Ventilation
Ventilation is the mechanical process whereby air is taken into and out of the lungs. Situations in which a patient might require venitlatory support range from apnea to patients experiencing depressed respiratory function. If the patient’s rate of breathing decreases significantly it can lead to hypercarbia, hypoxia, a lowered pH level and a decrease in respiratory minute volume. This can result in cardiac or respiratory arrest if it isn’t corrected.
Expired air ventilation has been accepted as the technique of choice since the late 1950s. It has been shown to be an effective practice for both professionals and lay persons including young children over 5 years of age. Ventilation using the expired air of the rescuer can be applied to the mouth or nose of the adult victim and to the mouth and nose of the infant. Mouth-to-Mouth ventilation and Mouth-to-Nose ventilation can provide effective ventilatory support to a patient. A major advantage of these methods of ventilation is that no equipment is required to effectively offer ventilatory support to the patient. However, the disadvantage of these methods of ventilatory support are that both methods only offer a limited oxygen supply due to the fact that oxygen expired from the rescuer will only contain 17 percent oxygen.
Mouth-to-Mask Ventilation or Pocket Mask Ventilation
A clear, plastic, molded facemask similar to that used in anesthesia may be used to provide mouth to mask ventilation. A unidirectional valve diverts the patient's expired air away from the rescuer and traps any macroscopic particles emerging from the patient. This valve improves the aesthetics and reduces risk of cross infection. The mouth to mask method is a two h...
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...on intermittently, reverting to controlled mechanical ventilation in patients who are not breathing. Some are contain a "pop-off" valve that prevents pressure-related injuries. A "pop-off" valve can prove to be detrimental in situations where the patient is suffering from a pulmonary contusion, bronchospasm, cardiogenic pulmonary edema, adult respiratory distress syndrome or disorders in which high levels of pressure in the airway must be surmounted.
In closing, there are several effective methods of supplying respiratory support to patients. Although, the mechanical ventilator has many advantages as mentioned earlier, the bag-valve method proves to have the largest amount of advantages. However, it should be noted that the bag-valve technique has also proven to be problematic when attempting to offer respiratory support to nonintubated patients.
VAP develops in a patient after 48 hours or more of endotracheal intubation. According to a study by Relio et al. (as citied in Fields, L.B., 2008, Journal of Neuroscience Nursing, 40(5), 291-8) VAP adds an additional cost of $29,000-$40,000 per patient and increases the morality rate by 40-80%. Mechanically ventilated patients are at an increased risk in developing VAP due to factors such as circumvention of body’s own natural defense mechanisms in the upper respiratory tract (the filtering and protective properties of nasal mucosa and cilia), dry open mouth, and aspiration of oral secretions, altered consciousness, immobility, and possible immunosuppression. Furthermore, the accumulation of plaque in the oral cavity creates a biofilm that allows the patient’s mouth to become colonized with bacteria.
1. Nine year old Jerry stumbled into a drug store, which is usually open late with very few attendants, gasping for breath. Blood was oozing from a small hole in his chest wall. When paramedics arrived, they said that Jerry had suffered a pneumothorax and atelectasis. Just what do both these terms mean and how do you explain his respiratory distress? How will it be treated?
This essay describes how the anaesthetic machine and airway management equipment are prepared in operating theatres and discusses how they are ensured safe for use. It evaluates the Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidelines related to safe practice and the preparation of the ET tubes, laryngeal masks, guedels, Naso pharyngeal airways and the laryngoscope. The function of the anaesthetic workstation is to deliver a mixture of anaesthetic agents and gases safely to the patient during the induction process and throughout surgery. In addition, it also provides ventilation to support breathing and monitors the patient’s vital signs to minimise the anaesthetic risks to the patient whilst in the care of health professionals. The pre-use check is vital to patient safety as an inadequate check of the anaesthetic machine or airway management equipment can and does lead to significant harm of the patient including mortality (Medicines and Healthcare Products Regulatory Agency (MHRA), 2008 and Magee, 2012).
Respiratory assessment is a significant aspect of nursing practice. According to the National Institute for Health and Care Excellence, respiratory rate is the best indicator of an ill patient and it is the first observation that will demonstrate a problem or deterioration in condition (Philip, Richardson, & Cohen, 2013). When a respiratory assessment performed effectively on a patient, it can result in upholding patient’s comfort and independence in progress of symptom management. Studies have acknowledged that in spite of the importance of the respiratory rate (RR) it is documented rarely than the other vital signs in the hospital settings (Parkes, 2011). This essay will highlight the importance of respiratory assessment and discuss why nurses
BiPAP is a form of noninvasive mechanical ventilation used on patients that have acute respiratory failure. Many of these patients go on noninvasive ventilation due to COPD exacerbations that are infectious, with congestive heart failure, and ventilator parameters based on their clinical assessment and changes in arterial blood gases. Two different studies were conducted on COPD patients, using a BiPAP machine to improve exacerbations and their activities of daily living. There are many positive outcomes for using these noninvasive ventilators however when used incorrectly, negative outcomes or not changes at all are always possible.
