Respiratory Support

  1. Ideal Breathing Pattern
    • Slow, deep inspiration 
    • Inspiratory Pause/hold
    • Exhalation slow, passive and relaxed 
  2. What is a sustained maximal inspiration (SMI, Incentive Spirometry)
    • Prevent atelectasis 
    • Prevent areas of lung from collasping 
    • Surgical pts taught prior to surgery
  3. Troubleshooting IS
    Patients must be reminded to inhale and not exhale into device.
  4. Indication IPPB therapy 
    • Prevent/correct atelectasis unable to take deep breath.
    • Prevent or decrease pulmonary edema 
    • Decrease WOB
    • Mechanical bronchodilation 
    • Distribute aerosols evenly for better deposition of meds
    • Removal airway secretions/mobilize secretions
    • Manipulation insp exp pattern 
    • Improve alveolar collateral vent 
    • Improve & promote cough mechanism 
  5. Contraindications IPPB Therapy
    • Pul hemorrhage
    • Untreated pneumothorax 
  6. Hazards IPPB
    • Dizziness
    • Tingling fingers, instruct pt breathe slower
    • Pneumothorax
  7. Flow Rate Control IPPB
    Turning knob higher # causes greater flow into mainstream breathing circuit and nebulizer (decrease I-time)
  8. IPPB Pressure
    • Volume changed adjusting pressure limit 
    • Leaks in circuit prevent normal cycling to exhalation. 
    • Obstruction/coughing ends inspiration 
  9. IPPB Sensitivity
    • Negative 1.0-2.0 cm H2O
    • Decrease sensitivity-self cycling occurs if respirator is set too sensitive
  10. IPPB has Loss pressure
    • Leak 
    • Insufficient flow
  11. IPPB has Excessive Pressure
    • Obstruction
    • Excessive Flow
  12. IPPB fails to cycle into inspiration
    • Adjust sensitivity
    • Tight seal around mouthpiece
  13. IPPB fails to cycle off 
    • Leak 
    • Mouthpiece/mask seal
    • Cuff leaking
    • Fenestrated trach tube open
    • loose equipment connection 
    • Pressure does not rise normally 
    • insufficient flow 
  14. Mask CPAP
    Short term, temp use for improving oxygenation in patients with CO2 poisoning, PNA, post-op atelectasis 
  15. Nasal CPAP
    • Neonates who are nose breathers 
    • Can lose CPAP if baby is crying give pacifier 
  16. CPAP Loss Pressure
    • Leak 
    • Insufficient Flow 
  17. CPAP Increased Pressure
    • Obstruction
    • Excessive flow continuous venting of pop off valve will occur
  18. NPPV Indications
    • Avoid intubations w/ COPD,CHF,pul edema 
    • Long term vent @ home
    • Provide support to pts w:
    •  Neuromuscular disease
    •  Restrictive chest wall disease
    •  OSA/Central Sleep Apnea
  19. What is EPAP?
    Same as CPAP, improves oxygenation or prevent airway closure in OSA. 
  20. What is IPAP?
    • Set higher pressure than EPAP, postive pressure during insp. phase
    • Stimulate pressure support vent w/CPAP
    • Maintain patent airway in OSA
  21. Settings on NPPV
    • EPAP 5-10 OSA uncomplicated 
    • EPAP 6-8 tx hypoxemia 
    • IPAP greater than EPAP 
    • I:E Ration 1:2
Card Set
Respiratory Support
Respiratory Therapy