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Special respiratory therapies
- 1. Ms. AMANDEEP KAUR NURSINGTUTOR MMCON
- 2. INTRODUCTION Numerous treatmentmodalities 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.
- 3. CLASSIFICATION OF RESPIRATORY MANAGEMENTMODALITIES Non-invassive respiratory therapies Invasive respiratory therapies
- 4. NON – INVASIVERESPIRATORY THERAPIES Oxygen Therapy Incentive spirometry Mini – nebulizer Therapy Intermittent Positive –pressure breathing ( IPPB) Chest physiotherapy ( Postral drainage ,chest percussion, breathing retraining
- 5. INVASIVE RESPIRATORY MODALITIES Endotrachealintubation Tracheostomy Mechanical ventilation
- 6. OXYGEN THERAPY Oxygentherapy is the administration of oxygen at a concentration greater than that found in the environmental atmosphere.
- 7. INDICATIONS OF OXYGENTHERAPY 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
- 8. COMPLICATIONS OF OXYGEN THERAPY Oxygen toxicity Suppression of ventilation Combustion (burning)
- 9. METHODS OF OXYGEN ADMINISTRATION Low flow system High flow system
- 10. LOW FLOW SYSTEM Cannula Oropharyngeal catheter Simple mask Partial rebreather mask Non breather mask
- 11. Cannula & Oropharygealcatheter
- 14. HIGH FLOW SYSTEMS Transtracheal catheter(invasive) Venturi mask Tracheostomy collar T – piece Face tent
- 15. INCENTIVE SPIROMETRY ( SUSTAINEDMAXIMAL 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.
- 16. PURPOSE OF INCENTIVESPIROMETRY The incentive spirometer that volume of air inhaled is increased gradually as the patient takes deeper and deeper breaths.
- 17. TYPPES OF INCENTIVESPIROMETRY Volume Spirometry :-forced expiratory volume (FEV1) measures how much air a person can exhale during a forced breath at the first second of forced expiration.
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- 19. 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 treat atelectasis.
- 20. INSTRUCTIONS REGARDING SPIROMETRY USING Proper position Technique for using the spirometry Frequency of usage
- 21. NEBULIZER THERAPY Thenebulizer 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.
- 22. INDICATIONS OF 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
- 23. CHEST PHYSIOTHERAPY (CPT) Chest physiotherapy includes:- Postural 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.
- 25. ENDOTRACHEAL INTUBATION Endo-trachealintubation involves passing an endo- tracheal tube through the mouth or nose into the trachea. Endo-tracheal 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.
- 26. TRACHEOSTOMY A tracheostomyis a surgical procedure in which an opening is made into the trachea. The indwelling tube is inserted into the trachea i.e. called as:- tracheostomy tube. A tracheostomy either Temporary or permanent.
- 27. COMPLICATIONS OF TRACHEOSTOMY Complications may occur early or late in the course of tracheostomy tube management. They may even occur after the tube has been removed.
- 28. EARLY COMPLICATIONS INCLUDING Bleeding Pneumothorax Air embolism Aspiration Subcutaneous or mediastinal emphysema Recurrent laryngeal nerve damage
- 29. LONG TERM COMPLICATIONS Airway obstructions from accumulation of secretions Infection Rupture of the innominate artery Dysphagia Tracheo-esophageal fistula Tracheal ischmia and necrosis
- 30. MECHANICAL VENTILATION Mechanicalventilation 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 A mechanical ventilator is a Positive or negative pressure breathing device that can maintain ventilation and oxygen delivery for a prolonged period
- 31. INDICATIONS Continues decreasein 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) Conditions such as Thoracic or abdominal surgery Drugs over dose Neuromuscular injury and inhalation ingury COPD , multiple trauma, shock, multisystem failure and coma.
- 32. CLASSIFICATION OF VENTILATORS Negative-pressure ventilators Positive- pressure ventilators
- 33. COMPLICATIONS Alterations incardiac function Barotrauma ( trauma to the trachea or alveoli secondary to Positive pressure) Ventilator associated pneumonia Pulmonary infection Sepsis
- 34. WEANING THE PATIENTFROM 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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