Basics of Ventilators Part One Terminology

With the rise in COVID cases, I’m trying to put out a series of basic FAQ’s so ATS’ers can decipher some of the Medspeak. Please note that I have spent my 2+ decades in pediatrics, so these thoughts are more or less geared towards that, BUT the basic concepts are the same

Ventilator Basics: Part One Terms

A ventilator is a machine that, for lack of a better word, breathes for you. They can be very basic to super-sophisticated, but at their most basic, they take a predetermined amount of gas and move it in and out of the lungs based on how they are set.

Basic Terms:

Inhalation / exhalation: Breath in breath out = one cycle it is also expressed as a ratio

I/E Ratio: Typical inhalation to exhalation is 1:2 or 3 however with sick lungs that can get closer to 1:1 or even inverse 2:1 to try to improve oxygen delivery and CO2 removal. Inverse ratios are damaging to the lung tissue

Tidal Volume: TV is the amount of air that moves out during one cycle. 4-6 cc per kg in peds.

Fi02 = the fraction of inspired oxygen. It is a percentage and can run from sea level 21% to 100%. This will be adjusted based on monitors and lab values. Normally the goal is to use the least amount of oxygen to keep the oxygen saturation above 93%; however, depending on the degree of respiratory failure, a lower number may be accepted. Oxygen at high levels over a period of time can damage the lung tissue aka oxygen toxicity

Rate: The rate at which you are breathing. The faster you breathe, the more carbon dioxide you can get rid of.

PEEP = Positive End Expiratory Pressure. PEEP is the amount of pressure left in the lungs after a ventilatory cycle (Inhalation/exhalation). For peds, a normal PEEP would be set at 3-5 cm of water. PEEP is essential to prevent the alveoli from collapsing. If you cycle a vent with zero PEEP, the Alveoli, the end unit of the lung, which looks like a tiny sack, is responsible for gas exchange to the pulmonary vessels; they collapse. When the vent cycles and pushes air back in, they will pop back open. The crackling sounds they make as they pop open is unmistakable, and it sounds like a bowl of rice crispies. PEEP affects levels of oxygen. More PEEP moves a greater amount of oxygen through the alveoli to the pulmonary capillary beds. The downside is that prolonged exposure to high pressures can damage the lungs, aka barotrauma.

PIP = Peak Inspiratory Pressure. The amount of pressure needed to deliver the desired Tidal Volume. Normal PIP’s are about 14-20 in healthy lungs. PIP is one of the drivers of oxygen delivery. PIP can be temporarily raised to help “recruit” or pop open closed off alveoli, or if the person has lung disease to help improve oxygenation. Anything over 30 will damage the lungs, and once you go higher, you will need to look at unconventional ventilators, like HFOV or even ECMO, both topics for another time

Pressure Support: Depending on the mode, most ventilators will help assist intubated patients when they take a breath on their own. Pressure support Typically, ten cmH2O will assist with these spontaneous breaths.

This is a really basic overview of vents, and it takes years for bedside staff to become adept at using them. As a transport nurse, I can run a setup and run a ventilator. Most ICU nurses know the whats and why and in a pinch can make basic setting changes; however, 90% or nurses DO not have the training or experience needed.

Next Up will be Ventilator Modes………

a reply to: FredT

basically your title is misspelt

current title is

"Basics of Ventalators Part One Terminology"

a reply to: UpIsNowDown

LOL thanks

Looks pretty accurate, I work ICU myself and yeah....looks good buddy.

I would have added CPAP as that's kind of the big one that gets chucked about in the media, I don't know if you want to put an edit in to cover that or if you're planning on covering it if you write about modes. If you want I can send you a PM with a definition if your struggling to find one.

a reply to: FredT

Excellent post , Excellent information.

a reply to: FredT


Long story short here OK....this is an area that has been intentionally weaponized against us all so please pay attention then do your own research instead of questioning me right off the bat.....just do it ok.

Artificially machining the lungs and Pumping blood that cannot possibly hold o2 because it is supersaturated with pollutants and toxins is called beating a dead Horse.......ok.

