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CVR > Adjuncts > Flashcards

Adjuncts Flashcards

1
Q

What is Non invasive ventilation?

A

A technique where positive pressure is applied to airways without a tube to provide ventilatory assistance.

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2
Q

NIV benefits

A

Improves oxygenation, lung volumes, enhances airway clearance and manages respiratory failure.

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3
Q

NIV devices

A

Nasal masks, full facemasks, nasal pillows and tracheostomy

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4
Q

NIV indications

A

Type 2 respiratory failure, nocturnal hypoventilation, acute exacerbations of COPD, weaning

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5
Q

What is CPAP?

A

Continuous positive airway pressure
It splints open floppy airways and recruits collateral ventilation channels
It is a type of NIV used with oxygen to treat type 1 respiratory failure

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6
Q

CPAP benefits

A

Improves V/Q

Maintains FRC

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7
Q

CPAP devices

A

Hood and mask
Nasal
Nasopharyngeal
Face mask

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8
Q

CPAP indications

A

Type 1 respiratory failure
Weaning
Increased WOB
Reduced lung volumes

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9
Q

What is IPPB

A

Intermittent positive pressure breathing
Assists with inspiration
Delivers 40% oxygen
Can use with TEE

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10
Q

IPPB benefits

A

Helps clear sputum, improves oxygenation, increases lung volumes, decreases work of breathing

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11
Q

IPPB indications

A 
Type 1 respiratory failure
Lots of secretions unable to clear
Need to improve lung expansion
Reduced lung volumes
Increased WOB
Treatment of atelectasis
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12
Q

IPPB application

A

1-2 H20 sensitivity

10-15cmH20 initial pressure

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13
Q

What is PEP

A

Positive expiratory pressure
It is breathing out against a resistance
The positive pressure splints airways to stabilize peripheral airways and prevent them from collapsing.
Gets air behind mucus via collateral ventilation channels and forces secretions to larger airways for expectoration

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14
Q

PEP indications

A

Retained secretions
Atelectasis
Non CF-bronchiectasis
Acute exacerbation of COPD

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15
Q

PEP application

A 
Seated
Inspire slightly greater than tidal
Exhale for 3 seconds
10-20cmH20
6-12 breaths
Followed by FET and coughing
6-12 cycles
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16
Q

What is oscillating PEP

A

Combination of PEP and high frequency oscillations

17
Q

Oscillating PEP devices

A

Flutter
Acapella
RC-cornet

18
Q

Oscillating PEP indications

A

Retained secretions
Atelectasis
COPD
Non CF-Bronchiectasis

19
Q

What is the flutter device?

A

Encases a high density ball which rolls up and down to interrupt expiratory flow and generate positive expiratory pressure
Generates oscillatory vibrations to shear secretions from airways

20
Q

Flutter application

A 
Upright position
Slow deep inspiration
Breath hold 2-3 seconds
Expire slightly faster than normal
Repeat 5-15 times
Followed by FET and coughing
21
Q

RC-Cornet application

A 
Upright position
Slow deep inspiration
Breath hold 2-3 seconds
Slightly active expiration
Repeat 8-10 times
Followed by FET and coughing
22
Q

Acapella application

A

Inspire with short breath hold
More active expiration
Followed by FET and coughing
Can use in any position

23
Q

What is respiratory muscle training

A

Improves strength and endurance of diaphragm

Tolerate greater inspiratory loads to prolong exercise tolerance and reduce dyspnoea

24
Q

What is weakness of respiratory muscles?

A

A reduction in contractility causing inability to generate normal levels of pressure and airflow during breathing.

25
Q

RMT devices

A

Passive flow resistance
Dynamically adjusted flow resistance
Pressure threshold valve

26
Q

RMT indications

A

COPD
Dyspnoea
Exercise intolerance
Surgical patients

27
Q

When is IMT most useful?

A

When added to whole body exercise training

28
Q

What is incentive spirometry?

A

Device activated b patient’s inspiratory effort

Can be used during TEE

29
Q

IS devices

A

Incentive spirometer

Tri-flow

30
Q

IS indications

A

Surgical patients
Prevent post op complications
Reduced lung volumes

31
Q

IS application

A

Slow deep breath in
Avoid quick inspiration
Recommend to patient they use it in their own time, e.g. every time the nurse walks past.
Tends to be used in surgical patients and may be useful for children.

32
Q

What is cough assist?

A

Uses positive pressure to deliver maximum lung inhalation
Then abruptly switches to negative pressure in upper airway
This rapid change stimulates airflow changes that occur during a cough

33
Q

Cough assist devices

A

Mechanical insufflator/exsufflator

34
Q

Cough assist indications

A

Respiratory muscle weakness
Weak cough
Neuromuscular disease
Retained secretions

35
Q

What is the risk with cough assist?

A

There is a risk of mobilizing large mucus plugs into central airways which can obstruct airways

36
Q

Cough assist application

A

Produces expiratory flows of greater than 160 L/M
Incorporate rest periods
Start pressures low to allow patient to acclimatise

CVR (20 decks)

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