Mechanical ventilation in emergency medical service

Aleksander Hepner, Paramedic/ICU Paramedic and University Clinical Lecturer talks to AirMed&Rescue about the practical application of mechanical ventilation to meet a patient’s needs using the Inovytec Ventway Sparrow EMS
Transport ventilators need to provide consistent and adequate ventilation for a broad range of patient types and clinical needs. What do you find most appealing in the Inovytec Ventway Sparrow?
Apart from synchronized intermittent mandatory ventilation (SIMV), it offers cardiopulmonary resuscitation (CPR) mode and continuous positive airway (CPAP) mode. You can ventilate patients over 5kg of weight and the peak inspiratory pressure range goes up to 60cm H2O, which gives good options in tailoring the mechanical ventilation to the patient’s needs.
What are the benefits of this ventilator for use by paramedics who are trained in ventilation?
Three factors play a main role here. The first thing is Sparrow’s sturdiness and reliability.
This little ventilator is truly like Humvee: it can cope in difficult situations without any technical issues and that’s crucial in the emergency medical service (EMS) world where we operate in a challenging environment. Secondly, it’s lightweight, and finally it is intuitive.
What are the difficulties with using ventilators within the field?
I don’t see any difficulties to be honest. Back in Poland, where I was trained and worked in both hospital and prehospital setting - ventilators are widely used and perceived as an additional pair of hands. Ventilators not only free up at least one person from performing Advance Life Support (ALS), removing the cognitive load from the team leader, but also minimize the risk of overinflation/hyperventilation, which is a huge risk to the patient, and unfortunately, quite a common problem in the EMS world.
I think that the challenge lies in the education process. I’m not aware of any basic Paramedic program in the UK that teaches advanced airway management and the use of a ventilator. I deeply believe a culture change is required.
Is the Ventway Sparrow hard-wearing enough for the rough work and constant movement that it is put through onboard the ambulance and in the field? How easy is it to maintain?
It is very sturdy, and maintenance is not a problem at all.
How important is the weight and footprint of medical equipment used within the Ambulance setting?
The average 12-hour shift involves approximately 1,800 manual handling tasks. With a primary bag (approximately 10kg), a defibrillator (7kg) and a suction unit (3kg), we really don’t need another heavy piece of kit onboard, and that’s where Sparrow (1kg) seems to be a perfect solution.
Does the Ventway Sparrow give you the functionality that is needed for day-to-day patient retrieval and transfer to hospital, and still offer ease of use?
To me Sparrow is so intuitive that once you get used to it, you really don't want to use other setups.
Having the turbine significantly reduces the footprint of the ventilator, and unless high oxygen volumes are needed, an oxygen cylinder is not required. What difference does it make to you?
Being not only a clinician but also a manual handling instructor, I have an awareness of the physical challenges that paramedics face on a daily basis. Reducing the weight of the load a Paramedic needs to carry is crucial, so not having to carry an oxygen cylinder is a massive benefit when it is not clinically required.