Nezavisle, ale synergisticke systemy!!
|
|
- Rosanna Shavonne Marshall
- 2 years ago
- Views:
Transcription
1 Mechanical insufflation/exsufflation (MI/E) Michal Rosicky, MD., Anestesi och Intensivvårdavdelning Kungälv Sjukhus Sverige
2 Transportni mechanizmy sekretu z DC Mukociliarni aparat Mobilizace sekretu z distalnich DC COPD, nikotinismus, CF, Kasel Mobilizace sekretu ci cizich predmetu ze sliznice DC, prevazujici vyznam predevsim od urovne strednich DC NMD, SCI, trauma, kachexie, Nezavisle, ale synergisticke systemy!!
3 Kasel: (pato)fyziologicke aspekty Iniciovan volne i mimovolne Za fyziologickych podminek neni nezbytny pro efektivni clearance DC (mukociliarni clearance) Nezbytny za patologickych podminek Podminky pro efektivni kasel: Funkcni glottis Intaktni CNS centra (medulla oblongata) Pruchodne DC Inspiracni objem 2,5l (TLC) Intaktni expiracni svaly Vysoke intrathorakalni tlaky (max. az 200cm H2O!!) Normalni CPF 6-12l/sec ( l/min) 620l/min)
4 Kasel: fyziologicke faze (adapted from
5 Priciny neefektivniho/abnormalniho cyklu kasle Neschopnost dostatecne hlubokeho nadechu Snizena schopnost (vykonnost) interkostalnich/abdominalnich abdominalnich svalu dosahnout pozadovaneho intrathorakalniho tlaku Nedostatecna funkce (ovladani, koordinace) glottis Centralni priciny Klinicke stavy (onemocneni): Hrudni, plicni trauma, pooperacni stavy (bolest) SCI (poraneni krcni michy/patere) Vrozene deformity Restriktivni, obstruktivni poruchy Neuromuskularni onemocneni Tracheostomie
6 Klinicke strategie pri potizich s mobilizaci sekretu z DC Adekvatni bilance tekutin Nutricni podpora, prevence kachexie, Fyzicka aktivita Kineziterapie, dechova gymnastika, Radne zvlhceni Mukolytika CPAP? Asistovany kasel CoughAssist "... chest vibration techniques, no matter how effective in mobilizing peripheral secretions, will not result in their expulsion without an effective cough flow." - Bach JR. Eur Respir J. 2003; 21:
7 Mechanical in/exsufflation Mechanical in/exsufflation MI/E Assisted coughing CoughAssist (Respironics, Philips) Lung Volume recruitment with CoughAssist Hostapparat??
8 Mechanical in/exsufflation, (CoughAssist ) Princip: prohloubene asistovane inspirium k docileni optimalni expanze plic nasledovane rychlym expiriem pri asistovanem podtlaku pro zvyseni a prodlouzeni expiracniho peak-flow
9 Mechanical in/exsufflation, (CoughAssist ): terminologie 1 cyklus (cykle): insuflace/exsuflace 1 aplikace (treatment): 3-5 cyklu (cykles) 1 serie (session): 3-5 aplikaci (treatments)
10 Indikace MI/E (CoughAssist ) Indikace Redukovany Peak Cough Flow (pcf) <270 lpm nezbytny k optimalni bronchialni toalete za ruznych patologickych (fyziologickych) podminek Maximalni vyvinuty expiracni tlak <60 cm H20 Klinicke efekty CoughAssist Uvolnuje sekret z distalnich casti plice Redukuje vyskyt plicnich infekci Bezpecna metoda, noninvazivni, doplnek (alternativa) k odsavani Dobra compliance pacienta Jednoducha aplikace pro zdravotnicky personal (laiky)
11 Indikace MI/E (CoughAssist ) Pacienti s infekci dolnich cest dychacich Restriktivni poruchy Obstruktivni poruchy Pooperacni stavy cetnosti odsavani dyskomfortu u odsavani cetnosti TS u pacientu s NIV Neuromuskularni poruchy ALS,SMA, GB, MS, Muskularni dystrofie Poraneni michy Myastenia gravis respiracnich infektu rehospitalizace cetnosti TS u pacientu s NIV kvality zivota
12 MI/E, CoughAssist : Clinical references American Thoracic Society (ATS) clinical practice guidelines strongly recommend CoughAssist to prevent respiratory complications in patients with neuromuscular disease. - Bach JR. Eur Respir J. 2003; 21: Cough augmentation with mechanical insufflation/exsufflation produces a significant increase in peak cough flow and facilitates airway secretion clearance in neuromuscular disorders. It has been reported to be successful in avoiding hospitalizations, pneumonias, episodes of respiratory failure, and tracheotomy for patients with Duchenne muscular dystrophy, spinal muscular atrophy, and ALS." - Winck JC, et al. Chest. 2004;126: "In addition to the medical benefits of enhanced airway clearance, the importance of the psychological benefits to patients with NMD should be considered as well." - Miske LJ, et al. Chest. 2004; 125:
