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PageRespiratory!

PageRespiratory!

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PageRespiratory!'s Latest Activity

  1. PageRespiratory!

    RT's Drawing from a UAC

    >What an incredible waste of resources.
  2. PageRespiratory!

    RT's Drawing from a UAC

    >Same in both NICU's I previously worked in. We also administered all the surfactant.
  3. PageRespiratory!

    Why hospitals continue use incentive spirometry

    >Not to mention the costs ($) associated with positive pressure therapy. I would imagine the longer term hidden costs would be notable as well, positive pressure used for lung recruitment can be dangerous. For sure, its bound to be appropiate for certain Pt populations however. As it stands, NIPPV is for Pts with acute respiratory failure that still have spontaneous effort and a patent AW. Certain NIPP ventilators may be used on intubated Pts as well, The Vision BiPAP by Respironics for example.
  4. PageRespiratory!

    Why hospitals continue use incentive spirometry

    >Hey, I just call 'em as I see 'em. Let me get this straight, you make an incredibly vague post questioning a procedure citing something you read somewhere. And then when another poster suggests the hospital may bill for it because its provided by a different profession than yours, you agree. And then after four pages of posters asking you to cite what you "read somewhere" you post the title of a nursing textbook. Perhaps for the benefit of the "OTHERS" you can tell us the chapter or even the page you're talking about. FTR: According to Chapter 39, pg. 907 under the ASSSESMENT OF OUTCOME heading in 'Egans Fundamentals of Respiratory Care' 9th edition, the benefits of I.S. include - improvement in signs of atelectasis, decreased RR, resolution of fever, return to normal pulse rate, improved breath sounds, improvement in chest radiograph, increased PaO2 & decreased PaCO2 (be sure not to confuse with PAO2 & PACO2), improved vital capaciy and peak flows, return of FRC to preoperative values (unless a pnuemonectomy was performed) and improved inspiratory muscle function. All this with a fairly inexspensive, non invasive, portable, easy to operate piece of equipment.
  5. PageRespiratory!

    Nassau Community College

    >Undoubtedly a Malloy student that just realized they're getting half the education for ten times the cost.GO LIONS!
  6. PageRespiratory!

    Why hospitals continue use incentive spirometry

    >>Cripes, why don't they just order IPPB? NIPPV is a VENTILATOR, for Pt's with acute respiratory failure.
  7. PageRespiratory!

    Why hospitals continue use incentive spirometry

    What are you getting at? Out with it already. I cannot find one single piece of literature that states "I.S. doesn't work", and about 500 that says it is effective. This one inparticular: The AARC clinical guidelines for SMI (Do you even know what that means?) http://www.rcjournal.com/cpgs/ispircpg.html] outlines it the best.Me thinks the OP is full of it and has a hidden agenda.
  8. PageRespiratory!

    arterial line insertion by OR/PACU nurses

    "Back from the dead 'yall.........back from the dead"
  9. PageRespiratory!

    SIMV mode and initiating a breath

    Synchronized...Intermittent...Mandatory...Ventilation...SIMV is a set rate (volume control or pressure control [either a set tidal volume or insp pressure]) and the Pt is able to breathe spontaneously (with or without pressure support) inbetween mandatory breaths. Pressure support is only activated during spontaneous breaths. In Assist Control (often called CMV or AC) the Pt may initiate a breath but it will be a set mandatory breath. There should be a trigger setting (pressure or flow) that determines how much effort is neccessary to initiate a breath. Often a vent will "autotrigger" if this is set to low, and/or, there is a lot of condensation (rainout) or some sort of partial occlusion or something in the circuit.
  10. PageRespiratory!

    The Best Route to a CRNA

    >>Hello cart, meet horse.
  11. PageRespiratory!

    Hyperpnea vs. Hyperventilation vs. Kussmaul's

    >Absolutely agree with everything excpet above quoted. An I'll admit I may be splitting hairs here, but "Ventilation" can only be assesed with a CO2 measurement. It seems to me WOB is what you're refering to. I often administer morphine to the dyspneic terminally ill Pt. and you're correct, CO2 (ventilation) is not a concern, easing thier WOB is what we're after. EGANS Fundamentals of Respiratory Care 9th edition, page 235: "Ventilation is determined by the partial pressure of CO2 and the resulting pH, specifically in the arterial blood. Ventilation is effective when the PaCO2 is maintained at a level that keeps the pH WNL." I definalely agree with you, this isn't "Right Vs. Wrong" it's more like "which term do you like better" LOL!
  12. PageRespiratory!

    BIPAP ventilation

    Holy jeez, was that question from 1998?!?!
  13. PageRespiratory!

    What is considered a large hospital??

    When I worked in a 1200 bed county hospital, I had a per diem gig at a "small" 400 bed community hospital, this was in metro NY. I now work in northern New England at a 25 bed hospital, the closest major tertiary care center is about 400 beds and considered huge.
  14. PageRespiratory!

    BIPAP ventilation

    As far as I understand it, the modes of ventilation on any brand ventilator can be labeled anything the manufacturer wants. So the term 'BiPAP' is actually a brand name that belongs to Respironics and whatever other company owns them. The techinical name for 'BiPAP' is NIPPV (Non-invasive positive pressure ventilation) and usually refers to .....you guessed it....positive pressure ventilation with a mask. The most commmon NIPPV machines can deliver a set FiO2, offer 2 levels of pressure to ventilate the Pt by. NIPPV is contraindicated in the apneic Pt. A RR is set, however its only a back up rate meaning it will try to deliver a set number of breaths if the Pt becomes apneic. Because it is non invassive, Pt readings (such as Vt) can only be estimated. Many invasive ICU ventilators have modes that provide similar support as NIPPV, but through an ETT. This is most often the 'CPAP' mode, not to confused with Continous Positive Airway Pressure (A different mode of NIPPV). Respironics (or whoever owns them) may indeed make an invasive ventilator, and it may have a mode called "BiPAP', I haven't seen it though.
  15. PageRespiratory!

    So we have a Code coming in....

    > That means you're doing it correctly. Did you notice how violent the thumper seemed to be? Quality CPR is ugly.
  16. PageRespiratory!

    So we have a Code coming in....

    > The only way to really asses the efficacy of chest compressions is to feel for the carotid pulse while administering compressions.