Now you understand why the process did not and does not work in some situations.

Its the bloods ability to hold o2 because SOMETHING ELSE ALIVE AND REPRODUCNG /POLLUTING HAS MADE THIS IMPOSSIBLE ... that is the causality of thE problems here ok.

NOW BECAUSE I AM SICK AND TIRED OF REPEATING THIS.....Covid is what is LIVING IN THE BLOODSTREAM POLLUTING IT.

Viruses are dead inert bits of RNA/DNA which are covered with Antibodies like little garbage bags....so come on and stop screwing around and use your cumulative brain power to solve thi9s mystery already ...jesus christ its not rocket science.....if viruses are DEAD then what could possibly be in your bloodstream and alive making more pollutants than the body can filter out?

When you finally do your research you will discover the catalyst behind what we mistakenly call cancer.....the answer has always been there.....some really nasty bad twisted sick puckers used their peanut brains to suppress and hide the truths....but stupid is as stupid does and they did not do a very good job.

So now together you can ALL FORCE OUT THE CURE FOR CANCER......or you can crap the bed and just read this , make some lukewarm critique not research it and move on like most lazy uncaring putzes would do.

Have a nice Day!

You guys have all the technical knowledge to get this straight ...clearly..so now that I have given you causality...make it god dam fit your diagnostic template and then end this gong show once and for all.......dont worry some greedy little whelp will write the White Papers and then push it through we just have to let enough people know the truth and those types will come out of the woodwork.....after all they are the ones who have taken it in the tailpipe the hardest after all and made to look like fools.

12 Minutes and no reply.....come on Goggle is faster than that....lets get this party started.....I have some Bigfoot Disclosure to work on today I dont have all day to pander and play here.

I will give it 5 more minutes then we have to move on....and you will have to sort this out the long hard way....on your own.

By the way.....this is accurate and relevant and you ought to know.....I am an abductee....not Aliens but Humans.....on a massive Military Ship.......and yes I am aware that I just made it impossible for many of you to continue reading with that comment....but its time for everyone to wake the puck up already.

There are millions of people like me who have been abducted....but they do not have functional conventional memories of the time.....however as with all things there are outliers and anomolies.....some of us remember because no process is perfect and mistakes happen naturally in this Universe .....and an even smaller number are ALLOWED TO REMEMBER.

Just look up Pleomorphic Bacteria and put this stupid topic to rest already....jeepers there are tons of interesting things to ponder in this universe....bad gut bacteria is not really worthy of our time is it?

originally posted by: one4all
12 Minutes and no reply.....come on Goggle is faster than that....lets get this party started.....I have some Bigfoot Disclosure to work on today I dont have all day to pander and play here.

I will give it 5 more minutes then we have to move on....and you will have to sort this out the long hard way....on your own.

By the way.....this is accurate and relevant and you ought to know.....I am an abductee....not Aliens but Humans.....on a massive Military Ship.......and yes I am aware that I just made it impossible for many of you to continue reading with that comment....but its time for everyone to wake the puck up already.

There are millions of people like me who have been abducted....but they do not have functional conventional memories of the time.....however as with all things there are outliers and anomolies.....some of us remember because no process is perfect and mistakes happen naturally in this Universe .....and an even smaller number are ALLOWED TO REMEMBER.

Just look up Pleomorphic Bacteria and put this stupid topic to rest already....jeepers there are tons of interesting things to ponder in this universe....bad gut bacteria is not really worthy of our time is it?

Lmao, your telling a guy with 20 actual years working with the stuff..how they work, or don't work..whatever.

Your arrogance is something to behold!! ETA..I should of asked..what is your experience with ventilators?

