Resp Care
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The health professional needs to make an educational diagnosis before he selects a specific approach to patient education. Tailoring a patient education program to the patient's belief regarding his health and the patient's expectations regarding his diagnosis and care is useful. ⋯ An educational program oriented to patients who demonstrate success when group strategies and support are used should encourage them to believe that their health can be controlled, even if it is dependent upon powerful others. Values clarification and behavior modification are also helpful in patient education.
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Comparative Study
A comparison of the oxygen cost of breathing between a continuous-flow CPAP system and a demand-flow CPAP system.
We undertook a study to measure the difference in work of breathing, as reflected by oxygen uptake (VO2) and carbon dioxide production (VCO2), between that on a continuous-flow CPAP system (Emerson IMV) and that on a demand-flow CPAP system (Bennett MA-2). A specially designed valve permitted the isolation and collection of expired gases from the Emerson IMV/CPAP ventilator. Ten patients receiving CPAP therapy were selected for study. ⋯ Analyses of VO2, VCO2, respiratory quotient, minute ventilation, tidal volume (VT), respiratory rate, and FIO2 were made serially at approximately 45-second intervals for 8 minutes. A comparison between the Emerson continuous-flow CPAP system and the MA-2 demand-flow CPAP system revealed that with the MA-2 the mean values for VO2, VCO2, and VT were, respectively, 16.3%, 12.6%, and 6.4% higher, a statistically significant difference. We believe that this difference was probably due to the additional effort required of the patient on the MA-2 to open and close the demand valve.
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Spirometry is widely performed by a variety of health professionals in settings outside the traditional pulmonary function laboratory. It is important to very that test results are accurate, because they are used to establish diagnoses and guide therapy. A quality-control program will help verify the accuracy of testing procedures and must be developed based on equipment, personnel, and test application. ⋯ Technicians are often evaluated on the ability to prepare, calibrate, and troubleshoot equipment, gain patient cooperation, determine the adequacy of effort, and calculate spirometry results. Calibration techniques may help in many aspects of this evaluation. Finally, advanced techniques may be used to study the methods used in performing clinical spirometry.