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Resp 17

Manual Resuscitators

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.
Created by: TnJFarrington12