Own the Hamilton

“Owning the Hamilton”…holding onto the simplicity of the past, embracing the complexity of the present, and making sure your skills don’t get left behind. This video walks you through the concepts and simulation exercises are your chance to put them into practice before the real patient rolls in.

The Oxylog 3000 has finally been retired, and the Hamilton T1 is stepping into its place. Moving from the Oxylog to the T1 isn’t just a small upgrade, it’s like swapping a Nokia 3310 for an iPhone 17. The Oxylog was a glorified bellows with alarms; the Hamilton is a sophisticated, multi-mode ventilator with built-in automation and diagnostics.

The leap in technology is both exciting and unsettling. Do we cling to the simple mental models that served us well, or embrace the “autopilot” of Adaptive Support Ventilation (ASV)?

The answer, of course, is both.

Safety comes from versatility. We can’t de-skill and hand over entirely to automation, nor can we ignore the advantages of a machine designed to optimise ventilation breath by breath. The challenge is to preserve the Oxylog mindset while layering in the new tools of the Hamilton. Presets like SIMV-protective, SIMV-obstructive, and NIV allow you to map your old mental model onto the new hardware, while the dynamic lung and ASV graph open diagnostic and strategic possibilities the Oxylog could never offer.

Simulation models

Practising both manual and automated strategies in controlled, high-stress scenarios is the only way to build confidence. You need to know how to “fly the plane” when the autopilot drops out, but you also need to trust what the autopilot can do when things get chaotic. Using the SmartLung 2000 test lung, running through rare but predictable disasters, and rehearsing plan A and plan B will turn the Hamilton from an intimidating black box into a partner you can rely on.