You are on call at night in a small community hospital in a rural part of Washington. One of your patients, a 65 year old female with pneumonia who was admitted earlier in the day to the step-down ICU, has acutely decompensated. Attempts at rescue bi-pap have not been successful. The patient is a full code. You elect to intubate the patient and place her on a ventilator. What will your settings be for the patient’s tidal volume? How will you handle vent changes until you can get her transferred to the tertiary medical center 100 miles away? Let’s take a look at The Ventilator App in action.
Very few situations are more nerve racking in medicine than having to emergently intubate a critically ill patient and manage them on the ventilator. As a full scope family physician, I am occasionally called to perform this skill. Thankfully, our facility has highly trained respiratory therapists, critical care pulmonologists and anesthesiologists to help! However, in many smaller community hospitals and emergency rooms, these team members may not be available. Over the years, I have learned the hard way – from experience during two tours of duty at medical facilities in Afghanistan, reading textbooks on ICU care such as the outstanding “The ICU Book” by Dr Paul Marino, and being taught by highly skilled sub-specialists. Nonetheless, I always shudder to think about having to stabilize a patient on a vent until help arrives or the patient is transferred to a higher level of care. Previously here on iMedicalApps.com, we have evaluated several critical care apps that discussed ventilators. We liked the recently reviewed Critical Care Compendium, and ICU Notes, but weren’t really big fans of Basics of Mechanical Ventilation.
But what about an app that is just about vents? One of the newest entries for iOS is The Ventilator App by Dr William Owens, MD and Creative App Solutions. Dr Owens is a board certified emergency medicine and critical care medicine physician at The University of South Carolina. He is the author of The Ventilator Book and the app is based on content from this book. The app includes a built-in calculator that uses the patient’s height and gender to generate the recommended tidal volume (for both ARDS and non-ARDS patients), an ARDSNet PEEP-FiO2 calculator to help advise changes in the vent settings, reference tables and formulas, and a ventilator troubleshooting guide for common scenarios like high pressure, low PaO2, etc.
Evidence based medicine:
The Ventilator App incorporates evidence based practice, as well as expert opinion/guideline based, recommendations into an easy to use app. The app contains useful calculators such as ARDSNet as well as handy FiO2—PEEP Table, and formulas for minute ventilation, PaO2/FiO2 ratio, and predicted body weight. The app contains appropriate reference material for its calculator functionality and other “troubleshooting tips.”
What providers would benefit from this App?
Respiratory therapists, medical students, residents, Family Medicine, Emergency Medicine, Internal Medicine, Critical Care/Pulmonary Faculty and Fellows, Nursing Staff and any provider who may be required to make changes to a ventilator/care for intubated patients.
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
- Contains several useful calculators for tidal volume, PEEP and FiO2.
- Uses well regarded material from ARDSNet and the author’s book.
- Excellent trouble shooting guide for vent management.
- Could benefit from more basic information on vent modes, settings.
- No hyperlinks for references included in app.
- Not available for Android.
A simple but potentially lifesaving app for providers who take care of ventilator patients with and without ARDS. The app will benefit a wide range of medical providers and provides critical information in a quick and easy way.
- Overall Score
- User Interface
Simple, quick calculators; what you need when time is of the essence.
- Multimedia Usage
Contains excellent materials derived from the author’s book as well as ARDSNet. Would be nice to see more links to online materials such as ARDSNet or other open source materials or sections of Dr Owen’s book, perhaps as an in-app purchase.
Reasonably priced when you consider the cost of an ICU/ventilator textbook.
- Real World Applicability
A simple app that providers who care for ventilated patients should strongly consider.
- Device Used For Review
iPhone 6S running iOS 9.1
- Available for DownloadiPhoneiPad