Effect of Continuous Cuff Pressure Regulator in General Anaesthesia with Laryngeal Mask Airway
|
|
- Derick Turner
- 5 years ago
- Views:
Transcription
1 The Journal of International Medical Research 2011; 39: Effect of Continuous Cuff Pressure Regulator in General Anaesthesia with Laryngeal Mask Airway Y-S JEON, J-W CHOI, H-S JUNG, Y-S KIM, D-W KIM, J-H KIM AND J-A LEE Department of Anaesthesiology and Pain Medicine, Saint Vincent Hospital, The Catholic University of Korea, Suwon, Kyeonggi-Do, Republic of Korea Postoperative pharyngolaryngeal complications (PPLC) occur during anaesthesia due to increased cuff pressure following the insertion of laryngeal mask airways. The use of a pressure regulator to prevent PPLC was evaluated in a prospective, randomized study. Sixty patients scheduled to receive general anaesthesia were randomly assigned to two equal groups of 30, either with or without the regulator. The just seal cuff pressure (JSCP), cuff pressure at 5-min intervals during anaesthesia, incidence of pharyngeal sore throat (PST), dysphagia, dysphonia and other complications were evaluated at 1 and 24 h postoperatively. The combined mean ± SD JSCP of both groups was 20.3 ± 3.2 mmhg. In the group with the regulator, cuff pressure was maintained at a constant level during anaesthesia. This study demonstrated that the regulator is a simple, functional device that can reduce the incidence of PST significantly at 1 h postoperatively, following general anaesthesia. KEY WORDS: PHARYNGOLARYNGEAL COMPLICATION; CUFF PRESSURE; CUFF VOLUME; ANAESTHESIA; REGULATOR Introduction The insertion of a laryngeal mask airway (LMA) to induce inhalation anaesthesia commonly causes a number of postoperative pharyngolaryngeal complications (PPLC). Cuff inflation with air and use of nitrous oxide as an inhalation agent during anaesthesia is one of the main causes of PPLC. Diffusion of nitrous oxide into the cuff increases the cuff volume and pressure and reduces oral mucosal perfusion. Finally, it can cause postoperative sore throat, dysphagia, dysphonia and, in rare cases, nerve injury. 1 To prevent PPLC, the manufacturer recommends that cuff pressure should be checked periodically, with the cuff volume withdrawn intermittently to maintain 44 mmhg or the minimal just seal cuff pressure (JSCP) during general anaesthesia. 2 Nevertheless, clinicians tend to inflate the cuff with maximal volume and do not use a cuff manometer in the clinical situation. Another difficulty is that the volume required to maintain JSCP in even the same patient may vary depending on the size of the LMA used, due to the relative size difference between the hypopharynx and LMA. A cuff volume change of just 1 2 ml, or simply touching the inflation indicator balloon, can make a considerable difference in cuff 1900
2 pressure. 2 Thus, there is need for a mechanism to maintain constant cuff pressure during anaesthesia. If the JSCP is set up based on the recoil characteristics of a syringe and is maintained during anaesthesia, PPLC may be effectively reduced. The present study aimed to measure JSCP following the insertion of LMA in patients undergoing general anaesthesia. In addition, the use of a simple pressure regulator designed to maintain the minimal JSCP in order to reduce PPLC in patients was evaluated. Patients and methods PATIENTS Patients were recruited from Saint Vincent Hospital, The Catholic University of Korea, Suwon, Republic of Korea, between January and April Inclusion criteria for the patients undergoing anaesthesia were American Society of Anesthesiologists physical classification status I or II and age between 18 and 80 years old. Patients were excluded if they were undergoing head and neck surgery or had positional change of the trunk, oral cavity problems or chronic obstructive pulmonary disease. Patients were randomly assigned to one of two groups, by opening a sealed envelope: group 1 underwent anaesthesia without a cuff pressure regulator; and group 2 underwent anaesthesia with a cuff pressure regulator following insertion of the LMA. This study was carried out following approval of the Saint Vincent Institutional Review Board, The Catholic University of Korea. Written informed consent for the study was obtained from all patients scheduled to receive general anaesthesia for 1 2 h. PROCEDURE FOR ANAESTHESIA Anaesthesia was induced with 2 mg/kg propofol and muscle relaxation was achieved with 0.6 mg/kg rocuronium intravenously (i.v.). The LMA (LMA Classic, LMA North America Inc., San Diego, CA, USA) sizes used were: size 3 (> 50 kg) or size 4 ( 50 kg) for women; size 4 (> 70 kg) or size 5 ( 70 kg) for men. Cuff pressure was deflated to 45 mmhg before insertion and the cuff was again inflated with 10 ml air before LMA insertion. LMA insertion was performed using the indexfinger insertion technique by an experienced anaesthesiologist. Patients who underwent three or more attempts for LMA insertion were excluded. After LMA insertion, the cuff was inflated with an additional 10 ml of air via a three-way stopcock (labelled i in Fig. 1) using a 20-ml plastic syringe. After achieving adequate cuff inflation, redundant air within the cuff was withdrawn through the syringe. This manipulation was performed three times at 1-min intervals and the mean pressure was recorded as the initial cuff pressure (0 min), termed the JSCP. The cuff volume in this state was termed the just seal cuff volume, namely the preinsertional air volume (10 ml) plus the additional air volume. The adequacy of LMA insertion was evaluated by the Keller method using a fibrescope (score 1, vocal cords not seen; score 2, vocal cords plus anterior epiglottis; score 3, vocal cords plus posterior epiglottis; score 4, only vocal cords seen). 3 Gas leakage was confirmed by the detection of audible noises in the mouth by use of a stethoscope. The end tidal carbon dioxide concentration and tidal volume were confirmed for adequate ventilation. Patients were mechanically ventilated with a tidal volume of 8 ml/kg and a respiratory rate of breaths/min. Maximum inspiratory pressure was maintained < 20 cmh 2 O (14.7 mmhg). Anaesthesia was maintained with nitrous oxide (60%) and oxygen (40%), and sevoflurane (
