Devices Flashcards
IS (incentive spirometry)
a method of encouraging voluntary “Deep breathing” by providing visual feedback about inspitatory volume. The Px “inhales” until a preset volume is reached, then sustains the inspiratory volume by “holding the breath” for 2-3sec.
It reduces the risk of “atelectasis” and pulmonary consolidation.
There is no evidence that IS reduces the incidence of PPC following _____ or ________ surgery (Overland etal, 2001); however, any type of lung expantion intervention is bettter than no prophylaxis (Lawrence et al, 2006).
Cardiac, Upper abdominal
both studies are “a systematic review”!!
Name some of the “Oscillating PEP devices”
- Flutter … a small, portable and pipe shaped. (steel ball enclosed)
- Acapella … uses a counterweighed plug and magnet to create airflow oscillations.
- Comet …. consists of a curved hard plastic outer tube. (independent of gravity, so can use in any position)
What’s the rationale behind “Oscillating PEP devices”
During expiration through the device (resistance), the movement of the ball creates a positive expiratiory pressure (PEP) (like pursed lip breathing) and an oscillatory vibration of the air within the airways (mucus mobilisation).
[It may precipitate expectoration and should be followed by a pause for BC following a huff (through device) or cough. (Patterson et al, 2005: Acapella as effective as ACBT)]
PEP devices rationale (from a lecture slide)
- Obtain temporary increase in FRC
- Allow TV to be above opening volume for otherwise closed airways
- Allow “collateral ventilation” to recruit alveoli
- Gets air behind secretions
- Use FET to mobilise and clear secretions
PEP device pressure targets ___ - ___ cmH2O in mid-expiration for sputum clearance.
10 - 20 cmH2O (bubble PEP water level 10cm depth)
PEP treatment is usually performed for approximately ___min, ___ a day, in Pxs with stable chest disease and excess bronchial secretions.
15min, twice a day
PEP method (from a lecture slide)
- Sit leaning forowards with elbow support, holding device
- 5-8 breaths slightly larger than TV
(with breath hold at the end of inspiration if possible; slightly active expiration against resistance, which aims to increase FRC across the cyle) - Huff through device
- BC to finish the cycle
Name 3 “Low flow” oxygen therapy devices.
systems deliver O2 which is diluted with room air
- Nasal Canula (FiO2 … 24 - 36%) [1 - 4L: 1L=24%]
- Simple face mask (FiO2 … 35 - 60%)
- Non re-breathing mask (FiO2 … 60 - 80%)
Name 3 “High flow” oxygen therapy devices
systems can deliver a prescribed air/oxygen
- Venturi mask (fixed FiO2 - prescribed O2 concentrations)
- Ambu bag (closed circuit; Reserevoir bag; 100% FIO2)
- High flow nasal prongs (Himidified;
“Nasal canula” advantages
- No re-breathing - gd for type1 &2 respiratory failure
- Comfortable & usuaally well tolerated
- Low cost, safe and simple
- good for cofused Px - less easily pulled off
- able to eat and drink, talk
Type 1 respiratory failure
PaO2 < 8 kpa with a normal or low PaO2 [Hypocaemic], which is caused by V/Q missmatch.
(common in … lung collapse/consolidation, asthma, pneumonia, pulmonary oedema, pulmonary embolism)
Type 2 respiratory failure
PaCO2 > 6.7 kpa accompanied by PaO2 < 8 kpa [Hypercapnic], which indicates inadequate alveolar ventilation
(common in … chronic bronchitis, chest injuries, drug overdose, post operative hypoxemia)
“Nasal canula” disadvantages
- Unpredictable FiO2
- Cannot be used for mid/high O2 FiO2 concentrations (>40%)
- Not suitable for Px with nasal obstruction
- Less effective for mouth breathers
Difference between “Angiogram” and “Angioplasty”
“Angiogram”: is the image taken when the artery is injected with dye and imaged under x-rays.
“Angiography”: is the procedure used to obtain an angiogram.
They are often used interchangeably in the vernacular.