13 Mechanical in/exsufflation Kontraindikace Pneumothorax Pokrocila faze COPD, bulozni emfysem, Barotrauma ICP ARDS/ALI Akutni plicni edem Porucha vedomi, neschopnost efektivni komunikace, Warning: Pacienti se znamou obehovou (kardialni) insuficienci: vhodna monitorace behem aplikace MI/E (SpO2, EKG) Jakakoli bolest na hrudniku ci dyspnoe: prerusit MI/E, klinicka diagnostika a prehodnoceni indikace MI/E, CF, bronchiektazie: muze provokovat kolaps ochable, patologicky zmenene steny DC,
14 MI/E, CoughAssist : klinicka aplikace Provedeni: Volba interface Volba rezimu Volba ( kalibrace ) pracovnich tlaku Automaticky rezim: nastaveni T- in/exsufl., T-pause Aplikace MI/E cyklu Odstraneni viditelneho sekretu Pauza cca 30-60sec. Volba rezimu T-insuflace T-exsuflace T-pause On/Off Manometr Manualni ovladani in/exsuflace P-insuflace Flow-insuflace Nastaveni P-in/exsuflace Typicke nastaveni: P-insufl cm H2O, T-insufl. 2-3sec P-exsufl cm H2O, T-exsufl. 2-3sec
15 MI/E, CoughAssist : interface
16 MI/E, CoughAssist : klinicke tipy a triky Priprava pacienta Dostatek casu pri prvni aplikaci, vysvetlit metodu, zkouska masky (interface) pacientem (personalem) Opora pro pacientovu hlavu Smluvit si signaly, komunikaci behem aplikace, Zkouska na necisto (reakce na vzduch, pretlak, podtlak) Interface Kvalitni maska, zkouska tesnosti Tracheostomie: nafoukla tesnici manzeta, adapter pro kolekci sekretu, Naustek: nosni klip, Provedeni Inicialne zkusit co nejnizsi tlak (15cm H2O), nicmene vetsina pacientu vyzaduje 30-40cm H2O, OBS: prilis nizke pracovni tlaky snizuji efektivitu Udrzet max. nadech cca 1-2sec. Manualni rezim pri zahajeni terapie Manualni komprese hrudniku pri vydechu (exsuflaci) Recruitment po ukonceni aplikace LungmedKlin/CoughAssist%20kliniska%20tips.doc
17 MI/E, CoughAssist Souhrn: Bezpecna noninvazivni metoda, vhodna pro home- care Dobra compliance pacienta i personalu User-friendly pristroj Optimalni mobilizace sekretu z distalnich casti DC Doplnuje (i zcela nahrazuje) klasicke odsavani u nekterych onemocneni Prokazana efektivita: kvality zivota, rehospitalizace, pneumonie, (NMD) Cost-effective (USA, Sverige)
Emma Barrett Band 7 Physiotherapist Paediatric Respiratory Care
Emma Barrett Band 7 Physiotherapist Paediatric Respiratory Care Causes of respiratory conditions in this patient group Assessment specifics Management options Physiotherapy techniques Prematurity / chronic
Clearly a better solution. CoughAssist is an effective, more comfortable way to clear airways.
Clearly a better solution CoughAssist is an effective, more comfortable way to clear airways. CoughAssist enables me to not only stay on top of my pulmonary hygiene with airway clearance, but it also helps
Respiratory Therapy Policy / Procedure Lung Volume Recruitment For Paralytic/Restrictive Disorders
Respiratory Therapy Policy / Procedure Lung Volume Recruitment For Paralytic/Restrictive Disorders Lung volume recruitment is a high-risk procedure that may generate droplets, exposing staff to respiratory
Caring for Neuromuscularly Weak Patient
Caring for Neuromuscularly Weak Patient Jonathan D. Finder, MD Associate Professor of Pediatrics University of Pittsburgh School of Medicine Pediatric Pulmonologist Children s Hospital of Pittsburgh QuickTime
Key Points from Dr. John R. Bach s Presentation at the Seventh Annual Speak Foundation Conference in Atlanta, GA (USA) July 24, 2015*
Key Points from Dr. John R. Bach s Presentation at the Seventh Annual Speak Foundation Conference in Atlanta, GA (USA) July 24, 2015* When respiratory weakness from neuromuscular disease occurs, the muscles
SUBJECT INFORMATION AND CONSENT FORM
University of British Columbia SUBJECT INFORMATION AND CONSENT FORM TITLE OF STUDY: A comparison of three methods for improving expiratory cough flow and lung volume in children with neuromuscular diseases
AVAPS-AE Auto-titration Mode of Noninvasive Ventilation. Monique Hom Sr. Clinical Education Manager HHS
AVAPS-AE Auto-titration Mode of Noninvasive Ventilation Monique Hom Sr. Clinical Education Manager HHS AVAPS-AE: Why do we need it? 3 AVAPS-AE AVAPS-AE is an Auto-titration Mode of Noninvasive ventilation
SPINAL MUSCULAR ATROPHY (SMA) is an autosomal recessive disorder and the
