Lindsey Jones 2 - Equipments
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| show | 1.Delivered FIO2: 24%-45% 2.Flow: 1-6 L/M
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| show | 1.Delivered FIO2: 40%-50% 2.Flow: 6-10 L/M
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| O2 Therapy Devices:Adult & Pediatric-Low flow -Partial Rebreather Mask | show 🗑
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| O2 Therapy Devices:Adult & Pediatric-High flow-Venturi Mask/Air-entrainment device | show 🗑
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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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| O2 Therapy Devices:Adult & Pediatric-High flow- In a non-breather Mask (NRB)-Why isa face seal important? | show 🗑
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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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| O2 Therapy Devices: define Air-entrainment device | show 🗑
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| O2 Therapy Devices: Equipments of Air-entrainment device- | show 🗑
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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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| show | 24%- 25:1 28%-10:1 30%-8:1 35%-5:1 40%-3:1 & 60%-1:1
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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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| O2 Therapy Devices:Neonatal O2 therapy- Incubator | show 🗑
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| O2 Therapy Devices:Neonatal O2 therapy- hazards of Incubator | show 🗑
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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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| O2 Conserving Devices:Reservoir Cannula | show 🗑
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| show | 1. It is surgically implanted thin catheter inserted thru the tracheal wall(b/w the 2nd & 3rd tracheal rings). Trachea acts a reservoir so flow may be reduce by as much as. 1/2.
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| O2 Conserving Devices: Transtracheal Oxygen Catheter (TTO2)-Hazards | show 🗑
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| show | Catheter may be obstructed need to flush with saline- 1st provide O2 by nasal cannula. Then troubleshoot & find a remedy.
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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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| show | it requires 2 separate banks of tanks for Primary & Reserve.(several H tanks are mounted to single manifold.)
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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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| show | Check Flow & Check Circuit breaker or fuse.
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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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| show | Works like a CPAP except used in conjunction w/ backup ventilatory rate ( mechanical ventilator)
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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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| Humidification & Aerosol Delivery : Passover Humidifier | show 🗑
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| show | The gas bubbles produce more surface area to pick up humidity. It is better than passover humidifier. Efficency depends upon water level. It involves an inlet tube w/ pop off alarm. If inlet tube is clogged pop off alarm wont funtion.
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| Humidification & Aerosol Delivery : How does Bubble Humidifier function can be checked? | show 🗑
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| show | Pop-off will not alarm, but flow meter will read zero (compensated flow zero).
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| Humidification & Aerosol Delivery : Heated Cascade Humidifier | show 🗑
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| show | It is efficient by expanding surface are for evaporation and humidification. It can accomplish 100% body's humidification needs. It does not produce particles so no nosocomial infections. Some of the most common wick devices are-Concha and Fisher-paykel.
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| Humidification & Aerosol Delivery : Heat moisture Exchanger (HME)- other name | show 🗑
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| Humidification & Aerosol Delivery : Heat moisture Exchanger (HME)- looks like what? | show 🗑
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| Humidification & Aerosol Delivery : Heat moisture Exchanger (HME)- Where is it placed? | show 🗑
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| Humidification & Aerosol Delivery : Heat moisture Exchanger (HME) - Is it considered as a deadspace? | show 🗑
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| Humidification & Aerosol Delivery : Heat moisture Exchanger (HME)- Does it cause increased ventilator pressure? | show 🗑
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| show | Yes we must remove before a MDI therapy
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| show | short term humidification eg. during transport.
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| Humidification & Aerosol Delivery : Heat moisture Exchanger (HME)- How do you dispose? | show 🗑
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| Humidification & Aerosol Delivery : Heat moisture Exchanger (HME)- What do we do if HME is clogged on a patient? | show 🗑
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| Humidification & Aerosol Delivery : Jet Nebulizer | show 🗑
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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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| Humidification & Aerosol Delivery :Hydrodynamic Nebulizer | show 🗑
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| Humidification & Aerosol Delivery : Ultrasonic Nebulizer | show 🗑
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| Humidification & Aerosol Delivery : How does Mist increase in Ultrasonic Nebulizer? | show 🗑
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| Humidification & Aerosol Delivery : Hazards of Ultrasonic Nebulizer(Vibrating Device- Piezoelectric disc)? | show 🗑
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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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| show | 1. It is portable. In mechanical ventilation -placed on inspiratory side of the circuit & b/w Y & pt. Gives uniform dosage&particle size requires pt. cooperation.Aerosol produced by pressurizing a gas or liquid in a closed canister. Spacer is recommended
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| Humidification & Aerosol Delivery : Why is spacer recommended for Metered Dose Inhaler's (MDI) | show 🗑
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| What is the vast majority Mechanical Ventilators used ? | show 🗑
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| Mechanical Ventilators: Define Volume-Cycled Ventilators | show 🗑
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| Mechanical Ventilators: What limit does Volume-Cycled Ventilators incorporate? | show 🗑
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| show | 1) Puritan-Bennett 7200 2) PB 840 3)Bear 1000
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| show | It will continue inspiration until a preset pressure is reached. 2) These machines will delivered the same pressure on every breathe regardless of the volume.
