Bronchial Hygiene Equipment Flashcards
Flutter Valve gravity?
gravity independent (must remain upright, have patient sitting up)
Flutter Valve directions and purpose
Start with flutter horizontal to floor, creates PEP and oscillation, have pt take a larger than normal breath, breath hold, and seal lips on mouthpiece, exhale actively, keeping cheeks stiff, perform 5-10 breaths until suppressed cough. perform 1 or 2 larger inspirations f/b forceful exhalation
Flutter oscillation frequencies are
b/w (body weight) 2-32Hz (hertz)
what does flutter valve do
creates PEP and oscillation
Oscillation
Movement
PEP
Positive Expiratory Pressure
EzPAP parts
Wavy end= ambient air inlet, air inlet= gas inlet port, white port= pressure monitoring port with cap (cap if not monitoring)
EzPAP flow setting is normally
5-7 lpm
Can you use EzPAP with mask?
yes, must create a seal
Can EzPAP deliver nebulizer
yes
EzPAP rules
slow inhalations and exhalations by the patient will maintain adequate airway pressure during the breathing cycle (maintain mouth or mask seal)
Therapeutic PAP pressures are
10-20cmH2O
Acapella Valve positives
Can be used in any position, with mask. Can be used to deliver nebulizer. Also produces PEP and oscillation.
Acapella technique
Instruct pt to hold larger than normal breath, hold breath., Create lip seal or mask seal, Instruct an exhalation for 1:3 or 1:4 ratio. Adjust to pt needs, have pt perform 10-20 breahs, perform coughing technique and repeat
Acapella oscillation frequencies reproduce
0-30 Hz
Acapella is adjustable
increasing the frequency (+) increases the PEP pressure which can be measured with pressure manometer
TheraPEP directions
Have pt sit up, take a breath slightly larger than normal, exhale actively but not forcefully, perform 10-20 breaths, remove treatment and cough, evaluate for independent use
TheraPEP therapeutic pressures
10-20cmH2O are indicated between lines, resistance can be increased or decreased
How many breaths on TheraPEP
10-20 breathes
Aerobika
OPEP therapy (oscillating positive expiratory pressure), inhale deeply on mouthpiece and hold 2-3 seconds and exhale 3-4 times longer than the inspiratory breath, continue for 10-20 breaths. perform 2-3 huff coughs to clear an airway. repeat
Metaneb details, blue ring=
changes resistance
Metaneb details, black ring=
used when delivering therapy through a ventilator
Metaneb requires
special circuit and adaptors
Metaneb can be delivered through
Mouthpiece, mask, Tracheostomy tube, and in line with the ventilator circuit
Vest- HFCWC Therapy, fitting full vest
top of the hipbone snug without being restricing
Vest-HFCWC therapy, fitting wrap vest
Fasten to pt during inspiration, snug without restricting
Vest-HFCWC therapy, fitting Chest Vest
inhale deeply and secure flaps to the front under the arm
Generic settings on vest
10-30 minute treatments, frequency 10-14 Hz, Pressure; 1-4 for the front vest/ 5-6 for the full vest
Cough assist
Delivers a positive pressure to assist with a deep breath (a deep breath is needed to produce an effective cough)
What is needed to produce an effective cough
Deep breath
Inspiratory pressure on cough assist/ vacuum pressure
25-35 cmH20 for 1 to 2 seconds followed by expiratory vacuum pressure -30 to -40 cmH20 for 1 to 2 seconds (this cycle mimics a cough by pulling the air out of the airways)
Cough assist cycles
Perform 5 cycle breaths followed by normal breathing for 30 seconds, repeat until secretions are cleared
Insufflation
inspiration
Exsufflation
Expiration
Cough Assist can be used with
Trach tube, mouthpiece, or mask
Postural Drainage, position held for how long
5-10 minutes, total treatment time 20-30 minutes up to an hour
Head down position should exceed
25 degrees below horizontal (HESS: 12-18 inches)
Important for Postural Drainage
Adequate hydration for secretion mobility, avoid strenous coughing, usually performed with percussion and vibration,
Hand clapping- percussion directions
Hand positioned 3 inches from chest, strike chest in waving movement
Hand clapping
Rhythmic striking of the chest wall in a wave like motion using both hands, hands in cupping position (relaxed), usually performed over a piece of thin clothing (gown), percuss back and forth in a circular pattern for 5-10 minutes, never percuss over bony prominences (clavicle/ vertebrae)
How can specialty beds help?
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