SUPPLEMENT ARTICLE Special Considerations in the Respiratory Management of Spinal Muscular Atrophy Mary K. Schroth, MD Department of Pediatrics, University of Wisconsin School of Medicine and Public Health,
Breathing at Ease. A Guide to Noninvasive Ventilation Therapy
Breathing at Ease A Guide to Noninvasive Ventilation Therapy University of Michigan Medical Center Adult Assisted Ventilation Clinic Armando Kurili, BS, CRT Overcoming the Challenges of NIV Therapy Respiratory
2016 Annual Connect Conference Tween and Teen Respiratory Care Dr. Dan Sheehan
2016 Annual Connect Conference Tween and Teen Respiratory Care Dr. Dan Sheehan Staying out of the Hospital Inspiring Respiratory Wellness Topics How to ACTIVELY participate in care DMD Respiratory Muscle
polymyositis body ventilator "iron lungs" "tank ventilators" "jacket ventilators" 1960
1, 1, 2 anterior horn cell neuropathic neuromuscular junctionmyopathic invasive mechanical ventilationnoninvasive ventilation 1 polymyositis body ventilator "iron lungs" "tank ventilators" "jacket ventilators"
Alternatives to Endotracheal Intubation for Patients with Neuromuscular Diseases
Authors: Emilio Servera, MD Jesús Sancho, MD Ma Jesús Zafra, RN Ana Catalá, RN Pedro Vergara, RT Julio Marín, MD Affiliations: From the Rehabilitation and Ventilation Unit, Department of Respiratory Medicine,
Does use of the Cough Assist Machine reduce respiratory morbidity for children with neuromuscular disease?
RESEARCH REPORT Does use of the Cough Assist Machine reduce respiratory morbidity for children with neuromuscular disease? Rachel Phillips BSc Phys (Hons), PgDip Clin Ed Elizabeth Edwards MB ChB FRACP
Respiratory Considerations. Noninvasive Mechanical Ventilation of Neuromuscular disorders. Scoliosis in NMD. Symptoms of Hypoventilation
Respiratory Considerations Noninvasive Mechanical Ventilation of Neuromuscular disorders Heakyung Kim, M.D. Pediatric Rehabilitation Medicine The Children s Hospital of Philadelphia University of Pennsylvania
BIPAP Synchrony TM AVAPS
BIPAP Synchrony TM AVAPS Product Presentation V1.6 Contents Home NIV Solution introduction BiPAP Technology and Auto-Trak algorithm Consensus conference, Chest 1999 The AVAPS algorithm The AVAPS settings
Making breathing easier
Making breathing easier Breathing difficulties can affect some individuals with neuromuscular disorders. Simple measures can be taken to reduce these problems, and in many situations it is possible to
Confirming Diagnosis Through Spirometry
Confirming Diagnosis Through Spirometry Shirley F. Jones, M.D., FCCP I have no conflicts of interest Instructional Objectives At the end of this session, learners will be able to: Select individual patients
AT HOME DR. D. K. PILLAI MUG @ UOM
NON - INVASIVE VENTILATION AT HOME DR. D. K. PILLAI 07.09.2011 MUG @ UOM In the beginning came. OSA (HS) 1. CPAP for OSAHS (Obstructive Sleep Apnoea Hypopnoea Syndrome) 2 NIPPV 2. NIPPV (Non
Non-Invasive Ventilation Reduces Respiratory Tract Infections in Children With Neuromuscular Disorders
Pediatric Pulmonology 43:67 71 (2008) Non-Invasive Ventilation Reduces Respiratory Tract Infections in Children With Neuromuscular Disorders C. Dohna-Schwake, MD,* P. Podlewski, MD, T. Voit, MD, and U.
Non Invasive Ventilation
Non Invasive Ventilation Linda Grady Clinical Nurse Specialist 2010 Non-Invasive Ventilation (NIV) Technique that provides and enhances alveolar ventilation without the use of an endotracheal intubation
Respiratory Care. A Life and Breath Career for You!
Respiratory Care A Life and Breath Career for You! Respiratory Care Makes a Difference At 9:32 am, Lori Moreno brought a newborn baby struggling to breathe back to life What have you accomplished today?
Keeping your lungs healthy
Keeping your lungs healthy A guide for you after spinal cord injury and other neurological conditions Regional Rehabilitation Program This booklet has been written by the health care providers who provide
RESPIRATORY CARE OF SMA AND CHOICES I. IDENTIFYING THE PROBLEM
RESPIRATORY CARE OF SMA AND CHOICES I. IDENTIFYING THE PROBLEM Respiratory care is critically important for individuals with spinal muscular atrophy and affects both their survival and quality of life.
