Resp Care
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To help prevent the use of manual resuscitators without supplemental oxygen we developed a device that automatically starts the flow of oxygen when the resuscitators is put into use and then stops the oxygen flow when the resuscitator is returned to its assigned resting place. This instant oxygen delivery valve does not compromise oxygen flowrates from the gas source. We have used this device without problems for several months in our intensive care until.
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The field of respiratory care has expanded quickly because of the technological advances of the past decade. This expansion has led the respiratory therapy practitioner (RTP) to view himself as functioning in a capacity that goes beyond technical competence to include patient evaluation and management. Other health care professionals, however, seem reluctant to accept this broadened role. ⋯ No significant difference was found in expectations related to the removal of bronchopulmonary secretions. It is clear that the role of the RTP is not completely identified, accepted, or understood. Because of the inconsistencies in role expectations, the potential for role conflict may be increased and the effectiveness of the health care team reduced.
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It is generally recognized that nebulizers can be a source of nosocomial infection. 'Cold mist' room humidifiers are a particular problem because they are difficult to sterilize. We evaluated a new device, the Sonic Mist ultrasonic room humidifier, to determine how quickly it became contaminated during continuous use by a population of cystic fibrosis patients. In addition, the study was designed to test the effectiveness of placing a bacterial filter on the air inlet of the humidifier. ⋯ A further test of the inlet filter was performed by exposing filtered and unfiltered units to mist from an intentionally contaminated humidifier. Again, the contamination rate was low and the filter apparently made no difference. These results indicate that the Sonic Mist humidifier may be appropriate for hospital use if adequate sterilization and contamination-monitoring practices are followed.
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Because of its portability, the hand-held computer can be easily used at the bedside to perform mathematical computations and assist with patient care decision making. This paper describes applications software for arterial blood gas interpretation with the hand-held computer. From the arterial blood gas values entered, the program calculates the arterial/alveolar PO2 ratio (a/A PO2), provides an interpretation of oxygenation, a/A PO2, ventilation, and acid-base status, and makes suggestions for therapy. This program can be used for the individualized bedside teaching of students and others with limited experience in arterial blood gas interpretation.
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Comparative Study
Impact on ventilator-check time of an in-circuit computerized respiratory monitoring system.
To ensure appropriate quality control of mechanical ventilatory support in our institution, checks of patient status and ventilator performance are made every 2 hours. Our standard method of surveillance requires disconnecting the patient from the ventilator and connecting him to extraneous monitoring devices. We assessed the use of an in-circuit computerized respiratory monitoring system for ventilator surveillance and found that with this system significantly less therapist time was required to perform a check (5.8 +/- 1.18 minutes vs 9.9 +/- 1.53 minutes for the standard procedure) and that use of this system avoids the potential hazards associated with disconnecting a patient from the ventilator and introducing additional monitoring devices to the airway.