Lindsey Jones 2 - Equipments
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| show | 1.Delivered FIO2: 24%-45% 2.Flow: 1-6 L/M
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| O2 Therapy Devices:Adult & Pediatric-Low flow -Simple mask | show 🗑
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| show | 1.Delivered FIO2:60%-65% 2.Flow: 6-10 L/M 4. no one way valves.
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| show | 1.DeliveredFIO2: 24%-55% 2. Works by mixing 100% O2 and room air. 3. Precise FIO2 delivery. 4. When FIO2 increases entraintment port is Decreased. 5. When FIO2 decreases the internal diameter of gas injector decreases.
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| show | 1.Delivered FIO2: 21-100% 2. It is a high flow device and keeps the reservoir bag from collapsing if the flow rate is High. 3. Used in Emergency cases. 4. it has one way valve that prevents from rebreathing CO2.
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| show | 1. Face seal is important because reservoir should collapse slightly on each inhalation. A)If bag does not collapse - mask should be tightened and a better seal should be obtained. B)If bag collapses NBR valve may be stuck then - replace with a new mask.
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| show | 1. Trach collar - fits loosely, easy to tolerate- used when T-pieceis inconvinient for the pt. due to pt. movement. 2. Aerosol mask-is only good for high flow system- otherwise air entrainment is too great and FIO2 will be decreased significantly.
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| show | 1.Used to deliever aerosol. 2.requires a high flow supply/a pre-mixed gas. 3.Attaches @the end of an ET tube/trach tube. 4.Must see continues aerosol production during both inspiration&expiration, if cant see the flow the aerosol then Increase the flow.
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| show | These devices mix O2 and air to achieve an exact FIO2.
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| show | 1. Venturi mask. 2. Large volume nebulizers (LVN). 3. Small IPPB macines. 4. Some pressure ventilators.
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| show | 1. Impeded flow or back pressure- causes an increasein FIO2. 2. Occluded entraintment port - causes increase in FIO2.
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| show | 1. when puff of aerosol coming from the tubing of a LVB set @ FIO2 28%. 2. The very last part of the delivered breath from a Bird IPPB machine. 3. A king in the aerosol tubing coming from a LVB. --> All these cases FIO2 increases.
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| O2 Therapy Devices: Air-entrainment device- Air/O2 mixture Ratios | show 🗑
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| O2 Therapy Devices: Air-entrainment device- Calculate Total Flow- if O2%=28%, O2 flow meter setting=6 L/min. ? | show 🗑
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| O2 Therapy Devices: Pediatric O2 therapy device | show 🗑
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| O2 Therapy Devices:Neonatal O2 therapy- O2 Tent | show 🗑
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| show | It is placed over infant's head. Flow=7-14Lpm can deliver upto 100% O2, with an O2 blender. It comes w/ temp. probe. If hot infant become apneic. If cool causes increase in O2 consumption. It is loud inside hood causes hearing loss-use a blender than LVN
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| show | 1. Only for neonates. 2. small, whole-body environment 3. precise control over environment including FI02. 4. Red-flag warning sign when suing FIO2 100%.
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| show | 1)Skin Burns 2) Hearing damage-very loud noise 3)Electrical shock
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| show | 1)it is open to room air 2)Not a good environment for O2 delivery. 3. must be combined with an O2 delivery device. 4) allows RT to have access to the infant to provide care. 5. useful in controlling temp.& helpful in decreasing insensible water loss.
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| show | 1. It is like a regular cannula except with a small reservoir under the nasal prongs or as a medallion reservoir inline, chest level. 2)it allows O2 be set @ a lower flow rate.