Oxygen - update April 2009 OXG
PRESENTATION Oxygen (O 2 ) is a gas provided in compressed form in a cylinder. It is also available in liquid form, in a system adapted for ambulance use. It is fed via a regulator and flow meter to the
Neuromuscular disorders Development of consensus for diagnosis and standards of care. Thomas Sejersen, Pediatric neurology
Neuromuscular disorders Development of consensus for diagnosis and standards of care Thomas Sejersen, Pediatric neurology What are neuromuscular disorders? How does the field of neuromuscular disorders
Home Healthcare Solutions. Brent Shafer, CEO Healthcare Home Healthcare Solutions
1 Home Healthcare Solutions Brent Shafer, CEO Healthcare Home Healthcare Solutions Home Healthcare Solutions focus Accelerating growth in: Sleep Respiratory Care Home Monitoring International expansion
CENTER FOR KLINISKE RETNINGSLINJER - CLEARINGHOUSE
Bilag 2 - Søgematricer Medline Træning amyotrophic lateral upper motor neuron disease Amyotrophic lateral sclerosis [MeSH] physical fitness [MeSH] physical training exercise therapy [MeSH] Rehabilitation
MECHANISM OF ACTION INDICATIONS
NONINVASIVE VENTILATION Noninvasive ventilation was commonly used in the 1950 s during the polio epidemic, mainly with negative pressure ventilators such as the iron lung. Noninvasive ventilation has recently
Rule of thumb: PEEP reduced cardiac function when its normal, and improves it if increased preload is the problem.
The Basics of Non-Invasive Mechanical Ventilation VENTILATOR SETTINGS TRIGGER - How sensitive the machine is to the patients attempts to breathe. Obviously, should be fairly sensitive. About -1 mmhg is
The challenges of conducting clinical development in rare / orphan diseases: The Industry Perspective
The challenges of conducting clinical development in rare / orphan diseases: The Industry Perspective Thomas Meier, PhD (Chief Scientific Officer) Muscle Study Group, September 22, 2009 Agenda Santhera
Critical Care Resident Respiratory Education Series. Respiratory Care Department Alfred I. dupont Hospital for Children Wilmington, DE.
Critical Care Resident Respiratory Education Series Respiratory Care Department Alfred I. dupont Hospital for Children Wilmington, DE. Objectives: Oscillator a. Theory of operation b. Care of the patient
Ventilator Application of the Passy-Muir Valve David A. Muir Course Outline Benefits Review of the Biased Closed Position No Leak Passy-Muir Valves
Ventilator Application of the Passy-Muir Valve Michael S. Harrell, B.S., RRT Director of Clinical Education-Respiratory mharell@passy-muir.com (949) 833-8255 David A. Muir 23 year-old ventilator dependent
Respiratory failure and Oxygen Therapy
Respiratory failure and Oxygen Therapy A patient with Hb 15 G % will carry 3X more O2 in his blood than someone with Hb 5G % Give Controlled O2 treatment in acute pulmonary oedema to avoid CO2 retention
RESPIRATORY CARE ADVICE : SCOLIOSIS For patients with myotubular and centronuclear myopathy and other congenital myopathies.
AUTHORS NOTE: The following respiratory advice on scoliosis management in patients with congenital myopathy is based on two papers, due to be published soon. Once published, updates will be posted here.
