SKILL FOCUS: Mechanical Ventilatr Management DISCIPLINE: Respiratry Therapy GAME: 6 VIRTUAL VENTILATOR GAME 6: FACULTY GUIDE Estimated Time: 30 minutes Scan t Begin Patient Name: Hectr Fernandez SCENARIO OVERVIEW In Game 6 f the ARISE Virtual Ventilatr Serius Game series, students receive reprt abut a 62-year-ld patient wh was just intubated and placed n mechanical ventilatin fr a severe exacerbatin f end-stage CHF. Pst-intubatin ABG s are pending. INSTRUCTIONS There are fur levels fr students t cmplete in this serius game. See the ARISE Virtual Ventilatr Serius Game: Overview and the ARISE Virtual Ventilatr Serius Game: Student Handut Game 6 fr detailed instructins. VIRTUAL VENTILATOR SERIOUS GAME UPDATED: FEBRUARY 7, 2018 1
LEARNING OBJECTIVES 1. Interpret Arterial Bld Gas results and select the crrect mechanical ventilatr setting changes accrding t NBRC standards 2. Apply crrect mechanical ventilatr setting changes t the ARISE Virtual Ventilatr accrding t NBRC standards 3. Mdify mechanical ventilatr alarms n the ARISE Virtual Ventilatr accrding t NBRC standards 4. Given patient ventilatr parameters, calculate static cmpliance, dynamic cmpliance, airway resistance, and I:E rati CURRICULUM MAPPING WTCS RESPIRATORY THERAPY PROGRAM OUTCOMES Apply respiratry therapy cncepts t patient care situatins Demnstrate technical prficiency required t fulfill the rle f a respiratry therapist Practice respiratry therapy accrding t established prfessinal and ethical standards RESPIRATORY LIFE SUPPORT Explain the general principles f mechanical ventilatin Apply invasive mechanical ventilatin Operate varius ventilatrs Evaluate patient respnse t mechanical ventilatin Crrelate mechanical ventilatin strategies t varius disease states RESPIRATORY DISEASE Interpret bld gas data ANSWER KEY The answers fr each level f Game 6 are as fllws: Level 1: Students must interpret the patient s Arterial Bld Gas by answering a multiple-chice questin. Then, they must chse ventilatr setting changes accrding t NBRC standards. Given the available patient infrmatin, the crrect answers are as fllws: Rate = 12 16 bpm (based n a desired PaCO2 f 35 45 mm Hg) VIRTUAL VENTILATOR SERIOUS GAME UPDATED: FEBRUARY 7, 2018 2
Tidal Vlume = 500 ml (This shuld nt be changed as his max Vt = 560 ml.) O2 % = 50 70% (based n a desired PaO2 f 80 100 mm Hg) PEEP = 10 cmh2o (n change) Level 2: Students must crrectly enter their chsen setting changes and adjust the alarms n the ARISE Virtual Ventilatr. If they enter the setting changes within the ranges listed abve AND change the alarm limits accrding t NBRC standards, they will be crrect. New alarm limits are as fllws: Pressure alarm: Maximum = 26 38 cm H2O and Minimum = 14 20 cm H2O Rate alarm: Maximum = 20 30 bpm and Minimum = 6 12 bpm VE alarm: Maximum = 8 12 lpm and Minimum = 2 6 lpm Apnea alarm: < r = t 20 secnds Nte: Students may adjust Flw and I Time settings, but they are nt cnnected t prgramming r checked against any parameters during the game. Level 3: Students must crrectly calculate the Static Cmpliance, Dynamic Cmpliance, Airway Resistance, and I:E Rati using a pre-filled ventilatr flwsheet. Static Cmpliance = 39.0 39.2 ml/cmh2o Dynamic Cmpliance = 22.9 23.1 ml/cmh2o Raw = 13.8 14.0 cmh2o/l/sec I:E rati f set rate = 1:3.3 t 1:3.5 SCORING The ARISE Virtual Ventilatr Serius Games prgramming keeps track f hw many attempts it takes a student t pass each level. The prgramming scres students based n the rati f the number f remaining attempts t the ttal available attempts. If a student achieves 75% r greater, they have passed that serius game. Hwever, a student can cmplete the game and nt pass it. Thus, at the end f each serius game, a screen is displayed n the ipad with thse results, a timestamp, and instructins n hw t take a screensht. Students can submit this screensht t their instructr as evidence f cmpletin. In additin, since this screensht includes the number f failed attempts fr each level, faculty can evaluate the data t determine if and where further instructin and/r practice is required. An example table is as fllws: Scrable Serius Game Levels Level 1: Suggested Ventilatr Settings 1 Level 2: Enter Ventilatr Settings 0 Level 3: Set Ventilatr Settings 2 Level 4: Perfrm Calculatins 0 Ttal Scre 9/12 Failed Attempts VIRTUAL VENTILATOR SERIOUS GAME UPDATED: FEBRUARY 7, 2018 3
SURVEY Print this page and prvide t students. Students, please cmplete a brief (2-3 minute) survey regarding yur experience with this ARISE simulatin. There are tw ptins: 1. Use QR Cde: Survey a. Nte: Yu will need t dwnlad a QR Cde reader/scanner nt yur wn device (smartphne r tablet). There are multiple free scanner apps available fr bth Andrid and Apple devices frm the app stre. b. This QR Cde will nt wrk in the ARIS app. SURVEY 2. Cpy and paste the fllwing survey link int yur brwser. a. https://ircvtc.c1.qualtrics.cm/se/?sid=sv_6mwfv98shbfrnbx VIRTUAL VENTILATOR SERIOUS GAME UPDATED: FEBRUARY 7, 2018 4
CREDITS Images purchased frm Shutterstck. REFERENCES Persing, G. (2016). Respiratry Care Exam Review (4th ed.). St, Luis, Missuri: Elsevier. This wrk by the Wiscnsin Technical Cllege System TAACCCT IV Cnsrtium is licensed under a Creative Cmmns Attributin 4.0 Internatinal license. Third party marks and brands are the prperty f their respective hlders. Please respect the cpyright and terms f use n any webpage links that may be included in this dcument. This wrkfrce prduct was funded by a grant awarded by the U.S. Department f Labr s Emplyment and Training Administratin. The prduct was created by the grantee and des nt necessarily reflect the fficial psitin f the U.S. Department f Labr. The U.S. Department f Labr makes n guarantees, warranties, r assurances f any kind, express r implied, with respect t such infrmatin, including any infrmatin n linked sites and including, but nt limited t, accuracy f the infrmatin r its cmpleteness, timeliness, usefulness, adequacy, cntinued availability, r wnership. This is an equal pprtunity prgram. Assistive technlgies are available upn request and include Vice/TTY (771 r 800-947-6644).c VIRTUAL VENTILATOR SERIOUS GAME UPDATED: FEBRUARY 7, 2018 5