Unit 4 test RCP 228 Flashcards
Objectives of Home/ Alternate Site Care
• Support and maintain life
• Improve physical, emotional, social well-being of patient
• Promote patient and family self-sufficiency
• Ensure cost-effective delivery of care(being@ home less expensive than hospital stay)
Discharge to Home/ Alternate Site
• Supplies and equipment procured from DME
(Durable Medical Equipment provider)
- 24/7 coverage
Conserving Device for Portable O2
• Uses flow sensor and valve to coordinate delivery of oxygen to patient with patient inspiratory effort
• Special regulator for tanks
• Patient must have sufficient inspiratory force to trigger sensor (pulse dose)
Humidification
• For any home system of oxygen-should use distilled water or boil own water
Oxygen Concentrator
• Not 100% oxygen, % decreases as flow rates increase or if >50ft tubing
- 94 to 95% at 1 to 2 LPM
- 85 to 93% at 3 to 5 LPM
- Most are limited to 5LPM; must run 2 in tandem to get higher flows when needed
• Cannula
- Most common
- Tubing up to 50ft in length
Nebulizer Therapy in the Home
• Compressor units
- Electrically powered - small air compressor
• Cleaning of neb circuits - daily
- Wash in mild soap and water, rinse
- Soak in one part white vinegar to 3 parts distilled water (once a week) wash, rinse
- Air dry
Oxygen Precautions
• No smoking/candles/close to gas stove, away from wall
• Liter flow is prescribed by physician - DO NOT ADJUST!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
!!!!!!!!!
• Emergency or back-up supply of tanks for liquid and concentrators
• If concentrator used, notify local power company
• Tanks secured in well ventilated area
• Never use grease or oil on any oxygen supply system
• Post an oxygen in use/no smoking sign
• Check connections regularly and change hoses/NC as needed-teach about alarms on stationary unit
Maintenance • Concentrators
- Monthly
• Checked FiO2 and flow accuracy
• Must deliver at least 85% at 4LPM or machine switched out/serviced
Certificate of Medical Necessity for Home Oxygen (CME)
• Qualifying criteria-(ABG, overnight pulse oximetry)
- Pa02 ≤ 55 mmHg or Sp02 ≤ 88%
• If oxygen evidence from hospitalization, needs to be repeated after 1 to 3 months to determine continued need
Prescription/care plan
based on documented hypoxemia
Flow rate/FiO2, frequency of use, duration of need, diagnosis, laboratory evidence…ABG or pulse oximetry… (evidence of need not performed by DME company)
Peak age for SIDS
is 2-4 months;
Three different oxygen systems for Oxygen delivery at home
Compressed Oxygen Cylinders
Liquid Oxygen System
Oxygen Concentrator
Compressed O2 max LPM settings at home is
5LPM
How Apnea Monitors Work
• EKG - senses electrical depolarization and repolarization of heart
• Respirations - impedance pneumograph detects respiratory rate as the thoracic case changes size during inspiration and expiration