3 Weight Regulator Pressure transducer Three-way stopcock (ii) Three-way stopcock (i) Laryngeal mask airway FIGURE 1: The cuff pressure regulator used in the present study to control and maintain cuff pressure during anaesthesia. The three-way stopcock (i) was used for cuff inflation with an additional 10 ml of air from a 20-ml plastic syringe after laryngeal mask airway insertion. After achieving adequate cuff inflation, redundant air within the cuff was withdrawn through the syringe. The three-way stopcock (ii) was for installation of a cuff pressure regulator between the cuff pressure monitoring kit and the cuff inflation site so as to be able to evacuate excessive cuff pressure in those patients randomized to anaesthesia with the regulator (group 2). The weight provided the counterforce required to maintain constant cuff pressure vol.%) or desflurane (4 6 vol.%). CUFF PRESSURE EVALUATION Cuff pressure was evaluated at 5-min intervals in both groups using a pressure monitoring kit (TranStar Single Pressure Monitoring Kit; Smiths Medical ASD, Dublin, OH, USA). A simple pressure regulator consisting of a 10-ml glass syringe with weights (between 27 and 38 g) was attached to the syringe plunger. The regulator was installed using a three-way stopcock between the pressure monitoring kit and the cuff inflation site (labelled ii in Fig. 1) to evaluate the change of cuff pressure in group 2; increased regulator volume was only evaluated in group 2. When patients recovered spontaneous respiration and were responsive to verbal commands, the cuff was deflated to 45 mmhg and the withdrawn cuff volume was recorded as the final cuff volume. Increased LMA volume was calculated as the final cuff volume minus the just seal cuff volume. The presence of blood on the LMA was checked after its removal. Both groups received fentanyl 50 µg i.v. 30 min before the end of the operation and i.v. patientcontrolled analgesia was maintained by fentanyl 600 µg and ketorolac 120 mg. Intraoperative gas insufflations, aspiration and laryngospasm were checked. EVALUATION OF PPLC The incidence of pharyngeal sore throat (PST), dysphagia, dysphonia, nausea and 1902
4 coughing were evaluated at 1 and 24 h postoperatively by nurses blinded to the group allocation. PST was measured as follows: 0, no complaint; 1, throat discomfort; 2, continuous throat pain. STATISTICAL ANALYSES Based on a PPLC incidence of 42% associated with a high cuff pressure, 4 a power of 80% and an α error of 0.05, it was calculated that 30 patients were required in each group to detect a 30% decrease in the incidence of PPLC. Parametric variables are expressed as mean ± SD. All statistical analyses were carried out using SPSS software, version 12.0 (SPSS Inc., Chicago, IL, USA) for Windows. Cuff pressure and cuff volume were analysed using a two-tailed Student s t- test. The χ 2 -test was used to analyse the incidence of PPLC. A P-value < 0.05 was considered to be statistically significant. Results The study included 60 patients who were randomly assigned into group 1 (n = 30) or group 2 (n = 30). Demographic data and patients characteristics are shown in Table 1 and demonstrated no significant differences between the two groups. Intraoperative LMA cuff volume and pressure are shown in Table 2. The combined mean ± SD JSCP of both groups was 20.3 ± 3.2 mmhg (range mmhg) and the combined mean ± SD cuff volume of both groups was 14.0 ± 2.9 ml (range ml). Gastric insufflations, gas leakage or laryngospasm were not observed in either group. Cuff pressure was maintained at a significantly lower level in group 2 than in group 1 for the duration of anaesthesia (P < 0.05) (Fig. 2). The incidences of PST, dysphonia, and dysphagia at 1 and 24 h postoperatively are shown in Table 3. The incidence of PST at 1 h TABLE 1: Demographic and clinical characteristics of the patients randomized to receive anaesthesia with or without a cuff pressure regulator Without regulator With regulator Characteristics (group 1; n = 30) (group 2; n = 30) Age, years 51.1 ± ± 15.3 Sex, male/female 4/26 6/24 Weight, kg 59.3 ± ± 9.3 Height, cm ± ± 8.9 Type of operation Gynaecological Orthopaedic General surgery 5 6 Duration of anaesthesia, min 87.3 ± ± 19.5 Mallampati classification, 1/2 25/5 26/4 LMA size, 3/4/5 2/26/2 2/24/4 Number of intubations, 1/2 25/5 25/5 Fibrescopic classification, 3/4 a 5/25 5/25 LMA blood stained 2 2 Data presented as mean ± SD or number of patients. a Fibrescopic classifications were evaluated as follows: score 1, cords not seen; score 2, cords plus anterior epiglottis; score 3, cords plus posterior epiglottis; score 4, only vocal cord. No statistically significant between-group differences (P > 0.05); Student s t-test. LMA, laryngeal mask airway. 1903
