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Thread: Vent Weaning with RT - Brain Trauma vs SCI

  1. #11
    Senior Member
    Join Date
    Oct 2011
    Location
    California
    Posts
    190
    Hi Scaper1,

    Oh gosh... when you trigger a breath, what is your average and highest tidal volumes? what is the pressure setting?

  2. #12
    On my particular vent there's a sensitivity dial for the trigger mechanism, and mine is set to low, meaning even a slight movement will suffice to trigger an extra breath. My volume is set to 900.

  3. #13
    Senior Member
    Join Date
    Oct 2011
    Location
    California
    Posts
    190
    1) It seems that my Dad was sleeping when they tried to test him. It's wierd - the doctors did the test. The RTs tell me that my Dad needs to be awake.

    So, the RTs tried again -- he could trigger his own breath for 3 hours and they wanted to keep my Dad going until he wiped out. My Dad was fine from their perspective -- but, I noted a drop in O and a lower heart rate. He was really tired the next day.

    Is there a risk to just have my Dad keep going until he wipes out? Shouldn't it be done like exercising other muscles in the body after a long hiatus, start out slow and gradually increase?

    I don't know the technicalities -- but I believe there's a particular mode called "pressure support" wherein he can breathe on his own (with pressure support) and his breath's tidal volume is measured. My Dad had settings at 15 and 10... highest tidal volume at 611 and 443 respectively. Also, you can set the lowest baseline such as 300 or 250, the machine will alarm and this will indicate that he's tired.

    Is this right, SCI nurse?


    2) KLD and others who may know - I'd appreciate your feedback.

    I spoke with Santa Clara again. I asked if a switch to Medicare would help.

    SC told me that Medicare will not pay for the vent weaning program because SC's program is unique in that it is a part of the ICU -- and, it is billed as such. Medicare will not pay for my Dad to transfer to the ICU.

    SC rec that I try to get the HMO to do a contract -- but, this would be "incredibly rare." I guess that she looked it up -- cuz in a previous conversation, she told me "never."

    I will call SC again because I don't understand why the HMO (which is a Medicare HMO) could pay for it but Medicare will not... there must be a way... can anyone think of one?
    Last edited by Joey_SF; 11-08-2012 at 12:50 AM.

  4. #14
    Hi Joey_Sf..Just happy to say that Mommy is home !! a real miracle! we had our merriest Christmas thank God ! we just had her breath using her diaphragm (placing a book on her stomach) so she would know if it's moving, that she is breathing properly cause she didn't seem to know how to do it right, like she has forgotten all about it..(they say it happens cause they tend to rely on the machine breathing for them) it was a long journey ..she is now on rehab, can make short walks and appetite is slowly coming back..now her check ups say her mitral valve repair is holding up real well. We are monitoring her BP and heart rate..

    I pray that a solution will come your way..God bless you & your Dad !!

  5. #15
    Let me just add..Mommy is sent home after 11 weeks in ICU (mitral valve repair, 1 vessel bypass, HIT reaction, 3 weeks intubated, 11 weeks of trache)..anything is possible. Praise God !!

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