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Resp 17
Manual Resuscitators
| Question | Answer |
|---|---|
| The operating principles of self filling resuscitator bags | 1. Portable, 2. delivery positive pressure 3. can deliver room air, O2 or combi 4. O2-inlet nipple, 5. O2 reservoir 6. Have standard in and out connection |
| Common uses of self filling bag | 1. ventilate during CPR, 2. Hypervintaliting before and after suctioning 3. ventilate during transport 4. management of mechanically ventilated patients |
| Standard fittings of a pt valve on a bag and explain why they are specific | 15 mmID (inside for connection to ET or trach)...20 mmOD (outside for connection to bag) |
| Spring loaded mechanism | are NOT sensitive to pt effort and spontaneous breathing WILL NOT open valve to allow pt breath from bag |
| Diaphragm valve | which are duckbill/fish mouth or leaf type |
| Duckbill | these valves are flexible and EASILY OPENED by pressure from bag compression, or by pt's spontaneous breathing effort |
| Leaf valve | spontaneous breathing WILL open valve to allow patient to breath from bag |
| Demand valve | gas powered device |
| Characteristics of good self inflating bag | Easy to clean, standard connections, delivers O2 concentrations at high stroke volume/rates, self in flating, non-rebreathing valve, available in adult,peds, and neonates |
| Common equipment failure issues and how to correct them. | If bag fills rapidly and collapses easily-check for absent inlet valve or if stuck open it up. 2. If bag becomes hard to compress-pt valve may be stuck open or closed 3. Excessively high flow to device may cause valves to jam. |
| Function and purpose of pop off or pressure relief valve on bag | prevents delivery of excessive pressure with infants/pediatric patients...prevents barotrauma/lung damage....prevents pneumothorax |
| Which bags have a pressure relief valve | Adults only!!! |
| Pressure relief valves fucntion at what pressure | Pediatric pop off at 40 cmH20 (+- 10 required) Neonate comes with 40 cmH20 (+-5 pressure pop off) |
| how to check bag for proper function | occlude the bag and see if it has a little squeeze....squeeze the bag to make sure there is a fall and a rise.....feel for air leaking out of outlet |
| Observations to assure ventilation when using a manual resuscitator | chest rise, breath sounds, ABG, and oximetry |
| Hazards and how they can be minimized | Gastric insufflation, vomitting/aspiration, barotrauma, hypoventilation |
| Purpose of the demand valve | Gas powered, pressure relieve is set at 40, you get 100% oxygen delivered on a 50 psi outlet, inspiration can be started by manual button or pt generating negative pressure (PATIENT CAN GENERATE A BREATH |
| Advantages of using demand valve | 100% FiO2, flows at least 40 lpm, one person can ventilate |
| Disadvantages of using demand valve | Requires 50 psi outlet, does not provide a feel for chest compliance, barotrauma caused by overventilating, oxygen tanks drain quickly, should not be used with intuabted pts, ADULTS ONLY |
| Troubleshoot potential hazards of demand valve | hyper or hypo ventilate, and barotrauma |
| Use and indications for PEEP attachments | Used for pts that have refractory hypoxemia (not responding to given O2). They have decreased FRC |
| What does the PEEP do to FRC | It overcomes the decreased FRC and keeps back pressure open (alveoli open) |
| When do you use PEEP | To improve oxygenation when increasing FIO2 when it's not sufficient Also when the pt is on a ventilator and it is hooked up with PEEP |
| If PEEP works on bag what will it do to PaO2? | It will increase it |
| Effect of aspiration on ventilating a patient with a bag | if aspiration occurs while using a bag that junk can get in the lungs, it will cause decreaed compliance |
| Steps for initial response when a pt is not responseive | do typical CPR steps... If not responsive use rescue breath (breath for them) 30 chest compressions to 2 breaths. |