5 TABLE 2: Intraoperative laryngeal mask airway cuff volume and pressure in patients randomized to receive anaesthesia with or without a cuff pressure regulator Without regulator With regulator Volume and pressure parameter (group 1; n = 30) (group 2; n = 30) Just seal cuff pressure, mmhg a 20.8 ± ± 1.7 Final cuff pressure, mmhg 54.6 ± ± 0.5 Just seal cuff volume, ml a 13.7 ± ± 2.9 Increased cuff volume, ml 6.1 ± ± 2.9 Increased regulator volume, ml NA 4.2 ± 1.7 Data presented as mean ± SD. P < 0.05 versus group 1; Student s t-test. a Just seal cuff pressure and just seal cuff volume are the initial cuff pressure and volume, respectively (0 min). NA, not applicable. postoperatively was significantly reduced in group 2 compared with group 1 (P < 0.05). In group 1, a low incidence of dysphagia occurred at 24 h postoperatively and a low incidence of dysphonia occurred at 1 h postoperatively; dysphagia and dysphonia did not occur in group 2. Discussion The present study demonstrated that maintenance of the JSCP by the recoil method can ventilate an adequate tidal volume with no gas leakage, gastric insufflations or laryngospasm. Furthermore, the regulator maintained a constant cuff pressure during general anaesthesia and reduced PPLC following insertion of the LMA. The causes of PPLC following the insertion of an LMA are multifactorial and the incidence varies according to the study design. One of the major causes is cuff Cuff pressure (mmhg) Group Group Time (min) FIGURE 2: Change in cuff pressure during the period of anaesthesia in patients randomized to receive anaesthesia with or without a cuff pressure regulator (group 1, without regulator; group 2, with regulator; mean ± SD; P < 0.05 group 1 versus group 2) 1904
6 TABLE 3: Laryngeal mask airway-related postoperative pharyngolaryngeal complications in patients randomized to receive anaesthesia with or without a cuff pressure regulator Without regulator With regulator Statistical Complication (group 1; n = 30) (group 2; n = 30) significance a PST, 1 h postoperatively Grade 0 9 (30.0) 23 (76.7) Grade 1 12 (40.0) 6 (20.0) P < 0.05 Grade 2 9 (30.0) 1 (3.3) PST, 24 h postoperatively Grade 0 18 (60.0) 24 (80.0) Grade 1 10 (33.3) 6 (20.0) NS Grade 2 2 (6.7) 0 Dysphagia, 1 h postoperatively 0 0 Dysphagia, 24 h postoperatively 2 (6.7) 0 NS Dysphonia, 1 h postoperatively 2 (6.7) 0 Dysphonia, 24 h postoperatively 0 0 NS Data presented as number (%) of patients. a χ 2 test; NS, not statistically significant (P > 0.05). Postoperative sore throat (PST) was graded as follows: 0, no complaint; 1, throat discomfort; 2, continuous throat pain. pressure, which is associated with the anaesthesiologist s skill, the level of insertion difficulty, the number of insertion attempts, the LMA size, 5 the use of dry and cold gas, 6 the duration of anaesthesia, 7 the type of ventilation 8 and the use of analgesics. It is important to use the minimal cuff pressure and cuff volume to reduce PPLC. Hockings et al. 9 reported that a cuff pressure of 40 cmh 2 O showed the least leakage volume compared with 20 or 60 cmh 2 O in paediatric patients with spontaneous breathing. Keller et al. 3 suggested making a change from the recommended volume of 30 ml to 20 ml in size 4 LMA because inflating the cuff to the maximum recommended volume could evoke a suboptimal condition. In contrast, Brimacombe and Keller 10 reported that the efficacy of the seal was not related to pharyngeal mucosal pressure. They also postulated that the soft, semiinflated cuff of the LMA can form an effective seal because it is compliant enough to adapt to a variety of different pharyngeal geometries. The mean ± SD cuff volume of both groups was 14.0 ± 2.9 ml (range ml) in the present study. Cuff volume can vary with the frequency of LMA sterilization and the size of the patient s oral cavity and cuff pressure is, therefore, more important than cuff volume. The present study demonstrated that the regulator did not prevent an increase in LMA cuff volume in group 2, but cuff pressure was, nevertheless, constantly maintained during the period of anaesthesia. The compliance of the LMA cuff might be increased by oral temperature. There are conflicting studies regarding LMA cuff-related PPLC. Seet et al. 11 found that limiting the LMA cuff pressure to 44 mmhg could reduce PPLC by 70% compared with routine care, and reduce postoperative PST (2.1% versus 8.7% at 2 h postoperatively; 3.1% versus 13.6% at 24 h postoperatively). Brimacombe et al. 4 reported that a low cuff volume (15 or 20 ml) reduced PST more than a high cuff volume (30 or 40 ml) at h postoperatively (20% versus 42%, 1905
7 respectively). Burgard et al. 12 concluded that a minimal seal reduced PST more than routine care (7.0% versus 15.7%, respectively). The incidence of PST in group 2 in the present study was significantly reduced compared with the incidence in group 1 at 1 h postoperatively, but was higher than in previous studies. 11,12 This may be due to longer anaesthesia times, no use of a heat and moisture exchange device, the use of small amounts of fentanyl (i.e. about 50 µg), or a high proportion of female patients in the study population. 13 One study reported that postoperative discomfort was not related to a variation in LMA cuff pressure. 8 This may have been because, in the four groups in that study, 150 mmhg was the initial cuff pressure. 8 Another study reported that cuff pressures of 30 or 180 mmhg did not significantly reduce the incidence of PST at 8, 24 and 48 h postoperatively. 