Cardio Respiratory Equipment

Question 1

What is this?
Purpose & medication?
Contraindications/precautions/considerations?
How to use it?

Answer 1

1. Metered dose inhaler
2. Relief from respiratory conditions (Asthma) and uses salbutamol acting as a bronchodilator to open airways
3. Consider ability to coordinate use, age and severity of patient. Can cause oral thrush
4. How to use MDI:
5. Shake canister ~10 times, then remove cap from mouthpiece
6. Hold canister upright and sit upright
7. Expire gently but not fully
8. Slight neck extension
9. Seal mouth around mouthpiece
10. Slow, deep inspiration – simultaneously press canister to release medication
11. Inspiratory hold (5-10sec)
12. Expire gently, through nose
13. wait ~20sec then repeat

Question 2

What is this?
Purpose & medication?
Contraindications/precautions/considerations?
How to use it?

Answer 2

1. Turbuhaler
2. Relief from respiratory conditions (Asthma & COPD) and uses symbicort (bronchodilator & corticosteroid) to open airways.
3. Consider ability to coordinate use, age and severity of patient. Can cause oral thrush. Patient needs a good inhalation. Use this if patient can coordinate MDI. Educate patient to rinse mouth
4. Unscrew and remove the protective cover
5. Hold canister upright
6. Load by turning the grip at the base to the right as far as it will go, then twist back to the left until it clicks
7. Sit upright
8. Expire gently but not fully
9. Seal mouth around mouthpiece
10. Slow, deep inspiration
11. Inspiratory hold (5-10sec)
12. Expire gently through nose
    10.Replace the cover
    If a second dose is required, wait ~20sec then repeat.

Question 3

What is this?
Purpose ?
Contraindications/precautions/considerations?
How to use it?

Answer 3

1. Spacer
2. Enhances medication deposition into the lungs and don’t need to rely on timing. Also reduces medication settling in the oropharynx and getting thrush.
3. If the patient has COPD, do not do inspiratory hold. The patient has to be able to hold the device. Consider the design for the patient
4. Shake MDI
   Insert into spacer
   Breath all the air out then seal lips over spacer
   Press MDI
   Breath in slowly and deeply
   Hold for 5-10 seconds

Question 4

What is this?
Purpose/flow rate?
Contraindications/precautions/considerations?

Answer 4

1. Nasal prongs
2. Variable oxygen delivery device to patient. Slow rate is 1-4L or Fi02 (0.24-0.36). Comfortable for the patient to eat and drink.
3. Can cause pressure sores around the nose.
   Absorption atelectasis
   Depression of ciliary function (fix with humid)
   Oxygen toxicity
   Monitor patient with COPD
   Mucosal damage

Question 5

What is this?
Purpose/flow rate?
Contraindications/precautions/considerations?

Answer 5

1. Hudson mask
2. Variable oxygen delivery system to the patient. Uses greater than 5L/min and FiO2 of 0.40-0.60. Needs high rate to prevent rebreathing exhaled gases.
3. Humidification needs due to high flow rate.
   Absorption atelectasis
   Depression of ciliary function (fix with humid)
   Oxygen toxicity
   Monitor patient with COPD
   Mucosal damage

Question 6

What is this?
Purpose/flow rate?
Contraindications/precautions/considerations?
Describe the valve mechanism and why use these masks?

Answer 6

1. Non rebreather mask
2. Variable oxygen delivery device to patient who is hypoxaemic/sever respiratory distress. Can delivery very high oxygen rate of 10-15L or Fio2 of up to 0.8/0.9. Patient is also able to talk with these types of masks.
3. Patient with COPD– These patients require low O2 levels to stimulate breathing (due to chronic high CO2), therefore high O2 can suppress respiratory drive to breath. Humidification needed due to high flow rate.
   Absorption atelectasis
   Depression of ciliary function (fix with humid)
   Oxygen toxicity
   Monitor patient with COPD
   Mucosal damage
4. Breath in through the bottom value, one way. Breath out through the side values, air can’t come back so not exhaled air. Generally used in more severe cases and the bag provides a high oxygen reservoir 60-100% oxygen, compared to Hudson mask of 40-60%.

Question 7

What is this?
Purpose/flow rate?
Contraindications/precautions/considerations?
masks?

Answer 7

1. Rebreather mask
2. Variable oxygen delivery device to patient who is hypoxaemic/sever respiratory distress. Can delivery very high oxygen rate of 6-10L or Fio2 of up to 0.6. Patient is also able to talk with these types of masks.
3. Risk of retaining Co2 is insufficient leading to hypercapnia. Patient with COPD– These patients require low O2 levels to stimulate breathing (due to chronic high CO2), therefore high O2 can suppress respiratory drive to breath. Humidification needed due to high flow rate.

