Literature Review Of High Flow Nasal Cannula

Suctioning resulted in moderate to large amounts of white sputum. The patients wife stated that he had been suffering from a cold for one week prior to admission. Therefore an increase in PEEP (Hi and Lo) was required to recruit the alveoli and aid in good gas exchange. (Dellinger at al, 2007) It is recommended that positive end expiratory pressure is set to avoid extensive lung collapse on expiration. (Dellinger et al, 2007) Maintaining pressure and spontaneous breathing resulted in an increase in arterial oxygenation and helped prevent a deterioration in pulmonary gas exchange. (Putensen et al 2006) Studies have been carried out to determine whether high PEEP increases patients outcomes. These include the ALVEOLI study and the Lung Open Ventilation (LOV). These studies do not show an improvement on mortality with the increase in PEEP however show a decrease in days on the ventilator. (Mercat et al 2008) The patients right side was worse than the left on the CXR and auscultation. Therefore he was being positioned right side up and his back on pressure area cares. Repositioning patients not only protects the patients skin but it also improves gas exchange and decrease the risk of ventilator acquired pneumonia. (Deutschmann and Neligan, 2010) Positioning the patient with the good lung down may improve paO₂ and aid in the drainage of secretion. (Deutschmann and Neligan, 2010) Elevating the head of

Both rapid, shallow breathing patterns and hypoventilation effect gas exchange. Arterial blood gases will be monitored and changes discussed with provider. Alteration in PaCO2 and PaO2 levels are signs of respiratory failure. Patient’s body position will be properly aligned for optimum respiratory excursion, this promotes lung expansion and improved air exchange. Patient will be suctioned as needed to clear secretions and maintain patent airways. The expected outcome is that the patient’s airway and gas exchange will be maintained as evidence by normal arterial blood gases (Herdman,

Emmanuel and his mother live in an urban community-housing complex. The building is worn down and dirty from the urban dust, cockroaches, and mold. Emmanuel is five years of age and has suffered from asthma for the last two years. One evening, his mother poured him some milk and put him to bed. Shortly afterward, Emmanuel woke up wheezing and coughing. As he gasped for air, he became more and more anxious. His mother ran for his inhaler, but he was too upset and restless to use it. Emmanuel’s skin became moist with sweat, and as he began to tire, his wheezing became quieter. His mother called 911 and waited anxiously for the ambulance to arrive.

Jane’s asthma was acute severe. Initially to alleviate some of Jane’s breathlessness she was sat up right in the bed and supported with pillows to improve air entry. Due to her low oxygen saturations she was placed on 40% oxygen via Hudson mask (BTS 2006), as Jane was mouth breathing the mask was the appropriate device to use to ensure adequate oxygenation (Walsh 2002). According to Inwald et al (2001) hypoxemia is frequently a primary cause in numerous asthma related deaths. By administering oxygen promptly, for acute severe asthma, serious hypoxemia

Even though the consequence of saline instillation on a ventilator patient in the acute care setting is pneumonia or the patient may become hemodynamically unstable, this practice remain contentious, the practice of this procedure will also decrease the oxygenation. (Ayhan, et al., 2015),

As a clinical facilitator, I provide learning opportunities to staff and nursing students at St Vincent’s Private Hospital Brisbane (SVPHB). Not long after I joined St Vincent’s, I encountered a patient who was receiving high flow oxygen (7 litres/min) via high flow nasal prongs without any humidification device running with it. The scene surprised me. Supplemental oxygen is

The most serious health problem that the client has is impaired gas exchange. According to Sue Galanes (2007), impaired gas exchange is result from the balance between ventilation and perfusion is offset by a certain condition which affects the efficiency of the gas exchange. On account of client has congestive heart failure that can contribute to dyspnea, which means the efficiency of gas exchange is decreased. One of the significant defining characteristics of impaired gas exchange is dyspnea (Sabtu, 03 Agustus 2013). In addition, it was hard for the patient to talk in long sentence due to difficulty in breathing. Hence, impaired gas exchange is one of the health problems that the client suffered from. In regards of O2 is the basic element that all of cells and organs need, it can be considered as a fuel of human body. Therefore, impaired gas exchange is the most severe health problem the patient has currently.

