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Home Care

Home Care Cards for Respiratory Exam

LOX Disadvantages • Can cause burns • O2 lost through venting if not used frequently • Needs to be replenished frequently if venting loss
LOX Advantages • Patient can be away from home for longer periods of time • Can be refilled as often as necessary • Quiet • Requires no electricity
Home Care Conditions Stable- no longer needs acute/sub-acute care Can care for themselves safely Can accurately administer prescribed therapy If patient cannot, family/ caregivers must be able to perform therapy Home environment must be adequate
DC Specifics Date of discharge Goal for home care (for that patient) Specific therapies with frequencies Equipment needed Patient/family instruction Home care agency selection Plans for follow up evaluation
Concentrator Advantages • Never runs out • Needs a little maintenance by Pt • Cheaper than tanks and LOX
Concentrator Disadvantages • Noisy • Requires electricity • Need other device for travel (tank, LOX) • Increased electric bill • Increased temperature (poorly ventilated room)
Functional Impairment Assessment Poor hand strength Poor vision Poor hearing Poor cognitive ability Trouble with learning procedures Poor short term memory Ability to ambulate
Medicare Payments • Payments capped at 13 mo • After that, Medicare only pays service fee • Pt responsible for remainder
Conflict of Interests When and RCP engages in any activity which compromises of the motive for provision of any therapy procedures, the advice of counsel given to patients and/or family, or any manner profits from referral arrangements with home care providers.
CPAP Sleep Study Documentation • Sleep study documenting 30 episodes of apnea lasting minimum of 10 sec per episode recorded during 6-7 hours of sleep
DC Planning Team Utilization review Physician Social worker Home health RN Home health RCP Durable medical equipment -DME provider Physical therapist (PT) Occupational therapist (OT) Dietician Psychologist Family or caregivers
O2 Conserving Devices Reservoir Cannula Transtracheal Delivery System Pulsed Dose System
Reservoir Cannula • Operates like a NRB mask • As Pt exhales, small reservoir holds continuously flowing O2 • O2 in reservoir available as bolus for next inspiration • Saves O2 by not “wasting” it during exhalation
Transtracheal Delivery System • Small catheter inserted through skin into trachea • Bypasses upper airways, so flow can be lower- saving O2 • Advantages: More appealing to the eye, Less visible • Disadvantages: Requires a lot of maintenance, invasive
Pulsed Dose System • Reduces amount of O2 used by 50-75% • Makes tank last 10-20 hours longer • 2 types • Demand valve: gives O2 only during inspiration • Rate sensitive device: Gives O2 every 2-3 breathes
Nebulizer Compressor 6-15 LPM
High Output Compressor 50 PSI
O2 Concentrator Flow/FiO2 Relationship Higher flow= Less O2
Created by: geko546