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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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| Mechanical Ventilators: In Pressure-Cycled Ventilators increased in pressure will result in what? | show 🗑
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| show | Theres is a diminishing return of volume .
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| show | Bird Mark and Bennett PRII are examples.
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| Mechanical Ventilators: What treatments are given with a Pressure-Cycled Ventilator? | show 🗑
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| show | Pressure-Cycled Ventilators are often pressure limited.
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| Mechanical Ventilators: In Pressure-Cycled Ventilators what happens when flow increases? | show 🗑
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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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| show | Air mix knob is pulled out. Gas is mixed in a venturi device. FIO2 varies from 40-80%. The chamber surrounding the venturi device will retain excess O2 from 1st breath & will then entrain that O2 on the next breath which causes increase in FIO2.
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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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| Mechanical Ventilators: In Pressure-Cycled Ventilators what is the characterestics of Bennett PRII? | show 🗑
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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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| Mechanical Ventilators: In Pressure-Cycled Ventilators- In Bennett PRII what happens to the Bennett valve? | show 🗑
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| Mechanical Ventilators: In Pressure-Cycled Ventilators what is the characterestics of AP4 & AP5 ? | show 🗑
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| show | Inspiration continues for a specified number of seconds. And usually incorporates a specified pressure regardless of volume delivered. Thus a time-cycled vent. Will require a set inspiratory time & pressure.
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| Mechanical Ventilators: Time-Cycled Ventilators are often used for? | show 🗑
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| show | It incorporates a Pressure Pop-off valve
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| show | Rate maybe set indirectly by setting expiratory time.
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| show | 1. Bilevel means that positive pressure is applied during both inspiratory and expiratory phases. 2. Breaths are flow triggered and also WOB is decreased.
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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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| show | The actual ventilatory pressure = (Inspiratory pressure - Expiratory pressure) Eg. Inspiratory Pressure = 15 cmH2O and Expiratory pressure = 8 cm H2O therefore 15-8 = 7 cmH2O.
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| Mechanical Ventilators: Bilevel Ventilators can be used for what all reasons? | show 🗑
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| show | Inspiratory pressure - IPAP and expiratory pressure - EPAP
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| show | Brand name - BIPAP and Therapy name - Bilevel therapy
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| Mechanical Ventilators: Bilevel Ventilators is not a good device for what patients? | show 🗑
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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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| show | Negative pressure ventilation is Time-cycled. Rate is controlled by - time of inspiration. Tidal volume is controlled by - amout of pressure applied.
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| show | Leak b/w the chest and the device.
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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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| show | It can be inserted throught the oral/nasal route.
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| Artificial Airways: Airway Types- Oral ET tubes route? | show 🗑
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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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| show | A hole in the outercannula.Helps in talking&weaning.Inserts innercannula for resuscitation.It caps tube closed&1st deflate cuff-remove innercannula&cap the tube.deflate while talking, remove innecannula& capping.Best for pts. partially dependent on a vent
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| show | 1. Used for home care and Long term pt. 2. No cuff (cannot mech. Ventilate) 3. Tube is made of silver.
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| show | 1. Also called Kamen-wilkinson. 2. The cuff is oassively full means leave pilot open to amnient air to keep cuff expanded. 3. To deflate/inflate or insertion/ removal of a cuff use a syringe.
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| Artificial Airways: Airway Types-what is the complications with a Tracheostomy tubes? | show 🗑
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| show | 1. Tube has 2 cuffs w/the opening of one lumen @ the end of the tube and another opening b/w the 2 cuffs. 2. One lumen(distal) will ventilate the lung side in which it is inserted. The other lumen (proximal) will ventilate the other lung side.
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| show | Good for Independent lung ventilation with 1. Bronchopleural fistulas. 2. During surger to areas of the lung (lobectomy, esophageal resection.)
