treatments Flashcards
what are the indications for oxygen therapy?
documented hypoxaemia
severe trauma
acute MI
short term therapy
decrease the symptoms associated with chronic hypoxaemia
what are the complications of oxygen therapy
oxygen toxicity
depression of ventilation
retinopathy of prematurity
absorption atelectasis
fire hazard
what are the precautions for manual techniques
apply with care or avoid if
current large frank haemoptysis
severe clotting disorder
uncontrolled thoracic pain
rib fractures/flail segment/osteoporosis/cancer
active pulmonary TB
pneumothorax/surgical emphysema
over incisions, burns or frail skin
implanted venous access devices
how do positions of ease reduce a patients WOB and sensation of breathlessness?
reducing the load
reducing energy demand
name some strategies to encourage relaxation
mindfulness apps
positioning
breathing control
what does pursed lip breathing do?
the positive pressure on exhalation prolongs expiratory time and reduces airway collapse in floppy airways of emphysema
what are the indications for using NIPPY clearway?
used in the management of any patient in which cough effectiveness has been reduced and who are at risk of developing further respiratory complications
how do adjuncts help
They help to keep your airways wide open to get air behind sputum to help move it towards the mouth. Minus PEP, they also provide vibrations that you will feel to thin and loosen the mucus in your lungs
name some physical problems that can remain following an ICU stay
weakness
walking distance
fitness
lack of stamina
SOB
leg weakness
tiredness
aches and pains
muscle pain
name some impactful sleep hygiene practices
get up and go to the sleep at the same time
establish a night time routine
limit caffeine
exercise
reduce stress
avoid large, fatty meals prior to sleeping
turn off electrics an hour before bed
create a healthy sleep environment
what is some evidence for pulmonary rehabilitation
reduced mortality
low cost service run
reduces the financial burden on NHS
reduction in hospital admissions and length of stay
improves HRQoL e.g. reduced depression and anxiety
improves both functional and maximal capacity - walk further, do the things they enjoy
what are the indications for CPAP
pneumonia
pulmonary oedema
flail chest
type 1 respiratory failure
what are the contraindications for CPAP
risk of barotrauma
type 2 respiratory failure
excessive secretions
severe bronchospasm
what are the precautions for CPAP
broncho pleural fistula
proximal airway tumour
raised intra cranial pressure/acute head injury
what are the complications of suctioning
hypoxia/hypoxemia
atelectasis
bronchospasm
infection
increased intercranial pressure
pneumothorax
anxiety
what are some contraindications for suctioning
suspected CSF leak
nasal fractures
stridor
severe bronchospasm
what are some precautions for suctioning
pulmonary oedema
high intercranial pressure
nasal polyps
cancer high in respiratory tract
cancer high in the GI tract
name the indications for nasal pharyngeal and oral suctioning
unable to clear secretions
secretions are audible/visible
secretions are persistent despite the patient’s best cough effort
secretions compromise oxygenation by decreasing SPO2/paO2 below what is acceptable for the patient
what are the indications to ventilate a patient
respiratory failure
prolonged post op recovery
altered conscious level
inability to protect airway
what are the complications with ventilation
CVS instability
barotrauma
V/Q mismatch
discomfort
excess secretions/infection
complications of high O2
gut and bowel dysfunction
weakened respiratory muscles
How does IPPB work
positive pressure is delivered using a respirator and mouth piece or mask
the flow of gas is triggered by the patients own inspiratory effort. sustained positive pressure is applied to the patients airway to a pre-set level, set by the physio
this pushes the patient into IRV and increases inspiratory lung volume
once the pre set inspiratory pressure is reached, the machine ceases to flow and pressure returns to 0. the patient breathes out passively
when should you consider IPPB
to open up collapsed alveoli
what are the contraindications of IPPB
risk of barotrauma
severe bronchospasm
excessive secretions
inability to protect airway from aspiration