BiPAP/NIV definitions
BiPAP/NIV definitions Bi-level Positive Airway Pressure is a type of non-invasive ventilation to provide positive pressure ventilation supporting patient s spontaneous breathing. A higher pressure (IPAP)
Guide to Respiratory Care for Neuromuscular Disorders
Guide to Respiratory Care for Neuromuscular Disorders National Office info@muscle.ca 2345 Yonge St. Suite 900 Toronto, ON M4P 2E5 Tel: 1-866-MUSCLE-8 416-488-0030 Fax: 416-488-7523 www.muscle.ca Vision
5/30/2014 OBJECTIVES THE ROLE OF A RESPIRATORY THERAPIST IN THE DELIVERY ROOM. Disclosure
THE ROLE OF A RESPIRATORY THERAPIST IN THE DELIVERY ROOM Ona Fofah, MD FAAP Assistant Professor of Pediatrics Director, Division of Neonatology Department of Pediatrics Rutgers- NJMS, Newark OBJECTIVES
Long Term Acute Care Hospital: Criteria for Admission
Easy Choice Health Plan, Inc. Harmony Health Plan of Illinois, Inc. M issouri Care, Inc. Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona, Inc. WellCare Health Insurance of Illinois,
Maria Tosoni & Lindsey Gannon
Maria Tosoni & Lindsey Gannon Thoracic Muscles Muscles of Inspiration External Intercostal Muscles & Intercartilaginous Intercostal Muscles Muscles of Expiration Interosseus Intercostal Muscles Abdominal
DEFINITION OF TERMS CPAP
Title: BiPAP/CPAP Protocol BiPAP/CPAP Protocol EFFECTIVE DATE: APPROVED: POLICY The MD, or the RCP (pursuant to the MD s medical order for respiratory therapy to follow the BiPAP/CPAP protocol), shall
Ventilation 101. Bag-Valve Device. Bag-Valve Device. Self-inflating bag. Flow-inflating bag
Ventilation 101 Bag-Valve Device Self-inflating bag Simple to use Doesn t need a gas source Inflate just until chest rises Doesn t provide CPAP Bag-Valve Device Flow-inflating bag Takes more training/practice
Used to treat tissue hypoxia Improve oxygen supply Reduce the work of breathing Potential to improve medical outcomes and save lives if used
Used to treat tissue hypoxia Improve oxygen supply Reduce the work of breathing Potential to improve medical outcomes and save lives if used appropriately Can cause harm if used inappropriately Main indication
Non-invasive Ventilation (NIV)
Non-invasive Ventilation (NIV) (Risk Associated: Misuse & overuse) Dr.Wagih Ouda ICU Consultant Coordinator HMG Al Qassim Hospital Kingdom of Saudi arabia Objectives Introduction. Goals of NIV. Advantages
QUELLES DIFFERENCES ENTRE BIPAP ET APRV?
ARDS: Challenging the Berlin criteria QUELLES DIFFERENCES ENTRE BIPAP ET APRV? JC RICHARD, A LYAZIDI Geneva Conflicts of interest Our clinical research laboratory has received research grants for clinical
For every breath he takes. Trilogy200 ventilator s added sensitivity lets you breathe easier knowing your patients are where they belong home.
For every breath he takes Trilogy200 ventilator s added sensitivity lets you breathe easier knowing your patients are where they belong home. Sensitive to your patients needs Trilogy200, a portable life-support
When to involve physiotherapy in palliative care?
WHO Collaborating Centre for Palliative Care, Policy and Rehabilitation When to involve physiotherapy in palliative care? Matthew Maddocks NIHR Post-Doctoral Research Fellow Eva Müllauer Specialist Physiotherapist
Oxygen Therapy. Oxygen therapy quick guide V3 July 2012.
PRESENTATION Oxygen (O 2 ) is a gas provided in a compressed form in a cylinder. It is also available in a liquid form. It is fed via a regulator and flow meter to the patient by means of plastic tubing
Function of Respiratory System. Respiratory Failure. Any condition in which the respiratory system fails to do its primary function:
Respiratory Failure Any condition in which the respiratory system fails to do its primary function: Oxygenate arterial blood and eliminate CO2 Function of Respiratory System Oxygenate arterial blood and
Respiratory, Ventilator and Trach Resources
The following excerpt has been taken from the Christopher & Dana Reeve Foundation Paralysis Resource Center website. http://www.paralysis.org/site/c.erjmjuoxfmh/b.1306557/k.a18e/respiratory.htm Respiratory,
Comprehensive Care for Duchenne Muscular Dystrophy
Comprehensive Care for Duchenne Muscular Dystrophy Brenda Wong, MD Cincinnati Children s Hospital Medical Center PPMD Annual Conference 2008 17 July 2008 Comprehensive Care for DMD Historical Perspective
Guiding Protocolized Patient Care through Branching Logic. By Cindy Sparkman, BS, RRT-NPS and Mickey Roach, BS, RRT
Guiding Protocolized Patient Care through Branching Logic By Cindy Sparkman, BS, RRT-NPS and Mickey Roach, BS, RRT University of Utah 2 University of Utah FY2012 Hospitals and Clinics; 4 Hospitals 10 Community
ARTICLE IN PRESS. Neuromuscular Disorders xx (2003) xxx xxx. Workshop report
Neuromuscular Disorders xx (2003) xxx xxx Workshop report 117th ENMC Workshop: Ventilatory Support in Congenital Neuromuscular Disorders Congenital Myopathies, Congenital Muscular Dystrophies, Congenital
Understanding ASV and AVAPS Algorithms
Understanding ASV and AVAPS Algorithms Raj Dasgupta MD, FACP, FCCP Assistant Professor of Clinical Medicine Pulmonary / Critical Care / Sleep Medicine University of Southern California (USC) Outline Central
Abstracts from published studies. Negative-pressure ventilation: is there still a role? A. Corrado, M. Gorini; Eur Respir J 2002; 20:
Abstracts from published studies Relating primarily to: I. Negative pressure ventilation: Negative-pressure ventilation: is there still a role? A. Corrado, M. Gorini; Eur Respir J 2002; 20: 187-197. Negative-pressure
Differentiating Asthma from COPD: Role of History, Physical Examination, Laboratory Studies, and Lung Function Testing
Differentiating Asthma from COPD: Role of History, Physical Examination, Laboratory Studies, and Lung Function Testing Stephen P Peters, MD, PhD, FAAAAI Professor of Medicine, Pediatrics and Translational
April 2015 CALGARY ZONE CLINICAL REFERENCE PULMONARY CENTRAL ACCESS & TRIAGE
April 2015 CALGARY ZONE CLINICAL REFERENCE CENTRAL ACCESS & TRIAGE Introduction Pulmonary consulting services are organized through the Calgary Zone Pulmonary Central Access and Triage (PCAT). Working
Non-Invasive Positive Pressure Ventilation in Heart Failure Patients: For Who, Wy & When?
