transcript
- Slide 1
- Just breathe! Respiratory Therapy!
- Slide 2
- Review of Respiratory We breathe by negative pressure. The
diaphragm pulls down and we pull air in through our nose and mouth.
We breathe in O2 ( Oxygen) and exhale CO2 ( carbon dioxide) COPD =
Chronic obstructive pulmonary disease (COPD) refers to a group of
lung diseases that block airflow as you exhale and make it
increasingly difficult for you to breathe. Emphysema and chronic
asthmatic bronchitis are the two main conditions that make up COPD.
In all cases, damage to your airways eventually interferes with the
exchange of oxygen and carbon dioxide in your lungs.
- Slide 3
- Homeostasis Too much O2 ( hyperventilating) and CO2 levels will
fall too much resulting in dizziness, confusion and eventually you
will pass out. * Emphysema Too little O2 (hypoxia) and CO2 levels
will rise (hypercapnea) and if not corrected you will fall asleep,
coma and eventually die. * Emphysema The body works to keep O2 and
CO2 level.
- Slide 4
- Acidosis Too much CO2 in the body is called acidosis Can be
caused by Respiratory problems or Metabolic problems : (
Kidney/Diabetes) Respiratory Acidosis comes from inadequate
ventilations. Head trauma, drug overdose, anesthesia, neuromuscular
diseases, spinal cord injury and obesity ( pickwickian syndrome)
The body will start breathing faster to correct this. If it cant
correct the acidosis, the person requires a ventilator.
- Slide 5
- Alkalosis Too little CO2 in the body is called alkalosis Can be
both Respiratory (Rare) or Metabolic. (Diuretics, Vomiting, or
Antacids) Respiratory alkalosis is caused mainly by anxiety
resulting in hyperventilation. Calming the person down will correct
respiratory alkalosis, Sedation helps.
- Slide 6
- Nasal Cannula 0.5-5 liters per minute of oxygen Used for Chest
pain, COPD, post operative support, mild pneumonias,etc
- Slide 7
- Venti Mask Venturi Mask (venti mask) 24%-50% concentration of
oxygen 24% uses 2-4, 35% uses 6-8 liters of O2, 45% uses 10 -
12liters and 50% uses 12-15 liters of O2. Used for patients who
require more than 5 liters of O2 or breathe through the mouth more.
Copd, Pulmonary Emboli, Pneumonia, etc
- Slide 8
- 100% Non-Rebreather 100% Non-Rebreather. 100% O2 Used for
Medical Emergencies, Severe Hypoxia Oxygen fills the bag and a
one-way valve prevents any CO2 from being reinhaled,
- Slide 9
- Nebulizers Used for the treatment of Asthma, Bronchitis,
Pneumonia, post operatively and post intubation. Most contain
steroids to reduce swelling in respiratory tracts Some contain
medicine to help remove mucous. Can be used during codes to give
meds if not other alternative not very effective.
- Slide 10
- Ambu Bag 100% Oxygen Placed securely over nose and mouth Bulb
is squeezed and air is forced into lungs. Used before and during
intubation, codes and surgery.
- Slide 11
- CPAP Machine CPAP = Continuous Positive Air Pressure Used for
sleep apnea, hypoxic patients and High CO2 levels Will be tried
before intubation. Not tolerated by everybody. Person must be able
to initiate breath.
- Slide 12
- Intubation and Ventilation Used for Surgery, Cardiac and
Respiratory arrest, Respiratory failure due to pneumonia, drugs,
cancer, end stage COPD, head trauma and airway protection for
alcohol withdrawal, uncontrolled seizures and uncontrolled
psychotic events. Settings on the ventilator can range from
breathing on your own to full respiratory support. Settings are
adjusted by Physician ( Emergency Room, Anesthesiologist or
Intensivist) according to ABG results and body size
- Slide 13
- Intubation ET Tube (Endotracheal Tube ) is placed trough the
mouth (or nose rarely) down the trachea, through the vocal cords to
above where the bronchus split ( 1inch above the Corina)
- Slide 14
- ET Tube The ET Tube is checked for placement all 3 ways : 1)CO2
detector - 2) Listening to the lungs for breath sounds 3) Chest
X-ray Tube must be secured at all times and pt is almost always
sedated.
- Slide 15
- Tracheostomy ET Tubes are only good for 7-14 days. If the pt
requires ventilation longer, a tracheostomy tube is placed. More
comfortable, easier to breath and the person does not have to be
sedated.
- Slide 16
- Ventilator Uses Positive pressure to ventilate. Multiple
settings are used to adjust the acid base balance. Rate the number
of breaths per minute to machine will give. Tidal Volume The volume
of air with each respiration Oxygen- How much O2 to deliver PEEP
(Positive end expiratory pressure) How much O2 to leave in the
lungs during exhalation.
- Slide 17
- Ventilators
- Slide 18
- Positives and Negatives Positive : It saves lives Negative :
Intubation trauma teeth, vocal cords, erosion of trachea (
bleeding), infection ( ventilator acquired Pneumonia), restraints,
bed sores, blood clots, swelling,painful and lastly -its
frightening!!!