7 The two groups in that study had a higher incidence of dysphagia than that seen in the present study (40% versus 6.7%, respectively, at day 1 postoperatively; 20% versus 0%, respectively, at day 2 postoperatively). The following instruments and/or processes have been investigated to reduce cuff pressure: use of saline or nitrous oxide and oxygen for cuff inflation; 14,15 use of air as an inhalation gas; 11 use of a specially designed endotracheal tube; and use of a detachable device or machine It is, however, expensive to use commercial devices or equipment to maintain the cuff pressure. In the present study, a simple pressure regulator system was devised. It is inexpensive, reliable and easy to use. In practice, an increase in the cuff volume by nitrous oxide diffusion pushes up the regulator piston and, as a result, an opposite force is required in order to maintain a constant cuff pressure. This is achieved by applying a weight to the piston. In addition, to maintain adequate lubrication between the piston and cylinder before installation of the regulator, the inner surface of the regulator should be coated with sterilized water. In conclusion, the present study suggests that the individual JSCP of a patient undergoing anaesthesia by insertion of a LMA must be carefully determined and reduced to a minimum, and the cuff inflation value should be determined using the recoil method. The results indicate that the pressure regulator used in this study is a simple, functional device that reduces early PPLC by maintaining patients cuff pressure at a constant level during the period of anaesthesia. Conflicts of interest The authors had no conflicts of interest to declare in relation to this article. Received for publication 23 March 2011 Accepted subject to revision 5 May 2011 Revised accepted 15 July 2011 Copyright 2011 Field House Publishing LLP References 1 Mizutamari E, Yano T, Ushijima K, et al: A comparison of postoperative PST after use of laryngeal mask airway and tracheal tube. J Anesth 2004; 18: The Laryngeal Mask Company Ltd: Instructions For Use LMA Classic, LMA Flexible, LMA Flexible Single Use and LMA Unique. Singapore: The Laryngeal Mask Company Ltd (available at: php?ifu=16). 3 Keller C, Pühringer F, Brimacombe JR: Influence of cuff volume on oropharyngeal leak pressure and fibreoptic position with laryngeal mask airway. Br J Anaesth 1998; 81: Brimacombe J, Holyoake L, Keller C, et al: Pharyngolaryngeal, neck, and jaw discomfort after anaesthesia with the face mask and 1906
8 laryngeal mask airway at high and low cuff volumes in males and females. Anesthesiology 2000; 93: Grady DM, McHardy F, Wong J, et al: Pharyngolaryngeal morbidity with the laryngeal mask airway in spontaneously breathing patients. Anesthesiology 2001; 94: Williams R, Rankin N, Smith T, et al: Relationship between the humidity and temperature of inspired gas and the function of the airway mucosa. Crit Care Med 1996; 24: Rieger A, Brunne B, Striebel HW: Intracuff pressures do not predict laryngopharyngeal discomfort after use of the laryngeal mask airway. Anesthesiology 1997; 87: Figueredo E, Vivar-Diago M, Muñoz-Blanco F: Laryngo-pharyngeal complaints after use of the laryngeal mask airway. Can J Anaesth 1999; 46: Hockings L, Heaney M, Chambers NA, et al: Reduced air leakage by adjusting the cuff pressure in pediatric laryngeal mask airways during spontaneous ventilation. Paediatr Anaesth 2010; 20: Brimacombe J, Keller C: A comparison of pharyngeal mucosal pressure and airway sealing pressure with the laryngeal mask airway in anesthesized adult patients. Anesth Analg 1998; 87: Seet E, Yousaf F, Gupta S, et al: Use of manometry for laryngeal mask airway reduces postoperative pharyngolaryngeal adverse events: a prospective randomized trial. Anesthesiology 2010; 112: Burgard G, Möllhoff T, Prien T: The effect of laryngeal mask cuff pressure on postoperative sore throat incidence. J Clin Anesth 1996; 8: Nott MR, Noble PD, Parmar M: Reducing the incidence of PST with the laryngeal mask airway. Eur J Anaesthesiol 1998; 15: Tekin M, Kati I, Tomak Y, et al: Comparison of the effects of room air and N 2 O + O 2 used for ProSeal LMA cuff inflation on cuff pressure and oropharyngeal structure. J Anesth 2008; 22: Ahmad NL, Norsidah AM: Change in endotracheal tube cuff pressure during nitrous oxide anaesthesia: a comparison between air and distilled water cuff inflation. Anaesth Intensive Care 2001; 29: Fujiwara M, Mizoguchi H, Kawamura J, et al: A new endotracheal tube with a cuff impervious to nitrous oxide: constancy of cuff pressure and volume. Anesth Analg 1995; 81: Lanz E, Zimmerschitt W: Volume and pressure changes due to nitrousoxide diffusion in costumary and in low-pressure cuffs of endotracheal tube. Anaesthesist 1976; 25: [in German, English abstract]. 18 Brandt L, Pokar H: The rediffusion system: limitation of nitrous oxide increases the cuff pressure of endotracheal tube. Anaesthesist 1983; 32: [in German, English abstract]. 19 Morris JV, Latto IP: An electropneumatic instrument for measuring and controlling the pressures in the cuffs of tracheal tubes: The Cardiff Cuff Controller. J Med Eng Technol 1985; 9: Resnikoff E, Katz JA: A modified epidural syringe as an endotracheal tube cuff pressurecontrolling device. Anesth Analg 1990; 70: Kay J, Fisher JA: Control of endotracheal tube cuff pressure using a simple device. Anesthesiology 1987; 66: 253. Author s address for correspondence Dr Jung-Ah Lee Department of Anaesthesiology and Pain Medicine, Saint Vincent Hospital, The Catholic University of Korea, 93-1 Chi-Dong, Paldal-Gu, Suwon City, Kyeonggi Do , Republic of Korea. likewinds@catholic.ac.kr 1907
A simple method of partial inflation of the LMA cuff before insertion in children to allow cuff pressure without adjustment after insertion
Clinical Research Article Korean J Anesthesiol 2012 June 62(6): 524-528 http://dx.doi.org/10.4097/kjae.2012.62.6.524 A simple method of partial inflation of the LMA cuff before insertion in children to
More informationLaryngeal Mask Airway (LMA) Indications and Use for the NH EMT-Intermediate and Paramedic
Laryngeal Mask Airway (LMA) Indications and Use for the NH EMT-Intermediate and Paramedic New Hampshire Division of Fire Standards & Training and Emergency Medical Services Introduction The LMA was invented
More informationLMA Airway portfolio. 3,000 published references. 300 million patient uses. Every 3 seconds an LMA airway is used somewhere in the world.