REUNIÃO CONJUNTA DOS GRUPOS DE ESTUDO DE CUIDADOS INTENSIVOS CARDÍACOS E DE FISIOPATOLOGIA DO ESFORÇO E REABILITAÇÃO CARDÍACA O L H Ã O 2 7 e 2 8 d e J a n e i r o 2 0 1 2 Non-Invasive Positive Pressure
De onderste steen boven. Regionale refereeravond IC 28 november 2012
De onderste steen boven Regionale refereeravond IC 28 november 2012 HISTORY Male 68 year Hypertension COPD gold IV Alcohol & nicotine abusus HISTORY - hospital admission: AE COPD with pneumonia (ph 7.32,
Asynchrony During Mechanical Ventilation Karen J. Bosma, MD, FRCPC
Asynchrony During Mechanical Ventilation Karen J. Bosma, MD, FRCPC Disclosure Statement I have received research funding from Covidien to support a clinical research assistant October 30, 2012 Objectives
PAP Therapy Devices: Delivering the Right Therapy To The Right Patient. Ryan Schmidt, BS,RRT Clinical Specialist Philips Respironics
PAP Therapy Devices: Delivering the Right Therapy To The Right Patient Ryan Schmidt, BS,RRT Clinical Specialist Philips Respironics Conflict of Interest Disclosure(s) I do not have any potential conflicts
Care Considerations In Duchenne Muscular Dystrophy
Care Considerations In Duchenne Muscular Dystrophy Susan L. Kerr, MD; Associate Professor of Clinical Neurology Nicholas J. Silvestri, MD; Clinical Assistant Professor of Neurology Daniel W. Sheehan, PhD,
Philips Respironics CEU Programs
Philips Respironics CEU Programs Sleep therapy presentations Interface and Therapy Options Overview Review the selection and fit of three mask categories: minimal contact or pillow masks, nasal masks,
Sign up to receive ATOTW weekly -
NON-INVASIVE VENTILATION IN THE INTENSIVE CARE UNIT ANAESTHESIA TUTORIAL OF THE WEEK 40 28 th DECEMBER 2006 Richard Beringer Contact: rich@rberinger.wanadoo.co.uk Self assessment Case 1: A previously healthy
COVER PAGE FOR the PDF file of PULMONARY FUNCTION TESTING
Page 1 of 11 COVER PAGE FOR the PDF file of PULMONARY FUNCTION TESTING This Pulmonary Function Testing file was found simply by doing an Internet word search of the phrase pulmonary function testing. It
Home Healthcare Solutions. Don Spence CEO Home Healthcare Solutions Philips Healthcare
Home Healthcare Solutions Don Spence CEO Home Healthcare Solutions Philips Healthcare The transformation of care in the home is required to address demographic changes The issues The consequences Our responses
2.06 Understand the functions and disorders of the respiratory system
2.06 Understand the functions and disorders of the respiratory system 2.06 Understand the functions and disorders of the respiratory system Essential questions What are the functions of the respiratory
NON-INVASIVE VENTILATION
Barcelona Devices for severe heart failure NON-INVASIVE VENTILATION Josep Masip MD, PhD, FESC Intensive Care Medicine Department H. Moisès Broggi - Sant Joan Despí. Barcelona Consorci Sanitari Integral
Ultrasound of muscle disorders
Ultrasound of muscle disorders Sigrid Pillen MD PhD Pediatric neurologist The Netherlands Disclosures None "Muscle ultrasound disclaimer" Muscle ultrasound Introduction Specific NMD Quantification Dynamic
Standard of Care: Pulmonary Physical Therapy Management of the patient with pulmonary disease
BRIGHAM & WOMEN S HOSPITAL Department of Rehabilitation Services Physical Therapy Standard of Care: Pulmonary Case Type / Diagnosis: This standard of care applies to any patient with obstructive or restrictive
SIGNS AND SYMPTOMS OF RESPIRATORY DISEASES LEARNING OBJECTIVES:
SIGNS AND SYMPTOMS OF RESPIRATORY DISEASES LEARNING OBJECTIVES: By the end of this session, students should be able to: Enumerate the various symptoms of respiratory disorders. Enumerate the different
Objectives COPD. Chronic Obstructive Pulmonary Disease (COPD) 4/19/2011
Objectives Discuss assessment findings and treatment for: Chronic Obstructive Pulmonary Disease Bronchitis Emphysema Asthma Anaphylaxis Other respiratory issues Provide some definitions Chronic Obstructive
Nutrition support in neurodegenerative diseases
ESPEN Congress Leipzig 2013 The ESPEN Guidelines session Nutrition support in neurodegenerative diseases R. Burgos (ES) ESPEN GUIDELINES ON NUTRITION SUPPORT IN NEURODEGENERATIVE DISORDERS Dr. Rosa Burgos
Workshop: Pulmonary rehabilitation and NIV
Workshop: Pulmonary rehabilitation and NIV Jean-Christian Borel INSERM U 1042, HP2 Laboratory, University Joseph Fourier, Grenoble, France, AGIRadom, Research and Development department, Meylan, France
