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I am not sure exactly what your point is. I rounded on each of my patients at bedside. Examined them carefully. I am curious what vent settings were in appropriate for a hypertense patient. My guess is you are either RRT or RN. I am blessed to work with excellent groups of both. It’s a crock of crap that a doctor would ask what BIPAP is. I call bullshit on that. If you would like to have a discussion on what you think poor vent settings are, what vent settings are you questioning. Yes there are bad docs who don’t know how to run a vent.

Please let’s have a conversation. I am curious what general credentials are (I won’t threaten to dox you or slander you as certain others here like to do). I’ll take you at your word. And enlighten me what you didn’t approve of. You might be correct. You might not be. Let’s explore this topic.

Indeed at least one Physician did exactly ask me what ‘BiPAP’ was. I was stunned at the time. All that I could say was that it was ‘two levels of CPAP. I did not explain about how one apect was regarding ventilation and the other oxygenation.

I had a Nurse in the Cardiac ICU ask for my help. I was not even assigned to that Unit on that particular day. I happened to be there for some reason which I cannot recall. We rotated shifts and perhaps I was Trauma that day. We bring patients up from the ER and stabilize them, typically following a CT Scan or perhaps an MRI. I honestly do not recall that particular day. It was 18 months ago or so.

Anyhow, most of the Nurses knew me, and she was almost frantic regarding her patient. I went into the room and the Pt was quite hypertensive. Cannot say exactly but it was likely 180-120, something like that, maybe higher. The Nurse, a young acquaintance was unsettled, as above.

I altered the vent settings. I would be lying if I said that I remembered exactly what they were, but seriously elevated. I think that it was probably Vol. AC with a rate of 14 and a Vt of around 450-500. FIO2 almost always 100 under such conditions, PEEP usually 5. Those are what we refer to as ‘vanilla’ and anything else would be surprising.

I looked at the PIPs and the exhaled volumes. I cannot recall what I did but I likely I switched to a Pressure mode in order to decrease the PIPs. Whatever I did, the BP normalized within just a few moments. That young Nurse was ecstatic. She went to the Resident and he almost immediately wrote the order. I fixed the problem.

Note: In my place, we had a lot of leeway. We would tweak things, watch the result, then get the orders written. Technically that is illegal, but because it was a teaching hospital, we did such things almost routinely.

Everyone was happy with me that day up there in the CCU, but it was not even my Unit.

Oh God I loved that job so much.