Presentation is loading. Please wait.

Presentation is loading. Please wait.

O2 Therapy, Lung Expansion Therapy & Airway Clearance

Similar presentations


Presentation on theme: "O2 Therapy, Lung Expansion Therapy & Airway Clearance"— Presentation transcript:

1 O2 Therapy, Lung Expansion Therapy & Airway Clearance
By Michael S. Allen, RRT Updated April 8, 2015

2 O2 Therapy, LET & BHT Key Note: Do least invasive therapy first
Do least costly therapy first If patient condition severe, then do severe therapy

3 Oxygen (O2) Therapy Why: SpO2 lower than 90% SaO2 lower than 92%
PaO2 lower than 80 mmHg Patient c/o SOB, dyspnea, or chest pain Patient Type: Anyone who meets above criteria regardless of age or diagnosis Exception: COPD, Emphysema, or Chronic CO2 retainer Premature neonate Devices Used: Nasal cannula Simple mask Air entrainment mask (aka: venti-mask) High Flow Nasal Cannula Non-Rebreather (NRB) Heated Humidified High Flow Nasal Cannula CPAP

4 No Smoking, Oxygen in Use

5 Oxygen therapy O2 devices
Device: Limitations: FIO2: Nasal Cannula Adult = 0.25 Lpm – 6 Lpm RA = 20% Infant = 1/32, 1/16, 1/8 1L = 24% 2L = 28% 3L = 32% 4L = 36% 5L = 40% 6L = ~44%? FIO2 is what we deliver SpO2 is what we measure

6 Oxygen therapy O2 devices
Device: Limitations: FIO2: Simple Mask 6 Lpm – 10 Lpm 35% – 50 %

7 Oxygen therapy O2 devices
Device: Limitations: FIO2: “Venti” air-entrainment mask 3 Lpm 24 – 32% 6 Lpm 36 – 44% 8 Lpm 50 – ~70%

8 Oxygen therapy O2 devices
Device: Limitations: FIO2: High Flow Nasal Cannula 3 Lpm – 12 Lpm questionable FIO2% (non heated) LPM flow titrated to SpO2

9 Oxygen therapy O2 devices
Device: Limitations: FIO2: Non-rebreather (NRB) 8 Lpm – 15 Lpm 60% – 95% “flush” (~16–40 Lpm) 95% – ~100%

10 Oxygen therapy O2 devices
Device: Limitations: FIO2: Oxymask FIO2 dictated by flow 1 LPM 24% - 25%   * Able to sxn patient, or 2 LPM 27% - 32% provide drink w/o removing mask. 4 LPM 34% - 40% 6 LPM 42% - 48% 8 LPM 49% - 55% 10 LPM 53% - 58% 12-15 LPM 59% - 65% It is suggested that this Oxymask can replace the NC, Simple mask, and NRB. However, assess for patient comfort and need. Refer to …

11 Oxygen therapy O2 devices
Device: Limitations: FIO2: Heated-Humidified 10 Lpm – 70 Lpm Blender needed for FIO2% High Flow Nasal Cannula excess rainout

12 Oxygen therapy O2 devices
Device: Limitations: FIO2: CPAP used in ICU 21% – 100% Note, a patient’s CPAP is used for OSA, but a CPAP/BiPAP such as seen above is for Oxygen therapy.

13 Caution, Lung Expansion in Progress

14 Lung Expansion Therapy aka: Hyperinflation Therapy
Why: Treat/Prevent Atelectasis Low lung volumes (as seen from a chest x-ray) Patient Type: Asthma, COPD, CHF, Pneumonia Decreasing SpO2 and/or increased need for O2 Atelectasis (BS = late inspiratory crackles; or as seen on chest x-ray) Fever Neuromuscular disorders Patients on bed-rest or bedridden Post Surgery (especially upper abdominal or thoracic) Devices Used: Deep breathing and cough (DB&C) Pursed Lip breathing Body Calisthenics Incentive Spirometer TheraPEP EzPAP IPPB CPAP/BiPAP

15 Devices for LET Deep-breath and Cough “DB&C”

16 Devices for LET Pursed Lip breathing

17 Devices for LET Patient position and Body Calisthenics

18 Devices for LET Incentive Spirometry

19 Devices for LET TheraPEP

20 Devices for LET EzPAP Refer to …

21 Devices for LET IPPB Bird Mark 7 IPPB circuit Bennett PR-2

22 Devices for LET CPAP/BiPAP

23 BHT … I Need Help

24 Bronchial Hygiene Therapy AKA: Pulmonary Toilet or Airway Clearance Techniques
Why: Increased mucus in airways Weak or non-productive (congested) cough Patient Type: Asthma, COPD, CHF, Pneumonia Bronchiectasis, Bronchiolectasis, Bronchiolitis, Bronchitis Ciliary dyskinetic syndrom Cystic Fibrosis Neuromuscular disorders Immobile, bed-rest or bedridden patients RSV Devices Used: Huff Cough TheraPEP Flutter or Acapella Chest Physiotherapy (CPT): Percussion (hands or percussion device) Percussor (pneumatic or electric) HFCWO (“the Vest”) Postural drainage Cough Assist (aka: insufflator-exsufflator) NT suction IPV (Intrapulmonary Percussive Ventilation)

25 Devices for BHT Huff Cough

26 Devices for BHT TheraPEP

27 Devices for BHT Flutter Acapella Aerobika oscillating PEP (OPEP)
Refer to … Aerobika oscillating PEP (OPEP) Refer to …

28 Devices for BHT Chest Physio-Therapy (CPT)
Hand percussion and hand-held device

29 Devices for BHT Chest Physio-Therapy (CPT)
Pneumatic Percussor Electric Percussor

30 Devices for BHT Chest Physio-Therapy (CPT)
High Frequency Chest Wall Oscilation (HFCWO)

31 Devices for BHT Postural Drainage

32 Devices for BHT Cough Assist Device

33 Devices for BHT Nasal-Tracheal Suction (NT sxn)

34 Devices for BHT IPV (Intrapulmonary Percussive Ventilation)

35 Medicine Delivery for BHT
Percussive Nebulizer VORTRAN PercussiveNEB® • New improved modulator operates more consistently • Intrapulmonary percussive aerosol nebulizer • Mucus clearance (i.e. cystic fibrosis, COPD and post-op atelectasis) • High aerosol output • Automatic PEP • Single patient, multiple use • Pressure dial adjustable between SOFT to HARD setting • Home or hospital use • High flow compressor available for home use


Download ppt "O2 Therapy, Lung Expansion Therapy & Airway Clearance"

Similar presentations


Ads by Google