Hunter, Annadurai and Rothwell defines ventialtor-associated pneumonia as nosocomial pneumonia occurring in patients receiving more than 48 hours of mechanical ventilation via tracheal or trascheotomy tube. It is commonly classified as either early onset (occurring within 96 hours of start of mechanical ventilation) or late onset (>96 hours after start of mechanical ventilation. A ventilator is a machine that is used to help a patient breathe by giving oxygen through an endotracheal tube, which is a tube placed in a patient’s mouth or nose, or through a tracheostomy, which is a surgical opening created trough the trachea in front of the neck. Infection may occur if bacteria or virus enters the tube into the lungs or airways by manual manipulation of the ventilator tubing.
Fluid volume overload within the intervascular space can cause shortness of breath, fluid within the lungs, engorged neck veins, increased blood pressure and heart rate with a bounding pulse. As blood volume increases so will blood pressure and heart rate. Impaired gas exchange related to pulmonary congestion causes crackles within the lung fields. If oxygen saturation is low the nurse should supply supplemental oxygen. The nurse would raise head of the bed at least thirty degrees or higher to promote breathing and reduce cardiac pressure. Having the patient cough and breath deep can pop open alveoli to clear lung passages. Once the patient is comfortable and in safe position the nurse can call the doctor. The nurse should anticipate another dose of diuretics, such as furosemide. This treatment will decrease respiratory rate and blood pressure by reducing the amount of sodium and fluid within the body. Breath sounds will improve as crackles decrease. Maintaining appropriate fluid volume stabilizes blood pressure, cellular metabolism and proper nutrition gained or wastes lost. Supplemental oxygen if oxygen saturation is low and the nurse has already supplied the patient with oxygen. (Ignatavicius & Workman,
HENDERSON, Y (1998) A practical approach to breathing control in primary care. Nursing Standard (JULY) 22 (44) p41
Medical technology today has achieved remarkable feats in prolonging the lives of human beings. Respirators can support a patient's failin...
In the 1940’s, respiratory therapists were called oxygen technicians. The only thing they did was set up oxygen tanks, masks, and nasal catheters. In the 1950s, respiratory therapists were known as inhalation therapists because they were able to deliver aerosol meds. In the 1960s, therapists were responsible for ventilator setup, ABGs, and PFTs. The term “respiratory therapist” became designated in 1974. Another part of respiratory therapy that has advanced is oxygen therapy. It was produced in large scale in 1907 where it was used for nasal catheters, oxygen tents, and oxygen mask. In the 1940’s, it was widely prescribed in hospitals. In the 1960’s, the modern versions of the nasal cannula, oxygen mask, partial rebreathing and nonrebreathing mask were available. In the 2000’s, home therapy oxygen and concentrators were developed. The first aerosolized medications were given in 1910. In the 1940’s, bronchodilators were introduced to help with asthma. Since then, newer delivery devices such as dry powder inhalers have been introduced. The first negative pressure tank ventilator was developed in
The respiratory system has six major areas that works together that allows the body to breathe, prevent choking, and not to allow harmful debris to enter the respiratory system are some of the functions that the respiratory system does. The respiratory system is divided into two regions, the upper and lower respiratory. The upper respiratory consists of the Nose (nasal) and Pharynx while the lower respiratory embodies the rest of the system which includes the Larynx, Trachea, Bronchioles and Lungs. The information provided will be done by three individuals the upper respiratory tract will be provided by Mr. David Brown, the lower respiratory tract will be given by Ms. Brianna Agee and the infectious diseases will be provided by Mr. Derrek Woods.
In certain cases patients are provided with mouthpieces and other breathing apparatus which helps them sleep properly.
The second intervention to improve gas exchange related to ineffective airway clearance is the use of a positive expiratory pressure device (PEP). PEP devices work by providing constant backwards pressure on the airways during expiration.
...ering to medication antibiotics which fight off infections, bronchodialators used to decrease dyspnea relieve broncho spasms , and pulmonary rehabilitation help betters their condition. The nurse expects the patient to be able to perform suitable activities without complication, avoid irritants that can worsen the disease (contaminated air) and reduce pulmonary infection by abiding to medications.
A pneumothorax is defined as “the presence of air or gas in the plural cavity which can impair oxygenation and/or ventilation” (Daley, 2014). The development of a pneumothorax to a tension pneumothorax can be caused from positive pressure ventilation.