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Rx Modalities - Coggle Diagram
Rx Modalities
Facial CPAP/NIV
Indications
Pul Oedema
Hypoxic but not exhausted pt
Atelectasis
Mild ARDs
Fibrotic lung disease
Sleep Apnoea
Contraindications
Facial #
CVS instability
Haemoptysis
Recent upper GI surgery
Undrained pneumothrorax
Active TB
Raised ICP
Lung abcess
NIV
gas exchange
< WoB
<Co2 levels
FRC
CPAP
Apnoea
T1 RF
Look out for
Hudmidification
O2
Mask fit
Manual Hyperinflation
Indications
Improve lung compliance
Correct V/Q mismatch
Unable to (I) expectorate
During ventilator tube changes
Reinflation of atlectatic lung
Contraindications
High levels of PEEP >10
Recent Pneumonectomy
Bronchospasm
Recent lung surgery
Undrained pneumothorax
Unstable CV state
Cautionary use
Surgical emphysema
Unstable rib #
Pain
ARDS
Bronchospasm
Unstable CVS or hypovolaemia
Head injury
Patients with high inotrope requirements
Pulmonary Oedema
Adverse effects
CV complications
Patient distress
Baro/volutrauma
Hypoxia from poor technique
Loss of PEEP
Suction
Indications
secretions should be accessible by catheter
Pt must not be able to clear own secretions
Secretions present that are detrimental to pt
Examples
No cough reflex
Intubated and ventilated
Trachy tube
Unconscious
Contra-indications
Recent Pneumonectomy
Bronchospasm
oesophageal surgery
Stridor
Trachyo/oesophogeal fistula
Basal skull #
Deranged clotting
Check platelets
Leakage of CSP
Occluded passages
Precautions
Severe CVS instability
Bronchospasm
Anticoag pts
High malignancy
Pul oedema
Loose teeth
Cough Assist
Airway clearance with oral/nasal pharyngeal airways
Oral airway
most conscious can't tolerate this airway
Angle of jaw to corner of mouth
NP airways
Used in pts with weak cough
Do not use if #base of skull
Sizing = tragus to nostrils
Signs of effective Rx
Sats
<RR
<WoB
Improved auscultation signs
Improved pt colour
Patent airway
Minimal complications
The Bird
Manual techniques