Titration protocol reference guide
Titration protocol reference guide Description Page Titration protocol goals 4 CPAP protocol CPAP protocol 6 CPAP titration protocol 7 CPAP reimbursement criteria 8 BiPAP S protocol BiPAP S protocol 10
308 Nasal CPAP 308 / Page 1 Of 7
308 Nasal CPAP 308 / Page 1 Of 7 Description CPAP via nasal mask may be used to relieve upper airway obstruction. Nasal CPAP is primarily used with patients who suffer from sleep apnea disorders. It is
Nature of disability. Hospital Details +91 44 22568009 +91 33 25111359. TEL : +91 22 6711 6618 / 09 l FAX : +91 22 26156290 +91 11 49637953
Nature of disability Hospital Details TEL : +91 22 6711 6618 / 09 l FAX : +91 22 26156290 +91 11 49637953 +91 44 22568009 +91 33 25111359 Information Sheet for Guest Requiring Medical Clearance (to be
Divadlo Národný dom. ! Streda!7.!11.!2012!!! 19.00!BUDOVA!DIVADLA!!SLÁVNOSTNÉ! OTVORENIE!ZJAZDU!!
PROGRAM Strana:1 Streda7.11.2012 19.00BUDOVADIVADLA SLÁVNOSTNÉ OTVORENIEZJAZDU Divadlo Národný dom Štvrtok8.11.2012 8.30 10.00 DEGENERATÍVNEOCHORENIA BLOK1 Predsedníctvo:BrožováH,CibulčíkF SkúsenostisliečbouParkinsonovejchoroby
Functional ability and muscle force in healthy children and ambulant Duchenne muscular dystrophy patients.
CHAPTER 3 Functional ability and muscle force in healthy children and ambulant Duchenne muscular dystrophy patients. Functional ability and muscle force in healthy children and ambulant Duchenne muscular
The Basics of ASV. Tips to a Successful Titration. Susan Keller Yenney, RPSGT
The Basics of ASV Tips to a Successful Titration Susan Keller Yenney, RPSGT The Basics of ASV - Objectives Understand ASV terminology Recognize parameters which need to be adjusted Differentiate between
Chapter 17 Medical Policy
RAD-1 LCD for Respiratory Assist Devices (L11482) Contractor Information Contractor Name Contractor Number 00635 Contractor Type LCD Information LCD Database ID Number L11482 AdminaStar Federal, Inc. DMERC
RESPIRATORY VENTILATION Page 1
Page 1 VENTILATION PARAMETERS A. Lung Volumes 1. Basic volumes: elements a. Tidal Volume (V T, TV): volume of gas exchanged each breath; can change as ventilation pattern changes b. Inspiratory Reserve
Titration protocol reference guide
Titration protocol reference guide Titration protocol reference guide Description Page Patient types 3 Titration protocol goals 4 CPAP CPAP protocol 5-6 auto CPAP auto CPAP protocol 7-8 BiPAP S BiPAP S
HLTEN609B Practise in the respiratory nursing environment
HLTEN609B Practise in the respiratory nursing environment Release: 1 HLTEN609B Practise in the respiratory nursing environment Modification History Not Applicable Unit Descriptor Descriptor This unit addresses
Arterial Blood Gas Interpretation. Self-Learning Module
Arterial Blood Gas Interpretation Self-Learning Module Introduction Washington Hospital Center Nursing Education Department Arterial blood gas (ABG) results enable nurses to assess and monitor a patient
RES Non-Invasive Positive Pressure Ventilation Guideline Page 1 of 9
Page 1 of 9 Scope: Respiratory Care Department, Physicians, Advanced Nurse Practitioners (APRN), Physician Assistants (PA) Population: Patients receiving rescue or non-rescue non-invasive positive pressure
Caring Choices. For Parents of Infants Newly Diagnosed with SMA Type 1 SMA CARE SERIES
Caring Choices For Parents of Infants Newly Diagnosed with SMA Type 1 SMA CARE SERIES SMA CARE SERIES - Caring Choices Contents Dear Parents, Friends and Family Members 3 What Decisions are Ahead 4 What
Physiotherapy for children with Neuromuscular Disorders
Physiotherapy for children with Neuromuscular Disorders Special considerations for therapists, schools and parents, recommendations and latest research. Chiara Tewierik, Neurosciences Physiotherapist,
D04/ODN/a NHS STANDARD CONTRACT FOR NEUROMUSCULAR OPERATIONAL DELIVERY NETWORKS SCHEDULE 2- THE SERVICES A. SERVICE SPECIFICATIONS
D04/ODN/a NHS STANDARD CONTRACT FOR NEUROMUSCULAR OPERATIONAL DELIVERY NETWORKS SCHEDULE 2- THE SERVICES A. SERVICE SPECIFICATIONS Service Specification No. Service Commissioner Lead Provider Lead Period
Families of Spinal Muscular Atrophy
Families of Spinal Muscular Atrophy Transcript of Respiratory Issues in SMA Chat, Monday, November 13, 2006, with Dr. Mary Schroth, Pediatric Pulmonologist at the University of Wisconsin in Madison. While
Section III. Revisions Approved 3/7/12 Effective 6/1/12; replaces 9/8/04; 12/1/11 and all prior versions of Protocols III.28/III.
