respiratory therapies
TRANSCRIPT
RESPIRATORY THERAPIESANILKUMAR BR , LECTURER
SHREE JENUKAL
INTRODUCTION
Numerous treatment modalities are used when caring for clients with various respiratory conditions.
The choice of treatment modalities is based on the oxygenation disorder and whether there is a problem with gas ventilation, diffusion or both.
CLASSIFICATION OF RESPIRATORY MANAGEMENT MODALITIES
Non-invassive respiratory therapies Invasive respiratory therapies
NON – INVASIVE RESPIRATORY THERAPIES
Oxygen Therapy Incentive spirometry Mini – nebulizer Therapy Intermittent Positive –pressure breathing ( IPPB) Chest physiotherapy ( Postral drainage ,chest
percussion, breathing retraining
INVASIVE RESPIRATORY MODALITIES
Endotracheal intubation Tracheostomy Mechanical ventilation
OXYGEN THERAPY
Oxygen therapy is the administration of oxygen at a concentration greater than that found in the environmental atmosphere.
INDICATIONS OF OXYGEN THERAPY
A change in the clients respiratory rate or pattern may be one of the earliest indications of the need for oxygen therapy.
Hypoxemia or hypoxia
COMPLICATIONS OF OXYGEN THERAPY
Oxygen toxicity Suppression of ventilation Combustion
METHODS OF OXYGEN ADMINISTRATION
Low flow system High flow system
LOW FLOW SYSTEM
Cannula Oropharyngeal catheter Simple mask Partial rebreather mask Non breather mask
HIGH FLOW SYSTEMS
Transtracheal catheter Venturi mask Tracheostomy collar T – piece Face tent
INCENTIVE SPIROMETRY ( SUSTAINED MAXIMAL INSPIRATION)
Incentive spirometry is a method of deep breathing that provides visual feedback to encourage the clients to inhale slowly and deeply to minimize lung inflation and prevent or reduce atelectasis.
PURPOSE OF INCENTIVE SPIROMETRY
The incentive spirometer that volume of air inhaled is increased gradually as the patient takes deeper and deeper breaths.
TYPPES OF INCENTIVE SPIROMETRY
Volume or Flow spirometry
INDICATIONS OF SPIROMETRY
Incentive spirometry is used after surgery, especially Thoracic and abdominal surgery, to promote the expansion of the alveoli and to prevent or trat atelectasis.
INSTRUCTIONS REGARDING SPIROMETRY USING
Proper position Technique for using the spirometry Frequency of usage
MINI-NEBULIZER THERAPY
The mini-nebulizer is a handled appartus that disperses a moisturizing agent or mediation, such as bronchodilator or mucolytic agent, into microscopic particles and delivers it to the lungs as the client inhales.
INDICATIONS OF MINI-NEBULIZER THERAPY
In case of difficulty in clearing respiratory secreations
Reduced vital capacity with ineffective deep breathing and coughing.
Most commonly used in COPD clients
INTERMITTENT POSITIVE PRESSURE BREATHING
Intermittent Positive- pressure breathing ( IPPB) is an older form of assisted or controlled Respiration in which compressed gas is delivered under Positive pressure into a person’s airways unitil a preset pressure is reached today.
It is infrequently used currently
CHEST PHYSIOTHERAPY ( CPT)
Chest physiotherapy includes Postral drainage, chest percussion, and chest vibration and breathing retraining.
The goals of CPT are to remove bronchial secretions, improve ventilation, and increases the efficiency of the respiratory muscles.
INVASIVE RESPIRATORY MODALITIES
ENDOTRACHEAL INTUBATION
Endotracheal intubation involves passing an endotracheal tube through the mouth or nose into the trachea.
Endotracheal intubation provides a patent airway when the patient is having respiratory distress that cannot be treated with simpler methods and is the method of choice in emergency care.
TRACHEOSTOMY
A tracheostomy is a surgical procedure in which an opening is made into the trachea.
The indwelling tube inserted into the trachea is called a tracheostomy tube.
A tracheostomy either Temporary or permanent.
COMPLICATIONS OF TRACHEOSTOMY
Complications may occur early or late in the course of tracheostomy tube management.
They may even occur yees after the tube has been removed.
EARLY COMPLICATIONS INCLUDING
Bleeding Pneumothorax Air embolism Aspiration Subcutaneous or mediastinal emphysema Recurrent laryngeal nerve damage
LONG TERM COMPLICATIONS
Airway instructions from accumulation of secretions Infection Rupture of the innominate arteryDysphagia Tracheoesophageal fistula Tracheal ischmia and necrosis
MECHANICAL VENTILATION
Mechanical ventilation may be required for a variety of reasons.
To control the patient Respiration during surgery or during treatment of severe head injury, to oxygenate the blood when the patient ventilatory efforts are inadequate
MECHANICAL VENTILATION
A mechanical ventilator is a Positive or negative pressure breathing device that can maintain ventilation and oxygen delivery for a prolonged period
INDICATIONS
Continues decrease in oxygenation (PaO2), an increase in arterial carbon dioxide levels ( PaCO2) and persistent acidosis ( decreased pH) mechanical ventilation may be necessary. ( Any dramatic alterations in ABGs valves)
INDICATIONS
Conditions such as Thoracic or abdominal surgery Drugs over dose Neuromuscular injury and inhalation ingury COPD , multiple trauma, shock, multisysstem
failure and coma.
CLASSIFICATION OF VENTILATORS
Negative- pressure ventilators Positive- pressure ventilators
COMPLICATIONS
Alterations in cardiac function Barotrauma ( trauma to the trachea or alveoli
secondary to Positive pressure) Ventilator associated pneumonia Pulmonary infection Sepsis
WEANING THE PATIENT FROM THE VENTILATOR
Respiratory weaning, the process of withdrawing the patient from dependncce on the ventilator, takes place in three stages, the patient is gradually removed from the ventilator, then from the tube, and finnaly from oxygen.
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