Gaylord is a Vapotherm Center of Excellence and Passy-Muir® Valve (PMV) Center of Excellence. These accreditations recognize healthcare facilities using technology to improve patient care, communication and outcomes, while maximizing the effectiveness and efficiency of staff and resources. Centers of Excellence partners are committed to excellence in their own facilities, and to sharing their knowledge, best practices and experience to improve the standard of care for all patients. Since we started using Vapotherm for tracheotomy humidification and the Passy-Muir® Speaking Valve for communication and improvement in swallowing, Gaylord has experienced meaningful improvement to clinical outcomes in weaning patients from the ventilator and greatly increased decannulation (removal of the tracheostomy tube) rates in the tracheostomy patients.
Pulmonary and Ventilator Technology at Gaylord
Mechanical ventilators assist patients who are not able to breathe on their own, following an illness or injury. The ventilator, or vent, blows air—or air with extra oxygen—into the airways and then the lungs, which is called positive pressure. Some patients are assisted by the vent to exhale, while some can breathe out on their own. The airways carry oxygen-rich air to the lungs and carry carbon dioxide, a waste gas, out of the lungs.
The airways include:
- Nose and linked air passages, called nasal
- Larynx (LAR-ingks), or voice box
- Trachea (TRA-ke-ah), or windpipe
- Tubes called bronchial tubes or bronchi, and their branches
A ventilator can be set to "breathe" a set number of times a minute. Sometimes it's set so that you can trigger the machine to blow air into your lungs. But, if you fail to trigger it within a certain amount of time, the machine automatically blows air to keep you breathing. The goal for the majority of patients coming to Gaylord on a vent is to wean them off the vent. There are some patients who will continue to rely on a vent long-term for certain periods during the day or while sleeping. In these situations, we will teach your family how to manage the ventilator in the home, or in another setting.
||Gaylord Hospital’s Pulmonary and Ventilator Weaning Program provides increased mobility and improved rehabilitation through the use high-end portable ventilators. These light-weight, compact ventilators allow vent-dependent patients the chance for early mobilization, benefiting movement and exercise, increasing the chances of successful weaning and allowing patients greater mobility. The portable vents have most of the same modes, settings, and capabilities as our standard bedside vents and patients who are stable enough to be outside their rooms can use them for transport, or to travel outside of their room with a respiratory therapist present.
Passy-Muir® Valve (PMV)
Video: Gaylord Clinicians Using the Passy-Muir Valve
|The Passy-Muir® Valve (PMV) is a simple medical device used by tracheostomy and ventilator patients, which redirects air flow through the vocal folds, mouth and nose, enabling improved communication. Evidence-based research has shown that the PMV helps with communication, swallowing, secretion management, and oxygenation. At Gaylord, PMVs are used in the decannulation process, allowing patients to adjust to a more normal breathing pattern, and as a tool to help wean patients from the ventilator. Additionally, the PMV can improve the sense of smell, leading to an increase in taste, and thereby appetite, which helps in a faster recovery. Gaylord is also a Passy-Muir Valve Center of Excellence.
Video: Gaylord Before & After Vapotherm
|Vapotherm provides the delivery of breathing gases for non-invasive ventilation for patients with acute or chronic respiratory disorders. The Vapotherm System delivers comfortable, well-tolerated therapy that may help patients avoid the discomfort and expense associated with mechanical or pressure based ventilation support. Delivered through a comfortable nasal cannula, Vapotherm delivers High Flow Therapy with medical grade vapor, precise temperature and oxygen control and an easy-to-use integrated system with built-in patient safety alarms. Gaylord is also a Vapotherm Center of Excellence.
Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
A swallow study or Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is used to evaluate a patient’s ability to swallow food and liquids. Because of a compromised respiratory status tracheostomy/ventilator dependent patients often pose a greater risk of aspiration that can result in food or liquid being inhaled into the respiratory system. An FEES study improves the ease and speed of patient evaluation and may allow a patient to safely eat earlier in the recovery process.
The FEES uses a flexible scope, known as a laryngoscope, to assess a patient’s ability to swallow. Because the FEES is a portable system the ventilator dependent patient can remain in his/her room while the study is being done.