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| O2 Conserving Devices: Transtracheal Oxygen Catheter (TTO2) | show 🗑
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| O2 Conserving Devices: Transtracheal Oxygen Catheter (TTO2)-Hazards | show 🗑
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| O2 Conserving Devices: Transtracheal Oxygen Catheter (TTO2)- What do we do if TT02 is Obstructed? | show 🗑
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| O2 Conserving Devices: Pulse-Dose O2 delivery | show 🗑
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| O2 Conserving Devices: Gas Containers & Bulk Delivery Systems: Cylinders-Procedure | show 🗑
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| show | 1)Hissing leak sound - Tighten all connection. 2)No apparent flow-check flow using a calibrated flow sensing device
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| O2 Conserving Devices: Gas Containers & Bulk Delivery Systems: Cylinders- Time Factors | show 🗑
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| show | Tank Duration(in mins.) = (Tank Pressure x Tank Factor) / Liter Flow
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| O2 Conserving Devices: Gas Containers & Bulk Delivery Systems: Cylinders- Bulk O2 system-1) Cylinder Manifolds | show 🗑
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| O2 Conserving Devices: Gas Containers & Bulk Delivery Systems: Cylinders- Bulk O2 system- 2)Bulk Liquid O2 | show 🗑
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| O2 Conserving Devices: Gas Containers & Bulk Delivery Systems: Cylinders -O2 concentrator(molecular sieve device | show 🗑
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| O2 Conserving Devices: Gas Containers & Bulk Delivery Systems: Cylinders -Troubleshooting of O2 concentrator(molecular sieve device | show 🗑
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| O2 Conserving Devices: O2 Enhancing system: CPAP | show 🗑
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| O2 Conserving Devices: O2 Enhancing system: Nasal CPAP | show 🗑
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| O2 Conserving Devices: O2 Enhancing system: PEEP | show 🗑
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| show | 1) Wate column 2) Exhalation Valve 3) Spring disk 4) Venturi
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| O2 Conserving Devices: O2 Enhancing system: Troubleshooting of PEEP & CPAP | show 🗑
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| O2 Conserving Devices: O2 Blending Devices | show 🗑
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| show | Gains humidity from a body of water thru evaporation as gas passes over its surface. It is not very effective. Not appropriate when using w/ mechanical vent. Or with incubated pts. Where the natural upper Airway is by passed.
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| Humidification & Aerosol Delivery : Bubble Humidifier | show 🗑
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| show | By occluding line on gasoutlet causing back pressure. If no pop-off alarm-system has a leak - tighten bottle/replace system if problem presists. If Pop-off alarm sounds w/out occlusion-check kink in the tube or for an obstruction such as H20 in the tube
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| Humidification & Aerosol Delivery :what happends in a Bubble Humidifier if the down tube become clogged? | show 🗑
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| Humidification & Aerosol Delivery : Heated Cascade Humidifier | show 🗑
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| Humidification & Aerosol Delivery : Wick Humidifier | show 🗑
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| Humidification & Aerosol Delivery : Heat moisture Exchanger (HME)- other name | show 🗑
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| show | Sponge Filter- traps heat & moisture that comes from the patient during expiration & delivers it back to the patient during inspiration.
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| show | placed between WYE and the patient on a mechanical ventilator circuit.
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| show | Yes. It will cause the PCO2 to rise (1-2 torr)
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| show | Yes it will increased Ventilator Pressure.
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| Humidification & Aerosol Delivery : Heat moisture Exchanger (HME)- should be Remove before an in-line Aerosol or MDI therapy? | show 🗑
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| Humidification & Aerosol Delivery : Heat moisture Exchanger (HME)-It is best used for ? | show 🗑
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| show | Never attempt to clean or rinse out an HME
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| show | It is best to switch to a cascade/wick type humidifier. If those are not available then replace w/ a new HME.
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| show | It is a handheld or small volume neb. Reservoir sizes are different. Each devices produces different dispositions of particle sizes. It uses high pressure gases to create particle sizes 2-10microns.
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| Humidification & Aerosol Delivery : Reservoir Jet Nebulizer | show 🗑
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| Humidification & Aerosol Delivery :Small particle aerosol generator(SPAG) | show 🗑
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| show | 1. Very effective nebulizer but not popular 2. Example nebulizer is the hydrosphere. 3. Able to meet the humidity deficit but can cause fluid overload.
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| Humidification & Aerosol Delivery : Ultrasonic Nebulizer | show 🗑
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| show | 1. Increasing blower 2. Ensuring adequate fluind in reservoir. 3. Incresing amplitude of vibration .
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| show | Cannot place a bronchodilator in the reservoir as the vibration can disrupt the molecular structure. FLUID OVERLOAD. Transient Dyspnea due to swelling of secretions(aerosol causes swelling of secretions).
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| show | 1. Least effective at producing uniform particle sizes. 2. Not recommended for use . 3. Associated with high frequency of contamination.
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| Humidification & Aerosol Delivery : Metered Dose Inhaler's (MDI) | show 🗑
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| show | It minimize particles that are large by allowing them to attach to wall of chamber. Requires less time coordination w/dose, pt. can squeeze&inhale. Pt. is to take several breaths to get all the particles.High inspiratory flow rate is not optimal for pt.