I use a CPAP every night and when I was admitted to hospital in March (did I have Covid or not they couldn't decide, but I now have antibodies) and the medics say the CPAP helped. I had Viral Pneumonia.
From am ignoramus perspective, it's nice to know you know how a ventilator works but it can work 100% but if the lungs can't uptake the Oxygen then that is a moot point.

a reply to: FredT

in the early states of the Covid mess, there were many people who died while using ventilators. Was there ever anything definitive that pointed to problems with the treatment, or the use of ventilators, or was that just normal due to the virus itself?
It was a topic of discussion in the MSM, then it faded out quickly as death rates decreased. (as my feeble mind can remember)

originally posted by: vonclod

originally posted by: one4all
12 Minutes and no reply.....come on Goggle is faster than that....lets get this party started.....I have some Bigfoot Disclosure to work on today I dont have all day to pander and play here.

I will give it 5 more minutes then we have to move on....and you will have to sort this out the long hard way....on your own.

By the way.....this is accurate and relevant and you ought to know.....I am an abductee....not Aliens but Humans.....on a massive Military Ship.......and yes I am aware that I just made it impossible for many of you to continue reading with that comment....but its time for everyone to wake the puck up already.

There are millions of people like me who have been abducted....but they do not have functional conventional memories of the time.....however as with all things there are outliers and anomolies.....some of us remember because no process is perfect and mistakes happen naturally in this Universe .....and an even smaller number are ALLOWED TO REMEMBER.

Just look up Pleomorphic Bacteria and put this stupid topic to rest already....jeepers there are tons of interesting things to ponder in this universe....bad gut bacteria is not really worthy of our time is it?

Lmao, your telling a guy with 20 actual years working with the stuff..how they work, or don't work..whatever.

Your arrogance is something to behold!!

ETA..I should of asked..what is your experience with ventilators?

No incorrect.

I am aknowledging that there are Professionals here who have the acumen I need to illustrate my point.....so I dont have to waste time.

I already know the causality....there is no "almost" there is no 1/2 way there is no way to avoid this stark reality.

I dont bother with the technical terminology...it bogs us down....its designed to do that.

Check and Re-cheque....Pete an Re-Peat....until we are to old to give a dam about changing the world for the better.

To make it basic so you understand this dynamic I will use this example.....2 kids are building a Puzzle together.....one kid is trying to build the perimeter first....the other kid is putting together clusters of pieces at 6x the speed the first kid is working at.....who do you think is going to see the Big Picture first?....the kid who is 1/4 way done building the OUTSIDE of the picture or the kid who is 1/3 done building the core of the image?

I build the core first you build the perimeter first....I arrive at our destination much faster than you do every single time by proxy......you believe the perimeter defines the picture so you are in a power position starting there but I believe the Picture defines the Perimeter so I begin with the core of the image.....

The Professionals define the Perimeter of this picture....they have not been able to complete the perimeter of the picture or problem......I am closing up the gaps for them......and yes eventually with my direction their knowledge and acumen and science will fit the template properly and accurately....this will be when the gaps close and the reality is inescapable.

I dont need experience with Ventilators...I need people who have that knowledge and acumen to put it here so it cannot be disputed....I already know their data fits my template perfectly not the fraudulent template these Professionals have been led to believe in and support..... I also know THEY WILL KNOW.....its not complicated....the mechanical parameters are a baseline....that is not in question but it is a surefire way to help define causality.....its WHY the process doesnt work that matters....and you now know.

originally posted by: crayzeed
I use a CPAP every night and when I was admitted to hospital in March (did I have Covid or not they couldn't decide, but I now have antibodies) and the medics say the CPAP helped. I had Viral Pneumonia.
From am ignoramus perspective, it's nice to know you know how a ventilator works but it can work 100% but if the lungs can't uptake the Oxygen then that is a moot point.

If the blood cannot hold the o2......then all bets are off and re-circulating it does nothing good....it just hyper-stresses the bodies cleanup and filtration processes and causes problems with organ function....leading to.....


I simple blood transfusion ASAP is the game-breaker here.