LMA Airway portfolio 3,000 published references. 300 million patient uses. Every 3 seconds an LMA airway is used somewhere in the world. Second generation SADs come highly recommended The NAP4 report 1
More informationQED-100 Clinical Brief
QED-100 Clinical Brief THE QED-100 WITH SPONTANEOUSLY BREATHING PATIENTS Author: Derek Sakata, MD Assistant Professor of Anesthesiology University of Utah Department of Anesthesiology QED-100 offers clinical
More informationComparison of cuff-pressure changes in silicone and PVC laryngeal masks during nitrous oxide anaesthesia in spontaneously breathing children
PRACE ORYGINALNE I KLINICZNE Anestezjologia Intensywna Terapia 2012, tom 44, numer 2, 72 79 ISSN 0209 1712 www.ait.viamedica.pl Comparison of cuff-pressure changes in silicone and PVC laryngeal masks during
More informationEffect of Fresh Gas Flow on Isoflurane Concentrations during Low-flow Anaesthesia
The Journal of International Medical Research 2005; 33: 513 519 Effect of Fresh Gas Flow on Isoflurane Concentrations during Low-flow Anaesthesia J-Y PARK 1, J-H KIM 2, W-Y KIM 2, M-S CHANG 2, J-Y KIM
More informationMucosal pressure and oropharyngeal leak pressure with the ProSeal versus laryngeal mask airway in anaesthetized paralysed patients
British Journal ofanaesthesia 85 (2): 262-6 (2000) Mucosal pressure and oropharyngeal leak pressure with the ProSeal versus laryngeal mask airway in anaesthetized paralysed patients C. Keller! and J. Brimacombe/?
More informationFOAM CUFFED TRACHEAL TUBES: CLINICAL AND LABORATORY ASSESSMENT
British Journal of Anaesthesia 99; 65: 433-43 FOAM CUFFED TRACHEAL TUBES: CLINICAL AND LABORATORY ASSESSMENT K. J. POWER SUMMARY The efficiency of a foam cuffed tracheal tube has been studied in protecting
More informationVIMA. (Volatile Induction and Maintenance Anesthesia) How and Why. James H. Philip M.E.(E), M.D.
VIMA (Volatile Induction and Maintenance Anesthesia) How and Why James H. Philip M.E.(E), M.D. Copyright 1995-2007, James H Philip, all rights reserved VIMA (Volatile Induction and Maintenance Anesthesia)
More informationGuidelines on Monitoring in Anaesthesia
Page 1 of 8 Guidelines on Monitoring in Anaesthesia Version Effective Date 1 OCT 1992 2 FEB 2002 3 APR 2012 4 JUL 2013 5 MAY 2017 Document No. HKCA P1 v5 Prepared by College Guidelines Committee Endorsed
More informationMechanical Ventilation
Mechanical Ventilation Chapter 4 Mechanical Ventilation Equipment When providing mechanical ventilation for pediatric casualties, it is important to select the appropriately sized bag-valve mask or endotracheal
More informationPRESSURE EXERTED BY THE LARYNGEAL MASK AIRWAY CUFF UPON THE PHARYNGEAL MUCOSA
British Journal of Anaesthesia 1993; 70: 25-29 PRESSURE EXERTED BY THE LARYNGEAL MASK AIRWAY CUFF UPON THE PHARYNGEAL MUCOSA R. MARJOT SUMMARY Ten patients were studied for each of the sizes 2, 3 and 4
More informationONLINE DATA SUPPLEMENT. First 24 hours: All patients with ARDS criteria were ventilated during 24 hours with low V T (6-8 ml/kg
APPENDIX 1 Appendix 1. Complete respiratory protocol. First 24 hours: All patients with ARDS criteria were ventilated during 24 hours with low V T (6-8 ml/kg predicted body weight (PBW)) (NEJM 2000; 342
More informationUsing the laryngeal mask airway to manage the difficult airway
Anesthesiology Clin N Am 20 (2002) 863 870 Using the laryngeal mask airway to manage the difficult airway Martin S. Bogetz, MD Department of Anesthesia and Perioperative Care, University of California
More informationHomecare Pneumology NEONATOLOGY ANAESTHESIA INTENSIVE CARE VENTILATION Step beyond the future
Homecare Pneumology NEONATOLOGY ANAESTHESIA INTENSIVE CARE VENTILATION Step beyond the future Sleep Diagnostics Service Patient Support The future starts now! For over 30 years, Heinen + Löwenstein has
More informationProduct information. The new LTS-D. The 2nd generation supraglottic airway device ideal for clinical use and pre-hospital environment
Product information The The 2nd generation supraglottic airway device ideal for clinical use and pre-hospital environment The Laryngeal Tube A success story Nothing is more fundamental to the practice
More informationEQUIPMENT. The LMA ProSeal a laryngeal mask with an oesophageal vent
British Journal of Anaesthesia 84 (5): 650 4 (2000) EQUIPMENT The LMA ProSeal a laryngeal mask with an oesophageal vent A. I. J. Brain 1 *, C. Verghese 1 and P. J. Strube 2 1 Department of Anaesthesia,
More informationInstructions/Procedure for Use of the Speaking Valve
