Resp Care
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We evaluated the performance and safety of 10 disposable resuscitators -- six adult units: SPUR, Code Blue, 1st Response, Hospitak MPR, CPR Bag, and Pulmanex; and four pediatric units: CPR Bag, 1st Response, Hospitak MPR, and LSP Bag Mask. ⋯ We conclude that only Code Blue, 1st response, Pulmanex (with tube-type reservoir), and SPUR meet ASTM Standard F-920 and are acceptable replacements for permanent resuscitators.
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Because little information has been available regarding common respiratory care practices in neonatology and pediatrics, it has been difficult to develop departmental standards of care. We therefore conducted a national survey of current practices, hoping to establish whether any de facto standards exist in the U.S. ⋯ While we do not claim that such de facto standards have a scientific basis, we suggest that respiratory care services whose practices vary from the de facto standards should investigate why their own practices differ and whether they can be justified.
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Due to increasing concern over potential cross-infection during cardiopulmonary resuscitation (CPR), a number of disposable resuscitators have become commercially available. The wearing of disposable medical gloves by persons performing CPR has also become commonplace. In this study, we evaluated the effects of hand size, use of disposable medical gloves, and number of hands used (one versus two) on the volumes delivered by five adult disposable resuscitators. ⋯ The use of gloves did not significantly affect volume delivery. Delivered volumes did increase significantly as hand size increased and as number of hands used to squeeze the bag increased, and observed differences in volume delivery between brands of resuscitators may be clinically important in some cases. This study emphasizes the importance of squeezing the resuscitator with two hands during bag-valve ventilation.
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We sought to determine the potential for disposable prefilled humidifiers to become contaminated during extended patient use. ⋯ An automatic 72-hour change-out for prefilled humidifiers used with low-flow oxygen (less than or equal to 4 L/min) is wasteful. Our study demonstrates that the use-time of humidifiers can be safely extended to as long as 6-12 days.
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Today we are faced with an ever-expanding array of technologies that allow monitoring to be accomplished more accurately and more easily than before. Each institution's needs differ--yet, the methods for determining appropriate utilization are similar. A rational method of utilization includes a criteria-based process for deciding who will be monitored and when. ⋯ However, they do carry the risk of increasing the overall cost of health care and of distracting us from personally assessing our patients. The existence of an expensive device is not reason enough to employ it. If it were, I would have a difficult time responding to my wife's frequent question of, "If they can send one man to the moon, why can't they send them all?"