The blood must be filtered immediatly or replaced with non-polluted blood....its just that simple...the knowledge of when to use the Ventilator is something I cannot speak to because I do not know enough about them.....and I dont need to know more about them.....because I already know WHY they dont work in many cases....I know what is----ALIVE--- insitu in the bloodstream STEALING VITAL RSOURCES -- AND producing toxins and pollutants faster than the body can fight them and filter them....death by a thousand cuts as all systems begin to go down in a cascading manner like Dominos.....BUT IT ALL CATALYSES FROM WITHIN THE BLOODSTREAM ITSELF.

a reply to: FredT

I'm a Biomedical Engineer.



Your primer is spot on!

originally posted by: network dude
a reply to: FredT

in the early states of the Covid mess, there were many people who died while using ventilators. Was there ever anything definitive that pointed to problems with the treatment, or the use of ventilators, or was that just normal due to the virus itself?
It was a topic of discussion in the MSM, then it faded out quickly as death rates decreased. (as my feeble mind can remember)

When you're on a vent, things are bad from the get-go.

The problem is that so much lung tissue gets destroyed by the virus. The O2 delivery is there, but the receiver isn't.

The bronchioles, alveoli, just aren't there for the O2/CO2 transfer.

originally posted by: DBCowboy

originally posted by: network dude
a reply to: FredT

in the early states of the Covid mess, there were many people who died while using ventilators. Was there ever anything definitive that pointed to problems with the treatment, or the use of ventilators, or was that just normal due to the virus itself?
It was a topic of discussion in the MSM, then it faded out quickly as death rates decreased. (as my feeble mind can remember)

When you're on a vent, things are bad from the get-go.

The problem is that so much lung tissue gets destroyed by the virus. The O2 delivery is there, but the receiver isn't.

The bronchioles, alveoli, just aren't there for the O2/CO2 transfer.

No it isnt.

The O2 is not there TO BEGIN WITH BECAUSE THE BLOOD IS NOT HOLDING IT ....and furthermore the reason the alveoli and bronchioles cannot do their jobs is because of the bodies own auto-immune system reacting to things being pushed to far ..... I can see this is not going to be a quick teach.....bring me an Immunologist who can explain EXACTLY what is happening with the lungs external to the covid BS-story ....we want biopsy data and then bring me the bloodwork....I want immediate bloodwork done pre-treatment and I want the bloods O2 carrying capacity to be tested immediatly....there is no point pumping polluted fluid through the bloodstreams Superstructure now is there???.....so for all you Professionals out there trying to help figure this out......what the puck happens if you intentionally pollute the bloodstream to the degree that the blood can no longer CARRY the oxygen?......the bloodstream is closed system....gated only by the filtering processes and organs....x-volume is maintained regularly......x-volume is critical to all aspects of System function....if x-volume is being polluted by an insitu catalyst faster than the body can filter it through its gates then just WHAT THE PUCK DO YOU THINK HAPPENS?....now you have your answers.....so use all your technical knowledge and acumen to prove this out...there is no alternative....show us the exact sequence of events which will occur if what I postulate is happening is in fact occuring.....I am 100% accurate and correct in causality , I have done my job,now others need to do theirs.

Jeepers I just read 1/2 the OPs post....having been thru this routine before I did not bother reading the data...but its horrifying because its now so clear that I am bang-on correct.....you dont need me to go through this step by painful step now....you guys can do that together now.

a reply to: one4all

Are you stating that the RBC's are not capable of carrying O2?

originally posted by: DBCowboy
a reply to: one4all

Are you stating that the RBC's are not capable of carrying O2?

I am unequivocaly stating that the causality of covid is a living Pleomorphic Bacteria originating INSITU as a "bad gut bacteria" which has the capability to MORPH is mass and shape down from a bacterial size to a viral size and then cascade into the bloodstream to exist there in viral size until it is forced or encouraged to morph and move again.

Once this bug invades the bloodstream it begins to execute its LIFECYCLE.....it steals resources to live on and it reproduces and dies and it excretes waste materials.....all of these processes cause the body to react and to try to defend itself.....this chain of reactions begins as soon as the blood is infected.

The causality is originating INSITU.

