> For the complete documentation index, see [llms.txt](https://bens-disorganisation.gitbook.io/anzca-rga-notes/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://bens-disorganisation.gitbook.io/anzca-rga-notes/rapid-access-clincal-bits/editor.md). # Ventilation Quick Setup Cards All these Ventilation notes are for Rural generalists using the Hamilton T1. I don't want to get in fights with professors or Intensivists or any other ventilation nerds here. While I would like reminisce about the Oxylog and wax lyrical areminic. The goal is short notes for Rural Generalists who have to do more that one thing simultaneously and who don't need to consider the possibility that the lungs may venitlate like psittacosis. ### Hamilton Ventilation Modes Cards Click on the card if you're panicking and looking for what to start the ventilator on. Click on the notes if you're wondering why or what to worry about.

Scenario (card)
#stable-ventilation
#obstructive-lung-copd-asthma-bronchiolitis
#restrictive-lung-pathology-pneumonia-ards-most-acute-lung-injury
#alarm-debugging

### Stable Ventilation:


STABLE VENTILATION MODE: ASV SETTINGS Backup RR: 12 bpm MinVol: 110% (start) • ±10% based on PaCO₂ PEEP: Start 5 • Titrate per PEEP/FiO₂ scale FiO₂: Start 100% • Titrate rapidly per SpO₂
MONITORING Convergence Rate: <15–30 breaths Safety Window: Watch for shrink/shift toward bottom-left if stable Flow Waveform: Check q15 min initially Look for air trapping

STABLE VENTILATION

MODE: ASV

SETTINGS

Backup RR: 12 bpm
MinVol: 110% (start)
• ±10% based on PaCO₂

PEEP: Start 5
• Titrate per PEEP/FiO₂ scale

FiO₂: Start 100%
• Titrate rapidly per SpO₂

MONITORING

Convergence Rate:
<15–30 breaths

Safety Window:

Watch for shrink/shift toward bottom-left if stable

Flow Waveform:

Check q15 min initially
Look for air trapping

### Obstructive Lung (COPD, Asthma, Bronchiolitis):


OBSTRUCTIVE LUNG PATHOLOGY MODE: SIMV+ SETTINGS Rate: Start 8–10 bpm • Ensure flow waveform returns to 0 TV: 4–6 mL/kg IBW • Often lower end due to low rate I Ratio: 1:4–1:5 • May require longer • Ensure flow returns to baseline Plimit: 40 cmH₂O PEEP: Asthma: Start 0 Others: Max 5
KEY PRINCIPLE Expiratory flow must return to baseline TARGETS SpO₂ Target: 86–92% CO₂ Target: 50 mmHg acceptable if pH >7.20 (Permissive hypercapnia) MONITORING Flow/Time Waveform: Watch for air trapping

OBSTRUCTIVE LUNG PATHOLOGY
MODE: SIMV+

SETTINGS

Rate: Start 8–10 bpm
• Ensure flow waveform returns to 0

TV: 4–6 mL/kg IBW
• Often lower end due to low rate

I Ratio: 1:4–1:5
• May require longer
• Ensure flow returns to baseline

Plimit: 40 cmH₂O

PEEP:
Asthma: Start 0
Others: Max 5

KEY PRINCIPLE
Expiratory flow must return to baseline

TARGETS

SpO₂ Target: 86–92%

CO₂ Target:
50 mmHg acceptable if pH >7.20 (Permissive hypercapnia)

MONITORING

Flow/Time Waveform:
Watch for air trapping

### Restrictive Lung Pathology (Pneumonia, ARDS, most acute lung injury):


PROTECTIVE LUNG STRATEGY MODE: SIMV+ MONITORING Pressure Limits: Avoid exceeding Plimit Oxygenation: Adjust FiO₂ + PEEP per scale
SETTINGS Rate: 12–16 bpm • Titrate based on blood gases TV: 6 mL/kg IBW I:E Ratio: 1:3 P-Ramp: 100 ms ETS: 25% Plimit: 30 cmH₂O PEEP: Start 5 • Adjust using PEEP/FiO₂ scale SpO₂ Target: 92–95% CO₂ Target: 35–45 mmHg

PROTECTIVE LUNG STRATEGY

MODE: SIMV+

MONITORING

Pressure Limits:
Avoid exceeding Plimit

Oxygenation:
Adjust FiO₂ + PEEP per scale

SETTINGS

Rate: 12–16 bpm
• Titrate based on blood gases

TV: 6 mL/kg IBW

I:E Ratio: 1:3

P-Ramp: 100 ms

ETS: 25%

Plimit: 30 cmH₂O

PEEP: Start 5
• Adjust using PEEP/FiO₂ scale

SpO₂ Target: 92–95%

CO₂ Target:
35–45 mmHg

### Alarm Debugging: