VOCSN: Five Devices in One
20
October

By Adem Lewis / in , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , /


Hey guys, so my name’s Aimee. I’m a Registered Respiratory Therapist here
in Las Vegas, NV. Some of you guys might actually know me from
my Instagram and YouTube Breathe Easy RT. Uhm, I just really quickly before we get the
video started, I’ve got some really cool stuff to show you but I wanted to thank Pima Medical
Institute her in Las Vegas, my old school, for letting us use their lab film and also
I wanted to let you know this video is sponsored by a Ventec Life Systems educational grant
and i’s making git possible for me to bring a really amazing piece of equipment that I
think you guys are really going to enjoy. So, I will leave links in the description
box of this video if you wanna check out more information on the educational grants but
other than that, let’s get started. So, before I bring everything out, one thing
I do want to touch on, is a lot of patients that require some type of ventilatory support
at home or whether it be a long term care facility, they need a lot of other devices
support them along with their mechanical ventilator. That’s going to be up to 5 plus devices and
that’s kind of what I’m showing you. Here we’ve got a cough assist, we’ve got a
trilogy, we’ve got a version of suction here, along with a vest, nebulizers, our oxygen
concentrator and even another option that you guys might have seen which is the LTV. So, all of these things are really great in
the therapeutic process but the problem is that it really tethers someone to their home. Can you imagine taking 5, 6 devices when you’re
trying to go out and do something? Or, you know, 55 plus pounds of equipment. And that’s kind of what I want to show you
guys. I want to show you guys something that’s going
to integrate all of these devices into one and kind of show you what a life untethered
can be like for someone that requires all of these devices. So, give me a couple minutes and we’ll get
into it. So, Mechanical ventilation can be really complicated
and overwhelming, as you can see. Give me just a second and I’m going to show
you how to make this a little bit easier. Okay, now I can focus. All that noise was getting a little bit crazy. But what I was trying to tell you guy earlier,
what I’ve brought you here to take a look at is actually VOCSN. At its core it’s a critical care ventilator. It has an internal oxygen concentrator that
can produce up to the equivalent or 6 liter per minute of oxygen. It has a cough assist as the touch of a button. High quality, hospital grade suction and then
a high performance nebulizer. All built into this one little package right
here. So it is so much more that just a ventilator
itself. I’m going to turn back on the LTV 1200 and
we also have a trilogy which are two common portable ventilators that people use. I kind of want to show you the difference
in changing modes between these devices and how much more simplistic it is with VOCSN. So, actually, let’s start with the LTV. To change your mode, you’ve got everything
set up here on the bottom. If you want to change from volume to pressure,
you need to hold down this button, select it a second time then you need to change your
pressure settings. You are now in pressure control mode. Each time you want to change a setting, you
have to select the specific area, so uhm, right now we are in AC pressure control. You can switch over to SIMV or CPAP. To change it, you’re going to hold down your
button and if you want to switch over you have to keep pressing. Be careful you don’t pass over it and then
hold it a third time to make sure you’re in the right area and then you can add your pressure
support. So, options for modes, basically you’ve got
your volume, you’ve got pressure, you’ve got SIMV and CPAP. and then we also have the Trilogy. This one can be a little bit trickier to change
the mode on, so we’re gonna unlock so we can actually access our screen here. We come down to settings and alarms. We’re gonna toggle down to mode and then you
have to do modify, and then once your screen is under modify you can then switch through
your modes that you have individually. Now, if you pass one you can go back up. So right now you’re in AC Volume so let’s
switch to… we’re going to hit okay, then go through and change your settings by toggling
down and toggling to the right and changing your parameters. So for example a CPAP of 10. Keep toggling down, you’re going to see your
different alarms and then you can change those accordingly of course. Then you’re going to do finish. It’s going to ask if you want to activate
CPAP mode, now we are in CPAP mode. You just have to do the toggling to get through
it. Let’s switch one more time to something that
has a rate here. Alright and then we have VOCSN. So, as you can see on the screen It’s just
kind of showing you your chosen settings, your base ones. We’ve got rate of 15 it’s showing volume. So when you go to therapy it’s going to show
you all of the therapy options you have. So right now I’m going to show you how to
