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Bubble humidifier
- Gas goes through the backchannel and then bubbles back up pushing water down and out to pt
- Nasal Cannula or Face Mask ONLY
- Flow rates of equal or greater than 10 L/min (can produce aerosol at flow rates ≥ 10 L/min)
- Recommended for flow rates 2-6 L/min
- Aka diffuser
- -diffuser allows more output
-
Wick humidifier
- Hudson Heater
- This device has a Concha-Column produces humidification using the evaporation process to ensure minimal resistance to gas flow.
- The wired-corrugated tube helps to maintain a constant temperature along the tube. This helps to reduce the “rain” forming when there is a crash of hot and cold temperatures (cold due to the surroundings; room temperature).
- This heater has a hose for water recycling that connect at the top of the reservoir system (prolonging the duration of the sterile water reservoir)
-
Room humidifier (Spinning disk)
The ones you buy at CVS or Walmart. Are used to humidify air in a room. Point machine directly over patient to humidify the air the patient breathes
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HME’s (Heat and Moisture Exchanger)
- “Artificial nose”
- Change every time check on pt is able, if not NO MORE THAN 3 days
- Filtration can be added (HMEF)
- Has mechanical deadspace
- Short term use
- Exhaled heat and moisture are captured by condenser during exhalation; cool and dry inspired gas is warmed and heated as it flows through condenser
- Standard output of >30mg/L
- Contraindications include:
- Thick, copious, bloody sputum
Expired tidal vol of less than 70%
Body temp less than 89.6F (32 CO)
High Minute Ventilation (≥10 L/min)
Pt receiving in line aerosol drugs
Pt on noninvasive ventilation
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Misty-Ox HiFi
- High Flow Device
- Can be connected to either connection on thorpe tube
- Has a capillary tube that allows the gas to push the water upward
- Can be run at a flow as high as 40 LPM
-
Heated wire circuits
Keep temp the same through whole system
-
Heated
are ACTIVE humidifiers
Provides 100% relative humidity
Bland aerosol therapy
Delivery of sterile water, hypotonic, isotonic, or hypertonic saline aerosols
LVN or VMN
-
non heated
are PASSIVE humidifiers
-
2.Know difference between LOW flow and HIGH flow humidifiers
(standard vs. Misty-Ox LDH, will see in lab)
-
Be able to label parts of various humidifiers
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4. Understand the principle of Humidity Deficit
Humidity deficit helps us understand and allows to know what is the amount of water vapour the body must add to the inspired gas to achieve saturation at body temperature (37 Co)
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CYLINDER DURATIONS
- Know how to calculate either E or H durations (Calculator WILL be on table to assist)
- E-.28
H-3.14
Duration of Flow= (Psig x Cylinder size) / flow
Psig- if not given use 2200
Gas duration is measured in min
Amount of gas in cylinder= Liquid O2 (lb) x 860/2.5lb/L
Duration of gas= Amount of gas in cylinder/Flow
-
AEM
Know your AIR:OXYGEN RATIOS
How to calculate TOTAL FLOWS
Understand the principle of operation
-
Know your AIR:OXYGEN RATIOS
“Magic Box” or memorize equations or formula
.24 -- 25:1
.28 -- 10:1
.31 -- 7:1
.35 -- 5:1
.40 -- 3:1
.50 -- 1.7:1
.60 -- 1:1
.70 -- .6:1
-
How to calculate TOTAL FLOWS
Total flow= L/min x Air Ratio #
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OXYGEN MODALITIES: Reference AARC CPG’s
Know ALL of the variable and fixed devices by identification (Sight)
Know ALL of the fi02 ranges of ALL modalities, High and low flow
Know ALL of the flow ranges of ALL modalities, High and low flow
Know proper indications for ALL modalities, High and low flow
-
Know ALL of the variable and fixed devices by identification (Sight)
Variable: NC, TC, SM, OM, PRBM, NRBM,
Fixed: HFNC, AEM, AEN, Aerosol Mask, T Tube, Face Tent, Trach Collar
-
Know ALL of the fi02 ranges of ALL modalities, High and low flow
Low flow devices:
NC .24-.44
TC .22-.35
SM .35-.50
OM .24-.90
PRBM .40-.70
NRBM .60-.80
High Flow devices:
HFNC .21-1
AEM .21-1
AEN .06-.08
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Know ALL of the flow ranges of ALL modalities, High and low flow
Low Flow Devices
NC 1-6 lpm
TC .25-4 lpm
SM 5-10 lpm
OM 1-flush lpm
PRBM 6-10 lpm
NRBM 10lpm
High Flow Devices
HFNC 40-60 lpm
AEM 4, 12-15 lpm
AEN 28-100 lpm
-
Know proper indications for ALL modalities, High and low flow
Face Tent- Facial burns or post op
T Tube- trach patients
-
FLOW METERS
- Know the functions and indications for the usage of both Thorpe tube and
- Bourdon gauge
- -
- Which is Pressure Compensated, Which is gravity dependent?
Types – Standard Flow, High Flow, Low Flow.
Purpose of the 50-psi port (sometimes referred to as the Power Port)
-
Know the functions and indications for the usage of both Thorpe tube and
Bourdon gauge
Thorpe Tube:
- Two flow sizes offered, smaller (>15/16 is for peds)
- Can be uncompensated or compensated
Bourdon Gauge:
- The gauge displays a predictable outlet flow
- Measures pressure
-
Which is Pressure Compensated, Which is gravity dependent?
Pressure Compensated is the Bourdon Gauge
Gravity Dependent is the Thorpe Tube
*Bourdon Gauge experiences backflow and can give a faulty reading
*Thorpe tube CAN be used for transport except that you will have to pick it up right to read the
volume
-
Types – Standard Flow, High Flow, Low Flow.
-
Purpose of the 50-psi port (sometimes referred to as the Power Port)
-
STATION OUTLETS
- Types and connections
- O DISS vs. QC
O Gas content coming from each outlet (Oxygen vs. Air)
-
-
O Gas content coming from each outlet (Oxygen vs. Air
Air-Yellow
O2- Green
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