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Artificial Airways_Ventilation > IPPB > Flashcards

IPPB Flashcards

1
Q

What is IPPB

A

the application of inspiratory positive pressure to a spontaneously breathing patient in an intermittent or short term therapeutic modality.

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2
Q

When is IPPB used?

A

When a patient has atelectasis and incentive spirometry is not working

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3
Q

What pulmonary function data supports the use of IPPB?

A
  • Decreased lung volumes as evidenced by FEV1 less than 65% of predicted
  • If the IC is less than 70% of predicted
  • If the vital capacity is less than 10 ml/kg
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4
Q

What happens to the alveoli in IPPB?

A

they increase in size due to positive pressure

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5
Q

What triggers the IPPB?

A

The patient triggers by inhaling, then pressure and flow move into the patient’s lungs from the device

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6
Q

What is the limit in IPPB?

A

IPPB is pressure limited

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7
Q

When does expiration start?

A

when preset pressure limit has been set, the flow stops and patient can exhale

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8
Q

What should the trigger sensitivity be set at?

A

-2 to -5 cmH2O

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9
Q

How is the flow rate set?

A

by observation- watch the pressure gauge and talk to the patient

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10
Q

How is the pressure set?

A

according to the prescribed tidal volume goal based on 10 to 15 ml/kg of ideal body weight but generally should be BELOW 20 cmH2O

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11
Q

Can IPPB be used to deliver aerosolized medicine?

A

yes

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12
Q

Can IPPB be used with ET tube or tracheostomy?

A

yes

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13
Q

Can IPPB be used with a mouthpiece?

A

yes

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14
Q

Can IPPB be used with a mask?

A

yes

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15
Q

What should you verify before beginning treatment?

A

physicians orders, review chest x-ray and written report, do a general patient assessment (vitals, chest exam)

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16
Q

What information should you give to the patient before initiating treatment?

A

why the doctor ordered it, what it does, how it feels, what the expected result should be. You should also demonstrate to patient

17
Q

In what position should the patient be positioned to receive IPPB?

A

either high fowlers (sitting up) or semi fowlers

18
Q

Can you set the respiratory rate for IPPB?

A

Yes. It should be set at 6 breaths per minute

19
Q

What should the I:E ratio be when giving IPPB?

A

1:3 or 1:4

20
Q

List at list 5 expected IPPB outcomes

A
  • improvement in vital capacity
  • increased FEV1
  • enhanced cough and secretion clearance
  • improved chest x-ray
  • improved breath sounds
  • improved oxygenation
  • favorable patient subjective response
21
Q

What are contraindications for IPPB?

A
  • tension pneumothorax
  • ICP over 15 mmHG
  • Hemodynamic instability
  • active hemoptysis
  • tracheoesophageal fistula
  • recent espophagea, facial, skull or oral surgery
  • active untreated TB
  • xray evidence of blebs
  • hiccups (singulus)
  • Nausea or air swallowing
22
Q

What are hazards and complications of IPPB?

A
  • Increased airway resistance
  • Pulmonary barotrauma
  • nosocomial infection
  • hyperoxia (when O2 is used as gas source)
  • impaired venous return (resulting in increased ICP)
  • gastric distention
  • air trapping, autopeep
  • psychological dependence
23
Q

How do you increase the e time?

A

by increasing the flow

24
Q

How do you increase the I time?

A

by decreasing the flow

25
Q

What happens if you cause a greater flow rate?

A

you decrease the I time

26
Q

What happens if you turn down the flow rate?

A

you increase the I time

27
Q

During inspiration if the manometer needle rises and then falls, then rises again, what should you do?

A

increase the flow rate

28
Q

How do you use venturi air mixing?

A

If the black skinny knob on the front is pushed in, the air mix feature is OFF. Knob out, it is on :)

29
Q

What FIO2 will “airmix” provide?

A

variable between 40-80%

30
Q

If using airmix feature, are any other adjustments necessary?

A

YES- you must increase the flow!

31
Q

How do you adjust the volume delivered to the patient?

A

by adjusting the pressure limit

32
Q

What happens in there are leaks in the circuit?

A

It will prevent normal cycling to exhalation

33
Q

What happens if a patient starts coughing during an IPPB treatment?

A

Coughing (or obstructions in tube) will prematurely end inspiration

34
Q

What happens if the sensitivity trigger is set too low?

A

it will autocycle- high numbers on this control indicate increased patient effort (decreased sensitivity), low numbers indicate decreased patient effort (increased sensitivity

35
Q

Will you ever in your life need this info except for the National exam?

A

NO

Artificial Airways_Ventilation (6 decks)

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