Aerosol Therapy Equipment PDF

Specialized SVNs – Respigard II Small-Volume Nebulizer Utilizes an expiratory filter Capable of particles < 2 microns Often used to administer Pentamidine (for PCP) Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 40  – Salter Labs Medical...

Specialized SVNs – Respigard II Small-Volume Nebulizer Utilizes an expiratory filter Capable of particles < 2 microns Often used to administer Pentamidine (for PCP) Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 40  – Salter Labs Medical Products NebuTechTM HDNTM Enhances delivery during inspiration via one-way valves 80% of delivery is < 5 microns Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 41  – Monaghan Medical Corporation AeroEclipse® Breath-Actuated Nebulizer Nebulizes only on inspiration – Less medication wasted – Smaller doses may be effective Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 42 Aerosol Therapy Equipment (continued) Aerosol Administration Devices – Brigg’s adapter or aerosol T – Aerosol mask – Trach mask – Face tent Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 43 Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 44  Brigg’s Adapter (aerosol T) 2 / 22mm ports opposite each other w/ a 15mm port @ right angle Use w/ 6” aerosol tubing as a reservoir Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 45  Aerosol Mask Similar to simple mask, but inlet is for large bore (blue) tubing (22mm) Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 46  Trach Mask Fits over a tracheostomy tube; secured w/ elastic strap; 22mm large-bore inlet Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 47  Face Tent Straps under chin, enclosing only lower part of face Used in recovery & for facial burns Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 48  Aerosol Therapy Equipment (continued) Metered Dose Inhalers Pressurized canister containing propellant and drug Propellants – Chlorofluorocarbons (CFCs): no longer used due to damage to the ozone layer – Hydrofluoroalkane (HFA): only propellant used in the currently available MDIs Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 49 Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 50  MDI Administration Good positioning is key to lung expansion! – Patient should be sitting up Breathe out fully through mouth. Insert mouthpiece into mouth and seal lips around it – If no spacer avaliable, hold MDI a few cm in front of mouth Press down on canister at beginning of breath; breathe in slowly and deeply. Perform an inspiratory hold for up to 10 seconds Exhale slowly, repeat to achieve desired dose 51  Holding Chamber vs Spacer Allows propellant to evaporate/slows delivery Larger particles fall out Holding chamber – has one way valve that will hold medication for a few seconds – Good for pts. w/ poor coordination Spacer – No one-way valve, medication goes directly to patient Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 52 Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 53 54  Dry Powder Inhalers – Aerosol in a dry powder form – Ambient air drawn through a small dose – No propellant needed – Pt must have sufficient inspiratory flow 40 to 60 L/min minimum – Diskhaler, Diskus, Turbuhaler, Ellipta Must make sure to keep unit level to avoid dry powder falling out Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 55  Diskhaler Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 56  Diskus Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 57  Turbuhaler Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 58 Aerosol Therapy Equipment (continued) Large-Volume Nebulizers – Used to provide continuous aerosol therapy – Large-bore aerosol tubing maximizes delivery – May deliver either: Cool/warm mist Aerosolized medication Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 59 Large Volume Neb for Cool Mist Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 60 Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 61  HEART Nebulizer High Output Extended Aerosol Respiratory Therapy Intended for continuous administration of aerosolized meds 240 mL reservoir 2.2 – 3.5 microns Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 62  Vortran HEART Neb Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 63  Small-Particle Aerosol Generator Specifically designed to deliver ribavirin as treatment for RSV Mean diameter of 1.3 microns 2 gas supplies – 26 psi to create aerosol – 2ndary supply for drying chamber to further reduce diameter Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 64  SPAG (cont’d.) Ribavirin administered via tent or hood Potential toxic effects of drug: – Conjunctivitis, rash, bronchospasm – No pregnant/nursing exposure Precautions – Negative P room – HEPA mask, gloves, gown, goggles Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 65  SPAG-2 Nebulizer Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 66  Ultrasonic Nebulizers Utilize high-frequency sound waves (Hz, amplitude) Components: generator, cabel, pizoelectric crystal, reservoir, fan frequency = smaller particles (1-10 microns amplitude = greater output Hazards: shock, nosocomial infections Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 67  Comparison b/t Frequency & Amplitude Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 68  Ultrasonic Neb Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 69 Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 70  DeVilbiss Ultra Neb 99 Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 71  Small-Volume Ultrasonic Nebs for Medication Delivery Ultrasonic nebs w/ fill volume of < 10mL Internal battery, 12v & 120v adapters Smaller particles than conventional gas- powered nebs Expensive Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 72  Small Volume Ultrasonic Nebs Plug in models Battery powered models 74 Vibrating Mesh Nebulizers Pumps push fluid through vibrating mesh to create aerosol. Produce particle sizes ranging from 2 to 5 μm Do not require propellants or gas to produce an aerosol; no gas is added to aerosol stream Shown to be more efficient than jet nebulizers Aerogen 75 Aerosol Therapy Equipment (continued) Pediatric Aerosol Tents – Croupette – Ohmeda Pediatric Aerosol Tent – Mistogen Child Adult Mist (CAM) Tent Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 76  Croupette Commonly used for pediatric aerosol therapy (see chapter 1) Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 77  Ohmeda Pediatric Aerosol Tent Self-contained refrigerated aerosol generator (keeps tent cool) No tent in picture Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 78  Mistogen Child/Adult Mist Tent Chills & circulates H2O to cool tent Incorporates a Mistogen HV-12 neb Copyright ©2005 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 79