breath because the oxidative processes in our body do not stop - as long as we are alive, of course. Constantly accumulates carbon dioxide, and it must be withdrawn. Oxygen is required all the time, life itself is impossible without it.

What were the first breathing apparatus?

The first ventilator simulated the movements of the thorax, lifting the ribs and widening the thorax. He was called a "cuirass" and put on top of the chest. A negative air pressure was created, that is, air was involuntarily sucked into the respiratory tract. Statistical data on how effective it was is not preserved.

Then, for centuries, devices like forge-bellows were used. The air was blown in, the pressure was adjusted "by eye". Frequent cases of rupture of the lungs due to excessive supply 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 pressure. This method is somewhat contradictory to physiology, but its effectiveness is very high: all people connected to the apparatus breathe - therefore, 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 the indicators are visible. Apparatus of earlier models are simpler, there is a simple transparent tube inside which the cannula moves. The movement of the cannula reflects the frequency of respiratory movements. There is also a pressure gauge, which shows the pressure of the injected mixture.

The executive unit is a set of devices. First of all, it is a high-pressure chamber for mixing pure oxygen with other gases. In the chamber, oxygen can be supplied from a central gas pipeline or cylinder. The centralized supply of oxygen is arranged in large clinics where there are oxygen stations. All the rest are content with cylinders, but the quality of artificial respiration does not change from this in any way.

It is mandatory to have a regulator of the gas mixture flow rate. This is a screw that changes the diameter of the tube that feeds oxygen.

In good devices there is also a chamber for mixing and heating gases. There is also a bacterial filter and a humectant.

For the patient, a breathing circuit is provided that delivers an oxygen-enriched gas mixture and a carbon dioxide outlet.

How does the device attach to the patient?

It depends on the condition of the person. Patients in whom swallowing and speech are preserved can receive life-giving oxygen through a mask. The device can temporarily "breathe" instead of a person with a heart attack, a trauma or a malignant tumor.

People who are unconscious, enter the tube into the trachea - intubate or perform a tracheostomy. The same is done for people who are conscious, but who have bulbar paralysis, such patients can not swallow and speak independently. 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 illumination and an endotracheal tube. Manipulation is performed only by a doctor who has sufficient experience. Initially, a laryngoscope is introduced, a device that pushes out the epiglottis and spreads the vocal cords. 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 blown with air.

The tube is injected through the mouth or nose, but through the mouth is more convenient.

Medical equipment for life support

To save lives and maintain health, one artificial ventilation is not enough. We need different medical equipment: defibrillators, endoscopes, laboratory equipment, ultrasound devices and much more.

The defibrillator allows you to restore the heart rhythm and effective blood circulation. They are necessarily equipped with cardiac emergency teams and intensive care units.

An objective assessment of the state of health 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 choose appropriate treatment in each case.

Devices for rescue teams

A catastrophe, a natural disaster or an accident can occur at any time and with anyone. A person in critical condition can be saved if there is available equipment for resuscitation. In the cars of rescue teams of the Ministry of Emergency Measures, medicine of catastrophes and cardiological "fast" there must be a portable ventilator, which makes it possible to transport the victims alive to stationary hospitals.

Portable devices differ from stationary only in size and number of modes. Pure oxygen is in cylinders, the number of which can be arbitrarily large.

The modes of using the portable device necessarily include forced and auxiliary ventilation.

Equipment for emergency medical care

All over the world, certain standards have been adopted, as well as medical equipment and tools for emergency assistance. So, the car should be with a high roof, so that employees can stand up to help. A vehicle for ventilation, pulse oximeters, infusors for dosed administration of drugs, catheters for large vessels, sets for conicotomy, intracardiac stimulation and spinal puncture are needed.

The equipment of an emergency vehicle and the actions of medical personnel must save a person's life until they are hospitalized.

The born baby must live

The birth of a man is not only the main and exciting event in the family, but also a dangerous period. During childbirth, the child is exposed to extreme stress, and resuscitation is often required . Revitalization of newborns is only possible by an experienced neonatologist, since the organism of the newly born child has specific features.

Immediately after birth, the doctor evaluates 4 criteria:

• Independence of breath;
• Heart rate;
• Independence of movement;
• Pulsation of the umbilical cord.

If the child shows at least one sign of life, then the likelihood of survival is very high.

Revitalization of newborns

Artificial ventilation of the lungs of newborns has its own peculiarities: the frequency of respiratory movements is in the range from 40 to 60 (in an adult at rest to 20), breathing is diaphragmatic. In the lungs can remain unrevealed areas, and the vital capacity of the lung is only 120-140 ml.

Because of these features, the use of adult devices for the revitalization of newborns is impossible. Therefore, the very principle of restoring breathing is different, namely high-frequency jet ventilation.

Any newborn ventilator is designed to deliver 100 to 200 ml of the respiratory mixture to the patient's airway at a frequency of more than 60 cycles / minute. The mixture is fed through a mask, intubation in the overwhelming frequency of cases is not used.

The advantage of this method is that the negative pressure is stored in the chest. This is very important for later life, because the normal physiology of all the 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. Thus, spontaneous breathing and the best ventilation mode are supported by the ventilator. Instruction to the apparatus 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 specific child, to catch his own rhythm of life and help him to adapt to the external environment.