People who already UNKNOWINGLY have an Insitu population of this bug in its "bad gut bacteria" form IN THEIR STOMACHS.....they "catch" this LIVING BUG in its viral form as what we call a cold.... once this viral sized pleomorphic bacteria enters the body it communicates with its relatives and triggers a MASS MORPHING AND MIGRATION of insitu bugs from the belly to he bloodstream.....this is the ONLY WAY our bloodstream can possibly be contaminated to the degrees we are seeing...there has to be an INSITU source of causality....its not ---ONLY---the viral bugs we catch in the "covid-cold" version of this pleomorphic bacteria that hurt us its the CUMULATIVE IMPACTS of the mass migration of insitu bugs and the newly arrived related bugs.....

So proper treatment for this is to clear up the bad gut bacteria immediatly so there can be no cascade effect....this is preventative.....but if this mass morphing and migration into the bloodstream has already occured then the blood must be filtered or replaced with clean non-polluted blood before the Ventilator is applied however that is done.

You asked me if I am stating that the RBCs cannot carry O2.....I am stating that the bloodstream cannot maintain an equitable volume of o2 carrying RBCs......that POLLUTANTS make it impossible for the o2 carrying RBCs to exist....the pollutants cause the bodies autoimmune system to hyper-react.....the RBCs are COMPETING FOR SPACE.....and are losing the battle.

Bottom line is this.....the blood system is a closed system and has a specific volume that it uses.....it can clean and filter and oxygenate this volume and there is a nice large performance envelope built in in case we get sick.....it takes a MASSIVE AMOUNT OF EXTERNALY CATALYSED DAMAGE to break own our bodies defenses.....especially within a protected closed System like the bloodstream..... MEANING YOU WOULD HAVE TO EAT A MOUTHFUL OF THE VIRAL SIZED BUG TO HAVE TERMINAL PROBLEMS......but this cannot happen....so the true causality is INSITU....the covid-cold is simply the trigger that sets off the powder-keg of pleomorphic bacteria hiding in your belly.

a reply to: one4all

There is no evidence of anemia in Covid positive patients.

originally posted by: DBCowboy
a reply to: one4all

There is no evidence of anemia in Covid positive patients.

Simple solution here ok.

Give a patient a blood transfusion before you ventilate them....this is a volume issue not a functionality issue....the bloodstream cannot carry the O2 ..... because to much blood has been contaminated/DISPLACED in the cascade effect when the massive volume of pleomorphic bacteria living in the gut morph and enter the bloodstream all at once.....between the bug and its lifecycle components and the bodies auto-immune systems reaction of hyper-producing anti-bodies .... we have a dynamic where the blood itself must be replaced or filtered immediatly.....its a displacement issue the blood is polluted with contaminants that the body tries to bag up with antibodies to protect itself ...in the emergency state it is in I imagine the body priorizes actions....and this is likely part of our dynamic.The infection with the viral sized pleomorphic bacteria triggering the cascadeing infection of the blood with an insitu gut based massive volume of physical living pleomorphic bacterial sized bugs that can morph and enter the bloodstream and the hyper-reaction of the auto-immune system to this mass invasion......

The important thing to remember here is that we need to clean up the gut fast....its a one shot cascade effect....however the bug leaves a vanguard behind in the belly....and they reproduce fast....and also once you clean them up in the gut you can re-infect yourself if you again eat contaminated foods....the good thing is this....it takes a sizable volume of insitu bugs to support a large enough cascade effect to hurt you terminally or seriously....and this takes some time to build up inside your belly......so we get a lot of chances to avoid this bugs impacts.

Yes you can catch the covid-cold viral version of this bug over and over and over there is no such thing as immunity.
Immunity is dead bugs.
Immunity is not eating contaminated foods again.
Immunity is regular policing of your bad gut bacteria.
Immunity is a normal process of healthy living we should have all been doing since childhood.

The covid-cold viral form of this living pleomorphic bacteria is not new....the pleomorphic bacteria in your belly is not new...the cascade effect is not new....the fungal stage that comes after the bug again morphs from a viral size to a fungal size is what we mistakenly call cancer is not new.