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| show | 1. short ET w/an inflatable mask(cuff)@the end.Cuff part is inserted in the deflated mode in the hypopharnx above the trachea&then inflated. It facilitates good breathing.Not to use w/PPV causes gastric innsufflation.Pt. cooperation needed for LMA removal
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| Artificial Airways: Airway Types- Combitube | show 🗑
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| show | 1. Usually plastic do not enter the trachea keeps airway open even if pt. is biting. 2. Proper size is distance b/w angle of jaw &tip of chin. 3. Inserted 180 Degrees from it final position then twisted into place. 4. Should not secure w/ a tape.
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| Artificial Airways: Airway Types- Nasal airway | show 🗑
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| show | Airways may or may not come w/inflatable cuffs. This varies according the tube's size, application and function.
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| show | 1.Large volume,Low pressure-minimizes pressure on the wall of trachea&avoids impedance of capillary blood flow& reduces the incidence of tracheal tissue damage.2. Low volume,High pressure-used on tubes that incorporate 2cuffs. (combitubes & lumenn tubes)
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| Artificial Airways: Airway Types- What is a cuff pressure? | show 🗑
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| Artificial Airways: Airway Types- What is Minimum Occluding Technique ? | show 🗑
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| Artificial Airways: Airway Types- What is Minimum leak Technique ? | show 🗑
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| Artificial Airways: Airway Types- Insertion equipment - Larngoscope? | show 🗑
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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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| Artificial Airways: Airway Types- Insertion equpiment- What are other intubation assisting tools?- Stylet? | show 🗑
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| Artificial Airways: Airway Types- Insertion equpiment- What are other intubation assisting tools?- Magill forceps | show 🗑
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| show | 1. Adult- use the 1st number of the pts. Wght. In kg. eg. Pt weighs 72 kg then use - 7 ET tube. If 84 kg then use 8 ET tube. 2.Pre-term infant- size 2 3.Full term infant - size 3.
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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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| show | 1. It determines the amount of CO in the blood. 2. Acceptable range - 1-3% (smokers b/w - 5-15%) 3. Above 20% - CO poisoning requires treatment. 100% O2, Hyperbaric therapy etc. 4. Since analyzed in the machine, data is a spot check value.
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| show | 1. It is a non-invasive way to measure O2 saturation. 2. It determines saturation by examining light wave lengths transmitted through the finger/ ear lobe etc.
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| Pulmonary Assessment Equipments: When is a Pulse-Oximeter show low accuracy or poor function? | show 🗑
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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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| show | 1. Used to measure FIO2. 2. requires calibration. 3. Should be used any time a change in FIO2 is made.
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| Pulmonary Assessment Equipments: What are the types of electrodes? | show 🗑
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| show | 1. It requires battery and a n electrolyte solution. 2. If analyzer don’t read 100% - then change battery. 3. If analyzer don’t read and battries are good - then change electrolyte solution. ex: clark electrode.
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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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| show | If bag collapses easily when squeezed & no chest rise replace bag & If bag is difficult to squeeze, ensure pt. valve isnt stuck, check if the problem is low pulmonary compliance. If bag is suspected faulty replace bag dont fix the problem unless no option
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| Pulmonary Resuscitation Equipments: Mouth-to-valve mask | show 🗑
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| Pulmonary Resuscitation Equipments: Demand valve (Pneumatically powered) | show 🗑
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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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| show | 1. should not exceed 1/2 of the internal diameter of the ET/Trach tube.
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| Suctioning Equipment: Catheter Size- Diameter in French Units | show 🗑
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| show | 1. Adults: 100-120 mmHg. 2. Pediatrics: 80-100 mmHg 3. Infant: 60-80 mmHg.
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| Suctioning Equipment: If suction not adequate what do we do? | show 🗑
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| show | 1. In-line specimen trap (luken's trap) 2. Tonsil suction devices- a. Know as a yankauer(brand) b. also know as oral suction device. C. Useful in suctioning mouth and throat.
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| Equipment Cleaning- Define Disinfection? | show 🗑
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| show | 1. No plastics. 2. Involves placement in packages prior to prodcedure.
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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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| Equipment Cleaning:Define Sterilization? | show 🗑
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| show | 1. Uses radioactive gamma rays. 2. DO NOT follow irradiation with ethylene oxide (ETO).
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| show | 1. Destroys equipment. 2. Useful for disposable items.
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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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| show | 1. Kills bacteria in 10 minutes. 2. Kills everything in 1 hr. 3. Uses acidic pH (2.5-3.5)
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| show | 1.Bronchoscope - Cidex ( Alkaline gluteraldehyde) 2. IPPB machine - ETO
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| show | 1.disposable method of determining pathogens survived a sterilization/disinfection procedure such as pasteurization. 2. If viable (able to live) spores are found, then equipments requires re-sterilized.
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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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