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Volume Loss 2 - Coggle Diagram
Volume Loss 2
Positive pressure precautions/contraindications
Undrained pneumothorax – (will make hole bigger)
surgical emphysema of unknown cause
Bullae - destruction of alveoli to create big air SAC - may explode if given bird
bronchospasm or acute asthma - may cause attack
recent Oesophageal or lung surgery
hypoxic drive patients
active TB or H1N1
Nausea
gastric distention without NG tube
Flail chest - fractured ribs 2 places, floating rib, can puncture,
proximal airway tumors
Broncho pleural fistula (hole between flora and fistula)
Haemoptysis - coughing up blood
Raised intracranial pressure + acute head injury
CVS instability (acute MI CCF arrhythmias or BP issues)
Facial # or burns
? ENT problems
Intermittent Positive Pressure Breathing (IPPB)
applies positive pressure during inspiration
pushes patient into IRV
greater volumes lead to improved gas exchange and decreased WOB
patient triggers inspiration by taking a breath then a sustained positive pressure is applied to airway to a set pressure
followed by passive inspiration
indications
Atelectasis / volume loss when patient is:
tired
drowsy
weak
Neurologically impaired
used primarily to increase volumes
settings
Sensitivity or starting effort
inspiratory pressure
Inspiratory flow rate
goal is to give patient long slow breath
CPAP
positive pressure throughout the whole respiratory cycle
strapped into mask with a tight seal
used in spontaneous breathing patients
maintains higher lung volumes by recruiting collapsed alvioli
not good if they have secretions
NIPPY Clearway and Cough Assist
is a mechanical insufflation-exsufflation
Insufflation = positive inspiratory pressure to increase volume (same as the bird)
Exsufflation = negative pressure applied at the mouth for secretion removal
can use both to act as a non-invasive ventilator (NIV)
can be delivered manually, patient triggered or time set
used with mouth piece, face mask or trache connector