change your mode of ventilation. So we’re going to hit ‘V’ for ventilation. Here you can actually see that you can have
3 pre-set modes. So if you know you need a little bit more
support when you’re out and about, or maybe you have a mode that you use at night vs day. You can have all of those pre-set in the system,
rather than having to toggle through every setting or pressing buttons and things like
that. It just makes it a lot more convenient for
you. And this whole device was basically designed
with both caretaker and patient in mind. So, let’s say right now we’re on our mobile
mode, as you can see it says now active. Let’s say you get home and you want to go
to bed. To set up your night mode, all you have to
do, is select, start. Now, it is going to prompt you to do a test
but for the sake of this video and the sake of time, we’re going to skip it and I’ll have
links below that can actually show you how to do your pre-use check. And you can see, now your night mode is active. So it’s a lot easier, again, it’s all touch
screen so you don’t have to worry about toggling through, resetting something every time. But let’s say you did want to quickly change
a setting. So you want to make an adjustment on your
mobile mode, you would select over here on the side, settings and alarms. All of your settings and all of your alarms
are going to be here on this page so just scroll through and go slow and you won’t miss
anything. So you’ve got your mode here, circuit type,
whether you’re using humidity not. Let’s say you wanted to change your mode from
pressure to AC volume. Do that, select and now you’re in AC volume. So it’s all very simple, VOCSN tells you exactly
what to do. Just follow the instructions and you’ll do
great. And then exit out, when in doubt, exit out
and you’ll be right back at your therapy screen. So one thing I do want to show you guys with
this also, is how quiet it is. Right now you can hear all three ventilators
going. So, we’re going to shut off the LTV, really
quick. It’s already gotten a little bit quieter. Our trilogy is off and now the only thing
we actually have running, is VOCSN and you can barely hear it. You’re not having to have me yell over it. It’s probably 3 times quieter than these devices
let alone when you’ve got multiple devices running at once. So it really just give you that extra peace
of mind. Especially if you’re out and about, and you
know, you’re in a restaurant or movie theater, wherever you’re going you don’t have to worry
about that additional noise in the background. alright, so one other thing I want to add,
uhm, VOCSN is capable of doing invasive, noninvasive and mouth piece ventilation and it has a really
comprehensive set of ventilatory modes. Regarding battery, obviously you can hook
this up to the wall and, you know, have it plugged in. If you’re out and about you can get up to
9 hours of battery and, you know, as you use various therapies that can go as low as 3
or 4 but you need to be using your oxygen concentrator, doing cough assist; really aggresively
using the therapies to get that low range. So, even at its lowest, it still is having
a longer battery life than the other two ventilators that we have. Something else that is nice too, if you do
happen to be out and about for a while, your batteries are, you have hot swappable batteries. So I’ll just show you here. Take you battery out, and something this size
is something that can be easily transported transported. You can even check battery by pressing your
button on the bottom and that is going to tell you what your current battery
life is. So if you happen to have one of these with
you, just pop it right back in and you are set to go. So you don’t have to worry about dragging
around giant batteries , such as on here, or batteries that may require something to
remove them. It just makes it a lot easier over all for
you. So all of the devices I’ve shown you so far
can have oxygen hooked up. Generally, it’s a bleed in system either from
a wall source or something such as an oxygen concentrator, tank; there are various options. That can, one, be costly especially at home
if you’re having to buy a concentrator on top of your ventilator and all of the various
other therapies you’re using. They tend to be a little bit noisy and sometimes
difficult to use. So I wanna show you, just quickly, some of
the differences here. So, over on the side, I’ve got an oxygen concentrator
here. If we turn it on, (laughs) one, you get a
lovely beep and then you need to adjust your O2 manually by twisting this knob and sometimes
there can be a little bit of a lag depending so you kind of have to watch it and make sure
at three liters per minute it doesn’t actually drop or go higher. Just so you guys can kind of, lovely little
bump at the end. So, I’m gonna turn, have that off just for
a second so you can kind of hear the difference because not only can you use a low pressure
system VOCSN and bleed in oxygen as well as hooking it up to a high-pressure source on
a wall, such as in a facility, I mentioned earlier there is actually an internal oxygen
concentrator in here that can get up to the equivalent of 6 liters per minute. So, I’m going to turn that on really quick. And same thing, under your therapy section,
you’re going to go to ‘O’ for oxygen. And same thing here as well, you have 3 presets. Everything I’m going to show you has three
presets. So, currently, we’re going to go to preset
one at 6 liters per minute, pulse dose and we hit start. We’ve got our oxygen concentrator running
now. So, it’s still quiet enough where I’m not
having to yell or a big bump when it starts or if we were to shut it off for any reason,
you’re not going to hear that loud kind of bump that we had with the other one. So, with your oxygen concentrator here as
well, if you want to change your liters per minute, it’s a little bit more simple. So, we’re on 6 liters right now, you go to
your settings, you’re just going to scroll down to your O2 flow and edit. You can either drag the bar back and forth
to change the LPM or you can actually enter your number in. So if we wanted to change to 5 lpm . Now we’re
running at 5 lpm. And then to stop, it’s going to verify everything
you want to do. So it’s just making sure, “Do you really want
to turn off your oxygen right now?”. So the nice thing about this as well is the
oxygen is delivered in pulse doses and it’s all combined in with the ventilation. So it is very seamless and your oxygen is
delivered within first 2/3 of a breath, as well, which not only makes the device more
energy efficient with the concentrator which is where you’re getting that longer batter
life from. It is also just more effective from a ventilation
and oxygenation standpoint. whereas with these other devices, you’re trying
to sync up the oxygen with the ventilator and then it, no matter what type of portable
oxygen concentrator that you’re buying it’s going to be an extra cost on top of the ventilator
your buying and it’s just going to be another item to carry around with you basically. So, again, this is really cutting down on,
you know, the bulkiness of all of the various therapies that you need to use. Now regarding clinicians, also, I know a lot
of clinicians that have had scary incidences where they’re stuck in an elevator and how
helpful would it have been to have an internal oxygen concentrator on hand in case that tank
runs out if you do get stuck or your transport takes longer than was anticipated. It’s just another peace of mind for you along
the way. For the next comparison I kind of wanted to
give you guys an idea of what these devices would look like side by side. We have the VOCSN and then over here this
is something that you might have more traditionally seen, where you’ve got your ventilator, your
cough assist, and then of course suction because that’s generally going to come right after
you use your cough assist. This is great for people with spinal cord
injuries, neuromuscular disease anything of the sort. But the thing that can be complicated about
this if you have a patient that is dependent upon using a vent, in order to use the traditional
form of cough assist you have to disconnect their circuit which as we know can, you know,
lead to higher rates of infection. That’s going to be really anxiety inducing
for a lot of people that depend on their vents as well because you’re taking away, their
breath, basically. They have to have the trust in
you to disconnect the vent, reconnect them and then again like I mentioned, just issues
with infection control. Another thing also that you’ll find in a lot
of facilities, there are not a lot of cough assists available. So as a clinician, half your time is going
to be spent even just trying to locate one and then once you do, getting everything set
up. So for this particular device, when you turn
it on, one you’ve got a little bit of noise and then your going to be manually setting
your pressures and your flows and again if this gets bumped, especially at least for
this model. There are other models of cough assist out
there don’t get me wrong but for this particular one it gets bumped, something like that, pressures
might be changed and if you’re not paying attention that can be a problem of course. This particular one you cannot set the time
insufflation and exsufflation so this one you are going to be doing it manually for
them and either watching the clock or hoping you’re counting well. insufflation…. It can be, you know, a little bit difficult. And then of course after this, the whole point
of this is to help move secretions, right? So you’re going to have to suction.You’re
either going to have your portable suction or the suction in the hospital that you’re
then going to have to turn on, disconnect again to suction, which is going to be even
more noise. and then when you’ve got that going, getting them reconnected back to the
vent. So it can really be a time consuming ordeal
and really stressful for not only the patient but the clinicians as well. Often times you need to have more than one
person there to do it anyway. So I’m just going to turn this off here so
you can kind of hear the comparison between the noise as well. Now with VOCSN, not only do you have your
cough assist at the touch of a button, so you’re not going to have to disconnect patients,
you’re not having to worry about that increase risk of infection. All of the circuits that are made for VOCSN,
all of these Ventec circuits, are made to be able to withstand the pressure that is
created when you’re doing cough assist along with your suction attached on the side. So again we’re on our therapy screen. you’re going to go to cough. And same thing as all the other screens, you
have various modes set because just like when we cough naturally, you’re going to have different
levels depending on the amount of secretions you need to move, anything like that. All you’re going to do, is you’re going to
hit start, it’s going to initiate the therapy. and right now this is set for 3 cough cycles. The nice thing about this is it’s actually
synching to the patient’s breathing as well. They can trigger that cough, where as with
this one I’m either going to be doing it manually where sometimes it doesn’t give the patient
long enough to synch up with the cough assist device. So it can be really uncomfortable trying to
get everything coordinated. I’m gonna show you on the second one here
a little bit closer, uhm, we’ll go into the suction in just a second, but there is a way
you can set up so your suction and your cough assist are running at the same time. Which makes it a little bit easier, again,
so you’re not having to worry about disconnecting or, “oh my gosh I need to suction, let me
get in there.” so that’s an option that’s offered as well. So we’re going to start one more time. and
we can see that we’ve got a C and an S on top for our suction as well. It might be a little bit difficult to see
but we do have some suction coming on this side here. And then we also have our gauge because suction
will continue to run for about 2 minutes or so but you can obviously manually stop that
as well.And then once the cough cycles are complete, what ever you have selected, for
that that round, it goes right back to ventilation. So you’re not having to worry about disconnect,
reconnect, patient anxiety, uhm, just like you I breathe, once the patient stops coughing
they go right back to breathing. Okay you guys, so you might be asking, what
is this in my hands. One other things I do want to touch on with
the touch button cough assist, is that if you have a patient that is on a heated humidier
and a heated circuit, there’s a special bypass that has been created just for that, that
has 2 check valves so that you can still use cough assist because you’re probably thinking,
“Well how are you shooting all of that pressure through the circuit and then sucking it back
and how are you not getting water from the humidifier into the circuit, into the patient’s
mouth.” You probably have a lot of questions about
that right now. So this has been created, again, so you don’t
have to disconnect the patient, to decrease the risk of infection from those frequent
disconnects. So if you guys think about it, if a patient
is used to having that heated humidity and then you’re disconnecting them and you’ve
got cool, dry air hitting their airways, that’s basically just asking for bronchospasm. you’re, you know, the airways are not used
to transitioning that quickly and it can cause issues. So this is something that I don’t think people
even realized that they needed initially because no one has done it before and that is something
that does make it so special. And again, it’s just with the patient in mind. For the suction by itself, it’s actually comparable
to the inline wall suction that you would see in a hospital, for example and something
else that’s really nice too about this also if you are kind of on the go and something
happens and you need to use suction, there’s a really discrete travel suction canister
on the side here and it looks like just another part of VOCSN. It’s really simpleton remove. There’s a little twist knob on the side here,
pops right off. It’s protected by a hydrophobic filter here,
so no secretions are actually going to get inside of VOCSN and then again you just turn
it and it’s right back on. This can also be attached to a full sized
canister that ‘s going to hold 500- 600 ml, whatever you may have if you don’t want to
use this constantly. So it is a very easy switch over. For your suction, you’re just going to your
therapy screen, hit suction. Again, very simple. You can have a set default. Right now we have our default set to -175
but if for some reason you need to increase that, it’s very simple to increase. For a one time increase, you’re just going
to hit your plus button up to whatever pressure you’d like, -220 in this case. and our suction is now on. It’s very quiet, you know, it’s not going
to be anything that’s going to draw a lot of attention a very uncomfortable situation
already for whoever is using it as opposed to if we’re turning on our suction over here
for example. Which is going to be drawing a lot more attention. This is just another example of how VOCSN
was created with the patient in mind. Every little detail, how discrete it is, how
quiet it is, you can hear the difference between the two devices VOCSN is a good 2-3 times
quieter that this device over here. And again for stopping suction, you just hit
stop. Takes it a second but you can hear it kind
of quieting down. Many people that use mechanical ventilation
at home also need some type of medication through a nebulizer. So I’ve got a version of a home nebulizer
system that someone might use. So when you tun it on, if they’re on a vent
you may have to break a circuit to start the process unless you have like a special valve
or something inline that you’re using. Particularly, with the Trilogy there is an
option in the alarm section to, it doesn’t actually compensate for the additional flow
that you’re getting through the nebulizer. because if you think about it, running your nebulizer
at 6 lpm, that’s 6,000 extra ml of volume that your patient is getting and if your vent’s not
compensating for that, and changing those flows either, one, you’re going to have to
go in and change the settings on your vent so you’re not giving them all that additional
volume or if people are using the alarm section on this, like some do, they’re still feeling
all that but it’s just silencing the alarm basically. It makes the alarm less sensitive and that
can be really uncomfortable to someone, especially if they’re not used to that, like most of
us are not. So what they have done with VOCSN actually,
not only is your nebulizer integrated into the whole system, but it actually compensates
for that flow. Now there is a port on the side here that
I’m going to show you and we’ll turn it on in a second so you can actually hear the nebulizer
as well and hear how quiet it is. That’s going to compensate for the additional
6 lpm that you’re getting. The nice thing about this also is it has a
timer on it. So you can set it for 15 minutes, 20 minutes,
whatever you need to do so if you get called away and the nebulizer, you know runs out
after that 15 minute mark, this is going to shut off and you won’t have to worry about,
you know, having that nebulizer running on nothing. Whereas with this type of set up, this particular
one does not have a shut off. You don’t have that flow compensation and
it’s just another device you have to carry with you. with VOCSN in particular, it does have
an option, if you wanted to use a nebulizer that was not connected to VOCSN itself, for
some reason, let’s say you were using an oxygen tank or running it off of a low pressure source,
as long as you’re running at 6lpm, you’re still going to get that same compensation. You do it the same way rather than choosing
internal neb, you’re going to choose right over here, right next to it, external neb
compensation and start. and there you go! And same thing, if for some reason you don’t
want your nebulizer to run the full time that you’ve set for it, you simply hit stop. It does give you an option to hit restart
if for some reason it was just a quick pause or you can simply exit out. and that’s it!
and with VOCSN your monitoring itself is so much easier. You can do it just by touching the screen
rather than menu diving, having to click through a bunch of options. All your going to do it simply hit monitors
at the top and you can actually customize the values that you want to see. Right now, we have things like, breath rate,
your exhaled tidal volume, your I:E ratio but there are 20 plus options that you can
customize on here so that it fits your needs. And your first 3 items that you see in your
monitors are actually going to be your home screen. like you can see here we’re showing breath
rate, exhaled tidal volume and which preset we’re using. In this case it’s our night preset. So if you go back to monitors, if for some
reason you want to get a quick look at what your current settings are, if you’re questioning
something you’re seeing on the monitors, you just hit down, scroll down and these are all
of your current settings for the mode of ventilation that you’re using. If you wanted to adjust what you’re seeing
on your monitors, all you’re going to do is hit customize, edit after selecting which
section you want to change. and this is where you’re going to find your
20 plus options of course they are going to change depending on the mode of ventilation
you’re using and things of that sort. and you do have an option to view your waveforms
also and that’s also on your monitors screen, because that’s a form of monitoring, right? So right here on the end here, you’re gonna
hit wave form and you can actually change through pressure, flow and volume. And the thing that you can do about that as
well is you can expand your graphics here, making them smaller or larger. As well as spacing out the time if you want
to see them every 15, 30 or 60 seconds. You can do that as well and even pausing them
if there is something you kind of want to look at. So right here, we’ll let one come through. Pause, and then you can closer inspect whatever
you’re looking at if you have questions about something. Something else that you can do as well, there
is actually an event log you can go through. so if you go to menu and logs it’s first going
to bring you to any recent alarms if they haven’t been cleared. So you’re going to hit events on the top and