Instructions/Procedure for Use of the Speaking Valve Notes on the use of the speaking valve for ventilator-dependent and non-ventilator dependent patients The speaking valve is a one-way valve that allows
More informationCARBON DIOXIDE ELIMINATION FROM SEMICLOSED SYSTEMS
Brit. J. Anaesth. (1956), 28, 196 CARBON DIOXIDE ELIMINATION FROM SEMICLOSED SYSTEMS BY RUSSELL M. DAVIES, I. R. VERNER Queen Victoria Hospital, East Grinstead AND A. BRACKEN Research and Development Centre,
More informationJ.A. BAIN AND W.E. SPOEREL~
PREDICTION OF ARTERIAL CARBON DIOXIDE TENSION DURING CONTROLLED VENTILATION WITH A MODIFIED MAPLESON D SYSTEM* J.A. BAIN AND W.E. SPOEREL~ ThE OBSERVATION that relatively low fresh gas inflows are adequate
More information27/10/58. Background and Rationale. Background and Rationale. Background and Rationale. Objective. Background and Rationale
The comparative study of optimal fresh gas flow used in Lack-Plus and Lack s circuit on spontaneously breathing anesthetized adults Sucher S, Theerapongpakdee S, SathitkarnmaneeT, MD Department of Anesthesiology,
More informationHONG KONG COLLEGE OF ANAESTHESIOLOGISTS TECHNICAL GUIDINES RECOMMENDATIONS ON CHECKING ANAESTHESIA DELIVERY SYSTEMS
RECOMMENDATIONS ON CHECKING ANAESTHESIA DELIVERY SYSTEMS 1. INTRODUCTION An anaesthesia delivery system includes any machine, equipment or apparatus which supplies gases, vapours, local anaesthesia and/or
More informationRecommendations on Checking Anaesthesia Delivery Systems
Page 1 of 11 Recommendations on Checking Anaesthesia Delivery Version Effective Date 1 Oct 1992 (reviewed Feb 07, Feb 02) 2 2004 3 Nov 2011 4 Dec 2016 Document No. HKCA T1 v4 Prepared by College Guidelines
More informationUnit 15 Manual Resuscitators
15-1 Unit 15 Manual Resuscitators GOAL On completion of this unit, the student should comprehend the proper operation of self-inflating resuscitation bags, flow-inflating resuscitation bags and gas-powered
More informationSolutions. Digital pressure management solutions. Copyright 2013 GaleMed Corporation
Solutions Digital pressure management solutions Content 1. About GiO Solutions 2. What is Gio 3. Clinical Applications 4. Product Range 5. Features 6. Specifications 7. Accessories 8. Order Information
More informationMedical Instruments in the Developing World
2.2 Ventilators 2.2.1 Clinical Use and Principles of Operation Many patients in an intensive care and the operating room require the mechanical ventilation of their lungs. All thoracic surgery patients,
More informationThe effect of tracheal tube size on air leak around the cuffs
Clinical Research Article Korean J Anesthesiol 2011 July 61(1): 24-29 DOI: 10.4097/kjae.2011.61.1.24 The effect of tracheal tube size on air leak around the cuffs Jin-Young Hwang 1, Sang-Hyun Park 1, Sung-Hee
More informationChapter 9 Airway Respirations Metabolism Oxygen Requirements Respiratory Anatomy Respiratory Anatomy Respiratory Anatomy Diaphragm
1 Chapter 9 Airway 2 Respirations Every cell of the body requires to survive Oxygen must come in and carbon must go out 3 Metabolism Metabolism--Process where the body s cells convert food to Adequate
More informationVENTILATORS PURPOSE OBJECTIVES
VENTILATORS PURPOSE To familiarize and acquaint the transfer Paramedic with the skills and knowledge necessary to adequately maintain a ventilator in the interfacility transfer environment. COGNITIVE OBJECTIVES
More informationAmbu AuraGain Single Use Laryngeal Mask - Sterile
Product Information Ambu AuraGain Single Use Laryngeal Mask - Sterile For use by medical professionals trained in airway management only 1 Product information This product information may be updated without
More informationRecommendations for the minimal monitoring of the patient during anaesthesia.
Guidelines for Safety in Veterinary Anaesthesia: Enclosure 2 Recommendations for the minimal monitoring of the patient during anaesthesia. Members of the ISVRA Task Force on Guidelines for Safety in Veterinary
More informationApplication of PEEP using the i-gel during volume-controlled ventilation in anesthetized, paralyzed patients
J Anesth (2013) 27:827 831 DOI 10.1007/s00540-013-1628-2 ORIGINAL ARTICLE Application of PEEP using the i-gel during volume-controlled ventilation in anesthetized, paralyzed patients Yong Beom Kim Young
More informationRecommended Minimum Facilities for Safe Anaesthetic Practice in Operating Suites
Page 1 of 11 Recommended Minimum Facilities for Safe Anaesthetic Practice in Operating Suites Version Effective Date 1 OCT 1992 2 FEB 2002 3 NOV 2011 4 DEC 2016 Document No. HKCA T2 v4 Prepared by College
More informationDescription: Percentage of cases with median tidal volumes less than or equal to 8 ml/kg.