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| What is the vast majority Mechanical Ventilators used ? | show 🗑
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| show | 1) It will continue inspiration until a preset volume of gas is delivered. 2)It ignores the amount of pressure/time it takes to deliver the volume.
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| show | 1)Pressue limit. Excessive pressure is harmful to pt. it causes Barotrauma. 2)i.e, inpiratory phase continues until a preset vol. is given UNLESS a predetermined pressure limit is reached 1st. 3)such vents. are called Vol.-cycled,Pressure-limited devices.
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| show | 1) Puritan-Bennett 7200 2) PB 840 3)Bear 1000
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| Mechanical Ventilators: Define Pressure-Cycled Ventilators | show 🗑
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| Mechanical Ventilators: What is the reason when Pressure-Cycled Ventilators incorporate minimum volume alarms? | show 🗑
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| Mechanical Ventilators: How does Pressure-Cycled Ventilators powered? | show 🗑
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| show | an Increase in volume.
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| show | Theres is a diminishing return of volume .
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| Mechanical Ventilators: Pressure-Cycled Ventilators - 2 Examples | show 🗑
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| Mechanical Ventilators: What treatments are given with a Pressure-Cycled Ventilator? | show 🗑
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| Mechanical Ventilators: What limit does Pressure-Cycled Ventilators gives? | show 🗑
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| show | Increased flow will decrease inpiratory time(Reverse is also true).
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| show | a Monometer needle. If it does not show a smooth rise then Increase the Flow Rate.
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| Mechanical Ventilators: In Pressure-Cycled Ventilators Air-mix on? | show 🗑
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| show | Air mix knob is pushed in. FIO2=100% pure source gas. Since there is no air entrainment total achievable flow rate is less. When switching from air entrainment to 100% source gas must immediately increase the flow to compensate.
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| Mechanical Ventilators: In Pressure-Cycled Ventilators what is Rate Control(Expiratory time control)? | show 🗑
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| show | Vol. is indirectly increased by increasing pressure. If cant reach a pressure indicates a leak -check for leaks starting @pt. (mask, lip seal). Examine for connections&holes. An increase in back pressure (coughing)causes pressure limit&will reduce volume
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| Mechanical Ventilators: In Pressure-Cycled Ventilators what is Sensitive Control? | show 🗑
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| show | 1.Output Flow=15 Lpm. Neb. Has 2 controls- expriatory&inspiratory nebulization. Neb. Gas source-100% regardless of air dilution on/off 3.Terminal flow control compensates for leaks but reduce flow & works thru air entrainment.
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| Mechanical Ventilators: In Pressure-Cycled Ventilators-In Bennett PRII rate control & Pressure control allows what? | show 🗑
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| show | Air dilution ON-Allows FIO2 OFF 40-80%. Air dilution OFF-achieves 100% O2.
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| show | Bennett Valve is flow limited device & will close if < 1 Lpm is detected.
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| Mechanical Ventilators: In Pressure-Cycled Ventilators what is the characterestics of AP4 & AP5 ? | show 🗑
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| Mechanical Ventilators: Define Time-Cycled Ventilators | show 🗑
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| show | Infants
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| Mechanical Ventilators: In Time-Cycled Ventilator what does it incorporates to guard against exposure to excessive pressures & consequent Barotrauma ? | show 🗑
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| show | Rate maybe set indirectly by setting expiratory time.
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| Mechanical Ventilators: Define Bilevel Ventilators? | show 🗑
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| Mechanical Ventilators: In Bilevel Ventilators what settings does it requier? | show 🗑
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| Mechanical Ventilators: In Bilevel Ventilators what must be higher than expiratory pressures? | show 🗑
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| Mechanical Ventilators: In Bilevel Ventilators what is the actual ventilatory pressure and give eg.? | show 🗑
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| Mechanical Ventilators: Bilevel Ventilators can be used for what all reasons? | show 🗑
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| Mechanical Ventilators: In Bilevel Ventilators what is an Inspiratory pressure and expiratory pressure called? | show 🗑
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| show | Brand name - BIPAP and Therapy name - Bilevel therapy
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| show | It is not good for pt. requiring High levels of ventilatory pressure because most machines are only capable of 20-25 cmH2O
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| show | 1. These are electricall powered vent & maybe vol./pressured cycled. 2. If pt. requires vent. More thatn 50% then a back up ven is needed. 3. Family education on CPR & vent. Operations is required. 4. Common Home vents. Are - PLV100, L6 etc.
