click below
click below
Normal Size Small Size show me how
Resp 2.3
Positive Airway Pressure Therapy
Question | Answer |
---|---|
Define IPPB | short term breathing treatment in which pressure above Atmospheric pressure are delivered to pt lung via a pressured cycled ventilator |
Goals of IPPB | deeper breath, promote cough, improve distribution of ventilation, better ABGs |
indications of IPPB | hypoventilation, atelectasis not responsive to other tx, reduced cough effort, increased airway resistance, increased WOB, accumulation of secretions, the inablility to inspire adequately |
General pt who can benefit from IPPB therapy | pt that can not take a deep breath |
hazards of IPPB | hypoventilation (to much O2), hyperventilation, pneumothorax, gastric distinction, decreased venous return exept with pt with pulmonary edema |
medication side effects | dizziness, tingling, numbness |
contraindications for IPPB | facial surgery, hypotension, TE fistula, bleb, hemoptysis |
Physiological effects | decrease WOB, increase tidal volume (ventilation), decrease CO2, increase O2 normal pH |
What should be included in an IPPB order | duration, treatment, frequency, and medication |
what should be monitored during IPPB treatment | appearance (color), BS, vitals |
Bird Mark 7 | Pressure cycled, with assist and assist/control modes, requires 50 psi gas source |
Pressure chamber | contain the pt pressure until the beginning of inspiration and houses the pressure control |
ambient chamber | exposed to room air and is the side that houses the sensitivity control |
alternative therapy to IPPB | EzPAP, IS, or pursed lip breathing |
Information to chart after delivery of IPPB | drug used, pre and post vitals, adverse reactions or responses |
assist mode | machine breath is delivered only when on inspiratory effort by the pt is sensed by the ventilator (PT IS TRIGGERING BREATH) |
assist/control mode | a machine breath is delivered when an inspiratory effecy by the patient is sensed by the ventilator (assist) or at set time intervals if the rate occurrence of insp effort fails below a set rate (control) |
control mode | machine breaths are delivered at preset intervals (MACHINE BREATH) |
Factors that determine the length of inspiration in a pressure cycled ventilator | pressure setting, flowrate, pt ventilator pattern, pt lung compliance and airway resistance |
How flow adjustment affects insp and exp time | When increase flow it decreases insp time When decrease flow it increases insp time |
What is the ideal I:E ratio when delivering IPPB | you want more expiratory time |
Purpose of EzPAP | prevention and treatment of atelectasis and for lung expansion therapy, recommended for pt with a decreased FRC |
Contraindications for EzPAp | none |
adverse reactions for EzPAP | increased WOB that may lead to hypoventilation, increased cranial pressure, cardiovascular compromise, decreased venous return, air swallowing, and pulmonary barotrauma |
Therapeutic outcomes of EzPAP | decrease atelectasis |