you can actually scroll through and this is going to tell you any of the functions that
is offered on here. It is going to tell you when suction started,
when it stopped. Your cough assist, what time, your nebulizer,
if you’ve used that and how many minutes it was set at or how long it actually ran. So with your event log, it can actually be
exported also if you are keeping track or a record of these things for all five therapies
for respiratory care, then you have quicker and easier access to be able to store these
things. I often hear concerns about, you know, having
ot pick and choose what they can take when they leave or perhaps when they go back to
the hospital there is always a concern that these big devices are going to break along
the way. With VOCSN that’s not as much of a worry. It’s made of a really durable material and
has a high quality that you can feel when using it. The screen is made of Gorilla Glass so you
don’t have to worry about that breaking or anything of the sort. It’s one device with five therapies so instead
of learning how to use five different devices for whatever it is that, you know, your loved
one may need, you only have to learn about this one and again you’re not going to be
having to worry about picking and choosing what you need to take with you or what you
can take with you. Whether it’s going to a movie theater or going
out and about or even if you need to go back to the hospital for some reason. It makes the whole transition from hospital
to home much more seamless. You have one device you need to learn even
with five therapies as opposed to multiple devices, multiple circuits, multiple wires. You know, it just, it makes life a lot easier
inside and outside the hospital. whether it’s you know using these therapies,
cleaning your device, buying the different accessories that go along with them. It’s just something that makes life so much
more untethered for people that need these on a regular basis. After going through the various therapies
that are offered with VOCSN, how it has all been integrated into one device to make the
life of the clinician easier and then more importantly the life of the patient, to make
that easier. It’s kind of the definition of, at least to
me, of patient centered care and I think it’s going to be really exciting to see this device
out in the world more and see how it is improving the lives of patients that are using it. Uhm, again it’s just so simple and easy to
use and that can be something that is really intimidating, especially when you’re bringing
your kid home for the first time. you’re already having such an overwhelming
experience, and this just adds a whole other level of simplicity to it and a whole other
peace of mind for families to bring something home that looks nice, sleek, clean and really
not intimidating. VOCSN is really great for anyone that weights
5 kilograms or over and the 5 therapies that are offered with it are completely customizable
to your needs. So if you only need ventilation and the oxygen
concentrator, that is what will be supplied on VOCSN for you. If you need it more customized and you want
to add the whole range; cough assist, suction and a nebulizer that is what you’ll get. So really it’s great from anything hospital,
to home and anything you may find in between.


8 thoughts on “VOCSN: Five Devices in One

  1. Hi Aimee!
    Not very related to the video, but I got accepted into the RT program (yay!) and I've been watching you and JustDella as well as a few others for a bit now. I was wondering if there was an e-mail I could use to contact you for some tips, as I'm planning on starting a YouTube channel following this journey. You've definitely been an inspiration, and with so few RT YouTubers out there, I want to join the ranks.
    Thanks!

  2. This is great! My father has the Trilogy one. Going out is such a mess all the time because we have to bring his suction machine and everything else.

  3. I had been following VOCSN for over a year and finally got my about a month ago. I have found it to be better than the Trilogy in many ways. I now don't have to change out inner cannula or cart my portable suction with me. I also don't have to cart the portable nebulizer around. I still trade out my cannula if I'm driving as suctioning is a two handed operation. I still need to get the charger and spare batteries but the last month has worked out well. I should add that I use a walker and spend about 4 or 6 hours a day shopping, community meetings, volunteering, shopping, and visiting with friends. I'm 24/7 vent/trach with an electrolarynx!

  4. I use all five pieces of equipment, and I asked my Dr. which wouldn't write me a script for it saying it'd have to be payed for out of pocket. I use a cough assist, a suction, oxygen, nebulizer, and use a ventilator. And last time we had to travel, taking all of this was a mess.

  5. Can you use this for oxygen without the vent being on? My son is only on bipap while sleeping but sometimes needs oxygen during the day. Also does it have a continuous flow option if it can be used without the vent?

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