the LTV 1200 ventilator

see also:

• assisted ventilation

• the LTV 1200 ventilator is a very versatile portable ventilator suitable for emergency departments and patient transfers.
• the user interface is not always intuitive and does require some instruction.
• it allows either pressure or volume control
• it allows the following modes with the option of built-in PEEP:
  • CMV for paralysed patients only (choose Assist/control mode and set sensitivity to dash (ie. no patient breath triggering)
  • Assist-Control Ventilation (ACV)
  • SIMV
  • CPAP or NPPV (ie. BiPap)
• default settings for either infant (ie. up to 8kg), paediatric (ie. up to 40kg) and adult patients
• a 3 minute 100% oxygen flush mode for suctioning, etc, is rapidly accessed by pressing and holding the FiO2 setting button for 3 secs.
• breath trigger setting is flow-triggered by default (ie. oxygen CONSERVE is OFF, sensitivity 1-9lpm, ventilator is in exhalation phase and minimum exhalation time has expired and the flow exceeds the sensitivity setting.
  • pressure triggering in exhalation phase can be set if oxygen CONSERVE is ON, in which case the sensitivity setting is in cm H20
  • there is a backup pressure trigger if sensitivity is anything other than dash (“-”), and airway pressure drops below minus 3cm H20 in exhalation phase after minimum exhalation time has expired.
• to change settings during an alarm, you must first silence the alarm!
• to turn it off, hold the On/Off button for 3 seconds, display will go off and ventilator will stop, but alarm will sound - you then need to silence the alarm.
• when using battery only, the LED display will go OFF automatically after ~1 minute (just as you are getting into the ambulance usually) to save the battery, the ventilator still functions and the LED display will light up if alarm occurs or you press any of the buttons.

• switch it on by pressing and holding On/Off button
• choose patient using selector dial - existing patient or new patient
• if new patient, select patient type via selector dial - infant, paed, or adult
• default settings will be applied, but note this may be Assist-Control Ventilation (ACV) mode

• press Assist/Control and SIMV/CPAP selection button until SIMV/CPAP flashes (usually needs 2 presses) then press it again to select that mode.
• choose either volume controlled or pressure controlled by repeatedly pressing its selection button
• adjust Breath Rate by clicking on its button then using the selector dial
• adjust I:E ratio by altering Inspiratory Time by clicking on its button then using the selector dial - machine displays a calculated I:E ratio - in general aim for ratio of about 1:2.0
• trigger sensitivity is usually set to 3lpm (sensitivity to trigger a breath is higher with lower values)
• adjust other controls as needed:
  • for volume control, adjust tidal volume
  • for pressure control, adjust peak inspiratory pressure
• optionally set PEEP by pressing the PEEP button and adjust using selector dial
• when finished, consider pressing Control Lock to avoid accidental alteration of settings.

• adjust as for SIMV above but use pressure control not volume control
• turn breath rate to dash
• turn sensitivity to 1lpm
• set Pressure Support to your desired inspiratory pressure (IPAP)
• set PEEP to desired expiratory pressure

• set pressure control
• set to SIMV/CPAP but press the button again so NPPV flashes, and while it is flashing the display should read Set IPAP - press on the Pressure support button and ajust if needed, display should now read Press PEEP, press PEEP button and ajust as needed, if you have done this sequence of button presses, the mode light should stay in NPPV mode.
• this method is generally avoided in ED's which use the older LTV 1000 ventilator as on that ventilator, going into this mode not only removes some of the alarms, but it is complex and non-intuitive of how to get into this mode, and worse, how to get out of this mode if you wish to ventilate an intubated next time when you turn the machine on!