Measure Abbreviation: PUL 02 Description: Percentage of cases with median tidal volumes less than or equal to 8 ml/kg. NQS Domain: Patient Safety Measure Type: Process Scope: Calculated on a per case basis.
More informationProceedings of the World Small Animal Veterinary Association Sydney, Australia 2007
Proceedings of the World Small Animal Sydney, Australia 2007 Hosted by: Next WSAVA Congress NURSES SETTING UP FOR ANAESTHESIA HOW TO PLAN FOR A SAFE ANAESTHETIC Sandra Forysth, BVSc DipACVA Institute of
More information한국학술정보. Investigations of the Air Volume for a Tracheal Tube Cuff in a Tr a c h e a l Models
Investigations of the Air Volume for a Tracheal Tube Cuff in a Tr a c h e a l Models Min Soo Kang, M.D., Ki Cheol You, M.D., Seung Hun O, M.D., Jae Hoon Kim, M.D., Moo Eob Ahn, M.D., Woo Jung Park, M.D.
More informationthroat/pharyngeal pack
DESCRIPTION IFU for Pat Tube endotracheal tube with integrated throat/pharyngeal pack The PAT Tube is supplied sterile with standard 15 mm connectors. The pharyngeal pack can be positioned above the laryngeal
More informationROUTINE PREOXYGENATION
EDITORIAL ROUTINE PREOXYGENATION It is a fact of great clinical importance that the body oxygen stores are so small, and if replenishment ceases, they are normally insufficient to sustain life for more
More informationBreathing Circuits. Product training
Breathing Circuits Product training Agenda Introduction to Breathing Circuits Anaesthesia Circuits Intensive Care Circuits Accessories 2 Covidien Introduction 3 Covidien What is a breathing circuit? In
More informationHealth Professional Info
Health Professional Info Mouthpiece Ventilation (MPV) What is MPV? MPV is a less intrusive form of noninvasive ventilation that uses a portable home mechanical ventilator (HMV) with a single-limb open-circuit
More informationLarySeal - Laryngeal Mask Airways
LarySeal - Laryngeal Mask Airways The LarySeal range of Laryngeal Mask Airways have the following common benefits, which are incorporated into the Clear, Blue, Multiple, MRI and Flexi. Reduced risk of
More informationZurich Open Repository and Archive. Measurement of tracheal wall pressure: a comparison of three different in vitro techniques
University of Zurich Zurich Open Repository and Archive Winterthurerstr. 190 CH-8057 Zurich http://www.zora.uzh.ch Year: 2008 Measurement of tracheal wall pressure: a comparison of three different in vitro
More information6 th Accredited Advanced Mechanical Ventilation Course for Anesthesiologists. Course Test Results for the accreditation of the acquired knowledge
6 th Accredited Advanced Mechanical Ventilation Course for Anesthesiologists Course Test Results for the accreditation of the acquired knowledge Q. Concerning the mechanics of the newborn s respiratory
More informationEffects of Breathing Pattern on Oxygen Delivery Via a Nasal or Pharyngeal Cannula
Effects of Breathing Pattern on Oxygen Delivery Via a Nasal or Pharyngeal Cannula Natsuhiro Yamamoto MD, Tetsuya Miyashita MD, Shunsuke Takaki MD, and Takahisa Goto MD BACKGROUND: During sedation for upper
More informationINSTRUCTIONS FOR USE KING LT 2
2 Caution: Federal law restricts this device to sale by or on the order of a physician. Instructions for Use In order to use the safely, the user must first be familiar with the following instructions,
More informationThe Internet Journal of Anesthesiology 2010 : Volume 22 Number 2
The Internet Journal of Anesthesiology 2010 : Volume 22 Number 2 Intelligent ventilator safety valve prevents accidental ventilator induced lung injury Jan Paul J. Mulier M.D., PhD. Department of Anaesthesiology
More informationChapter 4: Ventilation Test Bank MULTIPLE CHOICE
Instant download and all chapters Test Bank Respiratory Care Anatomy and Physiology Foundations for Clinical Practice 3rd Edition Will Beachey https://testbanklab.com/download/test-bank-respiratory-care-anatomy-physiologyfoundations-clinical-practice-3rd-edition-will-beachey/
More informationDr C Verghese LMA Research Centre Royal Berkshire Hospital Reading, UK. Page 30
TM TM TM PREFACE In the first ten years since its introduction in 1988, the Laryngeal Mask Airway (LMA) has been used over 100 million times. To date there have been over 2000 publications in medical literature
More informationEndotracheal Suctioning: In Line ETT
Approved by: Endotracheal Suctioning: In Line ETT Gail Cameron Senior Director Operations, Maternal, Neonatal & Child Health Programs Dr. Paul Byrne Medical Director, Neonatology Neonatal Policy & Procedures
More informationNitrous Oxide Sedation
Princess Margaret Hospital for Children GUIDELINE Nitrous Oxide Sedation Scope (Staff): Scope (Area): All Emergency Department Clinicians Emergency Department This document should be read in conjunction
More informationIDEAL FOR SHORT- TO MEDIUM- TERM ANAESTHESIA OR VENTILATION. Anaesthesia Tracheal Tubes
IDEAL FOR SHORT- TO MEDIUM- TERM ANAESTHESIA OR VENTILATION Anaesthesia Tracheal Tubes Common Features Clear tube material Allows visualisation of condensed exhaled air indicating tracheal intubation.