PROTOCOL III.28: Non-Invasive Positive Pressure Ventilation (NIPPV) and use of AEV Portable Ventilator EMT-BASIC EMT-INTERMEDIATE EMT-PARAMEDIC Introduction: NIPPV (CPAP/BiPAP) has been used effectively
Spinal Cord Injury Education. An Overview for Patients, Families, and Caregivers
Spinal Cord Injury Education An Overview for Patients, Families, and Caregivers Spinal Cord Anatomy A major component of the Central Nervous System (CNS) It is 15 to 16 inches long, and weighs 1 to 2 ounces
06/05/2014. Respiratory Medicine Professor Colin Sullivan
1 Respiratory Medicine Professor Colin Sullivan 2 3 Modalidade utilizada em 90% dos casos. Thorax 1998 53: 416-18 Lancet 1999 353:2100-05 AJRCCM 2004 169:156-62 AJRCCM 161:857-5-859, 2000 Chest 2005; 128:1304-1309
FEV 1 (PEF) ( % (FEV 1 %) PEF (PEF%) PEF% FEV 1 % Bland- Altman (-27.4% +28.8%) 5% 5% (airflow limitation);
CHEST FEV 1 Ashutosh N. Aggarwal, MD, FCCP; Dheeraj Gupta, MD, FCCP; and Surinder K. Jindal, MD, FCCP FEV 1 (PEF) ( % ) 6 y 6 167 FEV 1 (FEV 1 %) PEF (PEF%) PEF% FEV 1 % PEF% FEV 1 % Bland- Altman PEF%
Quality Scorecard overall heart attack care overall heart failure overall pneumonia care overall surgical infection rate patient safety survival
Quality Scorecard s are required to report quality statistics to the s for Medicare and Medicaid Services (CMS) and the Department of Health (DOH). This information is made available at www.hospitalcompare.hhs.gov
Hospital of the University of Pennsylvania Physician Practice Guideline
Page 1 of 5 KEY WORDS: Ventilator Respirator Weaning Extubation Liberation PURPOSE: To facilitate the liberation of patients from mechanical ventilation and provide a consistent approach to the ventilator
University of Kansas. Respiratory Care Education
University of Kansas Respiratory Care Education What is Respiratory Care? Respiratory Care is the health profession that specializes in the promotion of optimum cardiopulmonary function and health Respiratory
SIMPLY Oxygen Therapy. Dr William Dooley
SIMPLY Oxygen Therapy Dr William Dooley Plan Indications Delivery methods CPAP vs BiPAP Oxygen Devices Classified by Performance (variable or fixed) Duration (short term or long term) Flow (low or high)
Asthma in Older Adults: overcoming the challenges of diagnosis and management
Asthma in Older Adults: overcoming the challenges of diagnosis and management Jennifer Gonzalez McComb, MD, MPH, FACP Section Chief, Pulmonary and Critical Care Medicine UPMC Shadyside Hospital April 9,
February 2016 CALGARY ZONE CLINICAL REFERENCE PULMONARY CENTRAL ACCESS & TRIAGE
February 2016 CALGARY ZONE CLINICAL REFERENCE CENTRAL ACCESS & TRIAGE Introduction Pulmonary consulting services are organized through the Calgary Zone Pulmonary Central Access and Triage (PCAT). Working
NORTH WALES CRITICAL CARE NETWORK
NORTH WALES CRITICAL CARE NETWORK LEVELS OF CRITICAL CARE FOR ADULT PATIENTS Throughout the work of the North Wales Critical Care Network reference to Levels of Care for the critically ill are frequently