Resp Care
-
Ventilator manufacturers and the respiratory care academic community have not yet adopted a standardized system for classifying and describing ventilation modes. As a result, there is enough confusion that potential sales, education, and patient care are all put at risk. This proposal summarizes a ventilator-mode classification scheme and complete lexicon that has been extensively published over the last 15 years. ⋯ For a complete and unique mode specification (as in an operator's manual) we would use all 3 components. The classification system proposed in this article uses the equation of motion for the respiratory system as the underlying theoretical framework. All terms relevant to describing ventilation modes are defined in an extensive glossary.
-
Though advances in medical science have created improved therapies, often these are not widely provided throughout the health-care system. Also, there is growing recognition of the lack of safety in health-care delivery. ⋯ This paper explores the parallel developments in safety and quality-of-care assessment, evidence-based medicine, guideline creation, and how development of national and international quality-improvement campaigns are promoting rapid change in care delivery processes. I discuss how this new opportunity can improve the quality of respiratory care and enhance the adoption of respiratory care protocols.
-
To determine the effect of endotracheal-tube cuff deflation on airflow and F(IO2) during high-frequency percussive ventilation (HFPV), and explore methods of correcting the cuff-deflation-associated decrease in mean airway pressure and F(IO2) at the carina. ⋯ Cuff-deflation-associated F(IO2), P(aw), and pulsatile V(T) compromise can be partially corrected by any of the 4 methods we studied. Injecting supplemental oxygen at the inspiratory fail-safe valve is the most effective method.