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| Mechanical Ventilators: Transport Ventilators | show 🗑
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| Mechanical Ventilators: Negative Pressure Ventilators | show 🗑
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| Mechanical Ventilators: what happens in Negative Pressure Ventilator work when it is applied to the chest wall? | show 🗑
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| Mechanical Ventilators: In what cycle does the Negative Pressure Ventilator ventilates and what is Rate and tidal volume controlled by? | show 🗑
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| Mechanical Ventilators: In a Negative Pressure Ventilators what problems occur to get a good seal? | show 🗑
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| show | 1) Check return Tidal Volume 2) if Tidal Volume is less than delivered look for a leak & examine connection points in the circuit. 3) also ensure alarms are working. Eg. High & Low volume or pressure.
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| Artificial Airways: Airway Types-ET tubes | show 🗑
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| show | Oral route insertion is dacilitated by the use of a Laryngoscope an stylet.
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| Artificial Airways: Airway Types-Nasal ET tubes route? | show 🗑
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| show | 1. Oral intubation - 20-24 cm @ the lips(low 20's) 2. Nasal intubation - 25-29 cm @ the naris (High 20's)
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| Artificial Airways: Airway Types-what about ET tubes cuffs? | show 🗑
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| show | Long term method of reducing airway resistance.
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| Artificial Airways: Airway Types-different configurations of a Tracheostomy tubes | show 🗑
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| Artificial Airways: Airway Types- what is a Fenestrated Tracheostomy tubes? | show 🗑
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| Artificial Airways: Airway Types- what is Jackson Tracheostomy tubes? | show 🗑
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| Artificial Airways: Airway Types- what is a bivona foam Tracheostomy tube cuff? | show 🗑
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| Artificial Airways: Airway Types-what is the complications with a Tracheostomy tubes? | show 🗑
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| Artificial Airways: Airway Types- Double-lumen ET tube | show 🗑
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| Artificial Airways: Airway Types- what is Double-lumen ET tube good for and with? | show 🗑
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| Artificial Airways: Airway Types-Laryngeal Mask Airway | show 🗑
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| Artificial Airways: Airway Types- Combitube | show 🗑
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| Artificial Airways: Airway Types-Oral airway | show 🗑
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| show | 1. Also called Nasal trumphet. 2.Sizes - a. Outer diameter of the airway should match inside diameter of outer naris. B.lenth should be equal todistance b/w the earlobe & the nasal septum. When too long pt. coughs - change to short tube after insertion
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| Artificial Airways: Airway Types- Define cuffs? | show 🗑
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| Artificial Airways: Airway Types- 2 Types of cuffs? | show 🗑
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| show | 1.Cuff Normal is 20 mmHg. Higher than 20 mmHg could impede blood-flow&promote tissue death. It can be monitored using a pressure manometer. If NO pressure-check connections then add air&observe a pressure rise. If NO pressure rise - then replace the tube
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| show | MOV - adding & removing air from the cuff while ausculting over the neck. Enough air is added to stop the sound of air passing around the cuff.
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| show | MLT - It is performed like the MOV. Enough air is subtracted from the cuff to allow a very small leak at the top of inspiration.
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| show | It attaches to varies blade sizes, usually contains batteries to power a light on the blade.
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| show | 1. Miller blade(straight blade)- a. Fits under epiglottis. B. only used for infants. 2. Macintosh blade (curved blade)- fits into the vallecula.
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| Artificial Airways: Airway Types- Insertion equpiment- what are the Larngoscope lights? | show 🗑
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| Artificial Airways: Airway Types- Insertion equpiment- what are the Blade sizes of a larngoscope? | show 🗑
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| show | 1. ONLY fot Oral intubation. 2. Insert it into the ET tube to help shape it and ease insertion.
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| Artificial Airways: Airway Types- Insertion equpiment- What are other intubation assisting tools?- Magill forceps | show 🗑
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| Artificial Airways: Airway Types- What are the ET tubes sizes? | show 🗑
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| show | Used to make direct measurement of PCO2, PO2 an pH.
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| Pulmonary Assessment Equipments: Electrode Types of Blood gas analyzers | show 🗑
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| show | 1. Low pH solution- 6.84 High pH solution - 7.38 2. PCO2 calibration - 5% CO2 gas. 3. Low PO2 calibration - 0% O2. High PO2 calibration - 12%/20% O2.
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| show | 8 hrs.