Absorption atelectasis
Depression of ciliary function (fix with humid)
Oxygen toxicity
Monitor patient with COPD
Mucosal damage

.

Question 8

What is this?
Purpose/flow rate?
Contraindications/precautions/considerations?
masks?

Answer 8

1. Multivent mask
2. FIXED oxygen delivery device to patient who is. regardless of how deep of often they breath, the same oxygen will be delivered. Can deliver low 0.24-0.36 and high 0.36-0.50 FiO2.
3. Explanation of fixed delivery for COPD patient it control oxygen flow (fixed)
   Match oxygen at the wall with the device

Absorption atelectasis
Depression of ciliary function (fix with humid)
Oxygen toxicity
Monitor patient with COPD
Mucosal damage

.

Question 9

What is this?
Purpose/flow rate?
Contraindications/precautions/considerations?
masks?

Answer 9

1. Nebuliser
2. Delivery of respiratory meds (bronch & cortico) & can moisten the upper airways in surgical patients. Typically >6L. Baffle mechanism requires this flow rate to convert solution into fine droplets. Astma patients
3. Take care with COPD patients and use medical air not oxygen.

Absorption atelectasis
Depression of ciliary function (fix with humid)
Oxygen toxicity
Monitor patient with COPD
Mucosal damage

Question 10

What is this?
Purpose?
Contraindications/precautions/considerations?
masks?

Answer 10

1. Oropharyngeal airway
2. Keep the airway patent & facilities suctioning. Measured from the mouth to the mandible.
3. Can cause them to gag or vomit
   Care with teeth and patients bite reflex
   Place them in side lying in case of vomiting

Question 11

What is this?
Purpose?
Contraindications/precautions/considerations?
masks?

Answer 11

1. Nasopharyngeal airway
2. Maintain a clear airway & facilities suctioning. Measured from the nars to the ear.

3.
Anticoagulant therapy
Bleed easily
Cerebrospinal fluid leak
Hypotension
Nasal/facial #
Torn dura
Make sure to insert correction otherwise you can perforate cribriform plate
Insert with lubricant
Change several times a day

Question 12

What is this?
Purpose?
Contraindications/precautions/considerations?
masks?

Answer 12

1. Cuffed endotracheal tube
2. Form of intubation of acting as a formal airway and ends just before the carina. Used for patients who have airway obstruction or inadequate oxygen or ventilation. The cuffed part creates a seal, stops aspiration and locks in the tube. Patient needs to be unconscious, unable to swallow, requires full mecchanical ventilation.

3.
Can cause issues with teeth
Malposition with R main bronchus
Can have issues with kinking.
Infection risk
Uncuffed version for paediatric use, can swallow and awake. Moves around more and can increase secretions.

Question 13

What is this?
Purpose?
Contraindications/precautions/considerations?
masks?

Answer 13

1. Trachy
2. Form of intubation when upperair is obstructed. Inserted through cricoid cartilage and reach carina. airway for patient and to remove secretions. Used when needed for a prolonged time. ICU= precutaneious

3.
Surgical bleeding.
Surgical emphysema.
Blockage with secretions.

Question 14

What is this?
Purpose?
Contraindications/precautions/considerations?
masks?

Answer 14

1. Mini Trachy
2. Usually paediatric use for retained secretions but also in smaller adults.
3. Small tube will get blocked easier
   Infection risk
   Use size 8 catheter to suction

Question 15

Purpose?
Contraindications/precautions/considerations?
masks?

Answer 15

1. Trachy mask
2. Variable oxygen delivery device for a trachy. Sits overtop of the tachy
3. Careful with COPD patients and all regular oxygen precautions

Question 16

What is this?
Purpose?
Contraindications/precautions/considerations?

Answer 16

1. Swedish Nose
2. Humidification and filtration of the upper airway for a trachy. Also catches warm air on expiration for next breath
3. Often gets blocked, needs to be checked and suctioned regularly.

Question 17

What is this?
Purpose?
Contraindications/precautions/considerations?

Answer 17

1. Closed-suction system.
2. Provides the ability to keep the patient connected to the ventilator whilst being able to perform endotracheal suctioning. Less trauma as you dont need to disconnect/connect. Reduces loss of FRC as the patient is still being ventilated.
3. Similar risk to suctioning of hypoxaemia, airway and mucosal damage. May also be less effective when secretions are thick