Bronchial Hygiene Equipment

Question 1

Flutter Valve gravity?

Answer 1

gravity independent (must remain upright, have patient sitting up)

Question 2

Flutter Valve directions and purpose

Answer 2

Start with flutter horizontal to floor, creates PEP and oscillation, have pt take a larger than normal breath, breath hold, and seal lips on mouthpiece, exhale actively, keeping cheeks stiff, perform 5-10 breaths until suppressed cough. perform 1 or 2 larger inspirations f/b forceful exhalation

Question 3

Flutter oscillation frequencies are

Answer 3

b/w (body weight) 2-32Hz (hertz)

Question 4

what does flutter valve do

Answer 4

creates PEP and oscillation

Question 5

Oscillation

Answer 5

Movement

Question 6

PEP

Answer 6

Positive Expiratory Pressure

Question 7

EzPAP parts

Answer 7

Wavy end= ambient air inlet, air inlet= gas inlet port, white port= pressure monitoring port with cap (cap if not monitoring)

Question 8

EzPAP flow setting is normally

Answer 8

5-7 lpm

Question 9

Can you use EzPAP with mask?

Answer 9

yes, must create a seal

Question 10

Can EzPAP deliver nebulizer

Answer 10

yes

Question 11

EzPAP rules

Answer 11

slow inhalations and exhalations by the patient will maintain adequate airway pressure during the breathing cycle (maintain mouth or mask seal)

Question 12

Therapeutic PAP pressures are

Answer 12

10-20cmH2O

Question 13

Acapella Valve positives

Answer 13

Can be used in any position, with mask. Can be used to deliver nebulizer. Also produces PEP and oscillation.

Question 14

Acapella technique

Answer 14

Instruct pt to hold larger than normal breath, hold breath., Create lip seal or mask seal, Instruct an exhalation for 1:3 or 1:4 ratio. Adjust to pt needs, have pt perform 10-20 breahs, perform coughing technique and repeat

Question 15

Acapella oscillation frequencies reproduce

Answer 15

0-30 Hz

Question 16

Acapella is adjustable

Answer 16

increasing the frequency (+) increases the PEP pressure which can be measured with pressure manometer

Question 17

TheraPEP directions

Answer 17

Have pt sit up, take a breath slightly larger than normal, exhale actively but not forcefully, perform 10-20 breaths, remove treatment and cough, evaluate for independent use

Question 18

TheraPEP therapeutic pressures

Answer 18

10-20cmH2O are indicated between lines, resistance can be increased or decreased

Question 19

How many breaths on TheraPEP

Answer 19

10-20 breathes

Question 20

Aerobika

Answer 20

OPEP therapy (oscillating positive expiratory pressure), inhale deeply on mouthpiece and hold 2-3 seconds and exhale 3-4 times longer than the inspiratory breath, continue for 10-20 breaths. perform 2-3 huff coughs to clear an airway. repeat

Question 21

Metaneb details, blue ring=

Answer 21

changes resistance

Question 22

Metaneb details, black ring=

Answer 22

used when delivering therapy through a ventilator

Question 23

Metaneb requires

Answer 23

special circuit and adaptors

Question 24

Metaneb can be delivered through

Answer 24

Mouthpiece, mask, Tracheostomy tube, and in line with the ventilator circuit

Question 25

Vest- HFCWC Therapy, fitting full vest

Answer 25

top of the hipbone snug without being restricing

Question 26

Vest-HFCWC therapy, fitting wrap vest

Answer 26

Fasten to pt during inspiration, snug without restricting

Question 27

Vest-HFCWC therapy, fitting Chest Vest

Answer 27

inhale deeply and secure flaps to the front under the arm

Question 28

Generic settings on vest

Answer 28

10-30 minute treatments, frequency 10-14 Hz, Pressure; 1-4 for the front vest/ 5-6 for the full vest

Question 29

Cough assist

Answer 29

Delivers a positive pressure to assist with a deep breath (a deep breath is needed to produce an effective cough)

Question 30

What is needed to produce an effective cough

Answer 30

Deep breath

Question 31

Inspiratory pressure on cough assist/ vacuum pressure

Answer 31

25-35 cmH20 for 1 to 2 seconds followed by expiratory vacuum pressure -30 to -40 cmH20 for 1 to 2 seconds (this cycle mimics a cough by pulling the air out of the airways)

Question 32

Cough assist cycles

Answer 32

Perform 5 cycle breaths followed by normal breathing for 30 seconds, repeat until secretions are cleared

Question 33

Insufflation

Answer 33

inspiration

Question 34

Exsufflation

Answer 34

Expiration

Question 35

Cough Assist can be used with

Answer 35

Trach tube, mouthpiece, or mask

Question 36

Postural Drainage, position held for how long

Answer 36

5-10 minutes, total treatment time 20-30 minutes up to an hour

Question 37

Head down position should exceed

Answer 37

25 degrees below horizontal (HESS: 12-18 inches)

Question 38

Important for Postural Drainage

Answer 38

Adequate hydration for secretion mobility, avoid strenous coughing, usually performed with percussion and vibration,

Question 39

Hand clapping- percussion directions

Answer 39

Hand positioned 3 inches from chest, strike chest in waving movement

Question 40

Hand clapping

Answer 40

Rhythmic striking of the chest wall in a wave like motion using both hands, hands in cupping position (relaxed), usually performed over a piece of thin clothing (gown), percuss back and forth in a circular pattern for 5-10 minutes, never percuss over bony prominences (clavicle/ vertebrae)

Question 41

How can specialty beds help?

Answer 41

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