Endotracheal tubes containing a tapered cuff have recently been approved by the United States Food and Drug Administration and, based on the findings from in vitro and in vivo studies, are believed to achieve a better tracheal seal (Bowton et al., 2013). This enhanced fit is suggested to reduce the passage of potentially contaminated secretions around the cuff and into the distal airway of mechanically ventilated patients, thereby decreasing the development of VAP. In a study executed by Bowton et al. (2013), researchers examined whether these tapered endotracheal tubes would be more effective in reducing actual rates of VAP. Their study utilized a two-period observational approach in which each study period took place over six of the same calendar months so as to eliminate potential variations in season related to VAP. All adults over the age of 18 who were admitted into a variety of specialized ICUs, whose VAP rates closely resembled the average of all ICUs in the United States, were included in the study. During the first six month period, all endotracheal tubes utilized by the facility contained the standard, barrel-shaped cuff. Following this period, an audit was performed to ensure that all of these tubes were removed and, subsequently, they were replaced with tapered-cuff endotracheal tubes. Additionally, all emergency medical

Respiratory therapy refers to both a subject area within clinical medicine and to a distinct health care profession. During the 20th century, there were many health care fundamental transformations. Here are 10 possible predictions of what may occur in the future of respiratory care: (1) Less focus on raising PaO2 as a primary goal in managing patients with acute hypoxemic respiratory failure. (2) More attention to

38. American Journal of Respiratory care and critical care Medicine, Volume 175, issue 7, pages 698 – 704

The observation of both animal and humans has revealed that mechanical ventilation can cause severe lung injury if over-distention occurs (Roupie et al., 1995). To make the matter even worse, the very patients that need mechanical ventilation the most, patients with the acute respiratory distress syndrome for example, are especially susceptible to over-distention and therefore, lung injury (Stewart et al., 1998). The main reason that patients with acute respiratory distress syndrome or respiratory distress syndrome are in higher risk of lung injury is due to over-distention, caused by reduced numbers of alveoli as result of fluid buildup, consolidation, and atelectasis (Roupie et al., 1995).

The rationale for this intervention is that humidification can help to thin tenacious secretions, lower the risk of mucus plug formation and allow for better expectoration and easier extraction via suctioning (Branson, 2007). This is particularly relevant for patients with tracheostomies since air entering their lungs is not warmed by the nasal turbinates and can lead to dry secretions that are hard to remove (Lewis, 2014). To implement this intervention I consulted the patient’s chart to confirm that this was recommended. I then attached the patient’s tracheostomy mask to a constant flow of warm humidified

Managing complex ventilator patients require critical thinking to solve problems pertaining to ventilator issues. Even though I am a certified ventilator paramedic, ventilator management is managed an respiratory therapist. Having the ventilator certification was useful in which I was able to apply my knowledge to

One of the most common causes of an airway obstruction in unconscious patient's is their tongue. This problem can be overcome by the use of an oropharyngeal airway (OPA) or nasopharyngeal airway (NPA). These airway adjuncts are inserted into the patient's mouth or nostril, and are designed to hold the tongue in a position that prevents it from occluding the airway. Another skill authorized for BLS providers is the use of a bag-valve-mask (BVM). This tool allows EMS personnel to deliver positive pressure ventilations to a patient who is not breathing sufficiently on their own. However, this skill is commonly performed improperly. When using a BVM, an EMS provider must make certain that his patient's airway is patent, and that his head is positioned properly. Furthermore, it is critical that an EMS provider ensures that the mask is maintaining a complete seal around his patient's nose and mouth. Otherwise, pressure needed to force air into the lungs escapes through the unsealed portion of the mask, reducing the effectiveness of the ventilation. Another, more advanced skill used by EMS providers is the performance of an endotracheal

I note lung function tests performed in September revealed normal spirometry with no change post-bronchodilator, whilst gas transfer is mildly reduced.