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| Pulmonary Assessment Equipments: Blood gas quality control - 3 solutions introduced for a QC material? | show 🗑
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| Pulmonary Assessment Equipments: Types of graphical information on a QC device? | show 🗑
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| Pulmonary Assessment Equipments: what is a CO-Oximeter? | show 🗑
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| Pulmonary Assessment Equipments: What is a Pulse-Oximeter? | show 🗑
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| show | 1. High ambient light. 2. Finger nail polish. 3. Very low BP&perfusion (shock) 5.Erythema. -If suden fall is indicated SaO2 is noted-then suspect a problem w/ the probe 1 st - DO NOT increase the flow/ other intervention decision based on that data alone
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| Pulmonary Assessment Equipments: What is a Capnography (PECO2/PetCO2)? | show 🗑
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| Pulmonary Assessment Equipments: What is Inflection points in a Capnography (PECO2/PetCO2)? | show 🗑
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| Pulmonary Assessment Equipments: What is Pulmonary Function Testing (PFT)? | show 🗑
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| Pulmonary Assessment Equipments: What is an O2 analyzer? | show 🗑
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| Pulmonary Assessment Equipments: What are the types of electrodes? | show 🗑
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| Pulmonary Assessment Equipments: what is a polargraphic? | show 🗑
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| show | Its a cell batery & is good & common.If not working-it could be fuel cell is consumed so change cell.DON'T change solution/battery bcoz CELL is the battery.It is affected by high pressures changes in altitude, H20 on the electrode. PAP causes high reading
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| Pulmonary Resuscitation Equipments: Desired characterstics? | show 🗑
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| Pulmonary Resuscitation Equipments: Troubleshooting | show 🗑
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| show | 1. serves as a barrier b/w pt. and provider. 2. Cross contamination from pt.s expelled air is prevented through a one-way valve. 3. Superior to mouth-to-mouth ventilation.
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| show | 1. Deliever 100% FIO2. 2. Triggers by manual button & negative inspiratory pressure produced by the pt. 3. Not sensitive to changes in lung compliance-risks a pneumothorax. 4. Too powerful for infants. 5. Associated w/ gastric insufflation.
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| Suctioning Equipment: Suctioning Catheter- Closed system suction catheter | show 🗑
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| show | 1. Must maintain sterile technique when using. 2. one-time use only. (no cleaning)
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| show | 1. Tip of catheter is bent slightly to facilitate entrance and suction of the left mainstem bronchous. 2. Can be twisted to direct into either bronchus. 3. requires sterile technique.
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| Suctioning Equipment: Catheter Size- Length | show 🗑
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| Suctioning Equipment: Catheter Size- Diameter | show 🗑
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| show | 1. 1mm/ID of ET/Trach tube = 3 French. Ex. If Id = 6.0 mm, catheter shouldnt exceed 3.0mm i.e. 3.0mm*3 = 9 French catheter. 2.If catheter comes in 8-10 french & catheter needs to be 9 (choose smaller of 2 (8 fr.) 3. 10 & 12 Fr. Most common for adults.
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| show | 1. Adults: 100-120 mmHg. 2. Pediatrics: 80-100 mmHg 3. Infant: 60-80 mmHg.
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| show | 1. check connections 2. check collection bottle - change if full.
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| Suctioning Equipment: Other suction Devices | show 🗑
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| show | Kills pathogenic organisms.
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| Equipment Cleaning: Disinfection- Steam autoclave | show 🗑
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| show | 1. Done with pre-washing and hot-water soak. 2. Best to use with equipment used on patients with infectious disease such as hepatitis.
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| show | 1. ethyl and isopropyl are effective. 2. 70-90% concentrations.
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| show | Kill all living organisims
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| Equipment Cleaning: Sterilization- Irradiation | show 🗑
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| Equipment Cleaning: Sterilization- Incineration | show 🗑
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| Equipment Cleaning: Sterilization- Ethylene Oxide (ETO) | show 🗑
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| show | 1. Liquid. 2. Not good for electrical components. 3. Will kill all bacteri in 10 mins. 4. Will kill everything in 10 hrs. 5. Tuberculocidal in 20 mins. 6. Works by using a caustic (alkaline) pH (7.5-8.5)
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| Equipment Cleaning: Sterilization- Sonacide (Acid Gluteraldehyde) | show 🗑
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| show | 1.Bronchoscope - Cidex ( Alkaline gluteraldehyde) 2. IPPB machine - ETO
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| Biological control: | show 🗑
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| Infeection Control: a therapist have to use what precautions? | show 🗑
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| show | In a plastic bio-hazard waste bag.
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