More informationLinear Infl ation Technology Non-invasive Blood Pressure Measurement. inibp Case Report Experiences in OR
Linear Infl ation Technology Non-invasive Blood Pressure inibp Case Report Experiences in OR C ONTENTS Introduction 2 Technological Description of inibp inibp advantages 2 inibp technology adapts to each
More informationAlternate Suction to Reduce Prolonged Air Leak
Alternate Suction to Reduce Prolonged Air Leak Alessandro Brunelli Division of Thoracic Surgery Ancona, Italy AIR LEAKS Frequent Prolong the hospital stay Increase the hospital costs Increase the risk
More informationUpdate in Anaesthesia 31
Update in Anaesthesia 31 Experience with the Glostavent Anaesthetic Machine R J Eltringham, Consultant - Department of Anaesthesia, Gloucestershire Royal Hospital, Gloucester, U.K.; Fan Qiu Wei, Consultant
More informationFiberoptic Intubation Made Easi(er) Know Your Scope. Indications. Christine Whitten MD Department of Anesthesia Kaiser Permanente San Diego
Fiberoptic Intubation Made Easi(er) Christine Whitten MD Department of Anesthesia Kaiser Permanente San Diego Know Your Scope Check before use: if it won t work during check out, it won t work during intubation
More informationBreathing Process: Inhalation
Airway Chapter 6 Breathing Process: Inhalation Active part of breathing Diaphragm and intercostal muscles contract, allowing the lungs to expand. The decrease in pressure allows lungs to fill with air.
More informationRapid pressure compensation by automated cuff pressure controllers worsens sealing in tracheal tubes
British Journal of Anaesthesia 102 (2): 273 8 (09) doi:10.1093/bja/aen355 Advance Access publication December 25, 08 Rapid pressure compensation by automated cuff pressure controllers worsens sealing in
More informationINSTRUCTIONS FOR USE LMA Unique (Silicone Cuff) & LMA Unique (Silicone Cuff) Cuff Pilot
EN English Figure 1: The LMA Unique (Silicon Cuff) components INSTRUCTIONS FOR USE LMA Unique (Silicone Cuff) & LMA Unique (Silicone Cuff) Cuff Pilot CAUTION: Federal (USA) law restricts this device to
More informationThe Puritan Bennett 980 Neonatal Ventilator System. Helping to Protect Our Most Vulnerable NEWBORNS
The Puritan Bennett 980 Neonatal Ventilator System Helping to Protect Our Most Vulnerable NEWBORNS 2 Helping Provide Comfortable Care When newborns first weeks or months of life are spent in the NICU,
More informationNeonatal tidal volume targeted ventilation
Neonatal tidal volume targeted ventilation Colin Morley Retired Professor of Neonatal Medicine, Royal Women s Hospital, Melbourne, Australia. Honorary Visiting Fellow, Dept Obstetrics and Gynaecology,
More informationSelecting the Ventilator and the Mode. Chapter 6
Selecting the Ventilator and the Mode Chapter 6 Criteria for Ventilator Selection Why does the patient need ventilatory support? Does the ventilation problem require a special mode? What therapeutic goals
More informationLAB 7 HUMAN RESPIRATORY LAB. Complete the charts on pgs. 67 and 68 and read directions for using BIOPAC
66 LAB 7 HUMAN RESPIRATORY LAB Assignments: Due before lab: Quiz: Three Respiratory Interactive Physiology Animations pages 69 73. Complete the charts on pgs. 67 and 68 and read directions for using BIOPAC
More informationPROBLEM SET 9. SOLUTIONS April 23, 2004
Harvard-MIT Division of Health Sciences and Technology HST.542J: Quantitative Physiology: Organ Transport Systems Instructors: Roger Mark and Jose Venegas MASSACHUSETTS INSTITUTE OF TECHNOLOGY Departments
More informationRESPIRATORY PHYSIOLOGY, PHYSICS AND PATHOLOGY IN RELATION TO ANAESTHESIA AND INTENSIVE CARE
Course n : Course 3 Title: RESPIRATORY PHYSIOLOGY, PHYSICS AND PATHOLOGY IN RELATION TO ANAESTHESIA AND INTENSIVE CARE Sub-category: Intensive Care for Respiratory Distress Topic: Pulmonary Function and
More informationWhy we should care (I)
What the $*!# is Lung Protective Ventilation and Why Should I be Using it in the OR? Disclosures KATHERINE PALMIERI, MD, MBA 64 TH ANNUAL POSTGRADUATE SYMPOSIUM UNIVERSITY OF KANSAS MEDICAL CENTER DEPARTMENT
More informationSUPPLEMENTARY APPENDIX. Ary Serpa Neto MD MSc, Fabienne D Simonis MD, Carmen SV Barbas MD PhD, Michelle Biehl MD, Rogier M Determann MD PhD, Jonathan
1 LUNG PROTECTIVE VENTILATION WITH LOW TIDAL VOLUMES AND THE OCCURRENCE OF PULMONARY COMPLICATIONS IN PATIENTS WITHOUT ARDS: a systematic review and individual patient data metaanalysis SUPPLEMENTARY APPENDIX
More informationHAMILTON-C2 HAMILTON-C2. The universal ventilation solution
HAMILTON-C2 HAMILTON-C2 The universal ventilation solution The universal ventilation solution HAMILTON-C2 - The compact ventilation solution The HAMILTON-C2 mechanical ventilator is a universal ventilation
More informationKeywords: emergency airway management, gastric regurgitation, intubating laryngeal mask airway, laryngeal tube, tidal volume
http://ccforum.com/content/4/6/369 Primary research Emergency airway management by intensive care unit nurses with the intubating laryngeal mask airway and the laryngeal tube Volker Dörges*, Volker Wenzel,
More informationWar Surgery Dr. Abdulwahid INTRODUCTION: AIRWAY, BREATHING
War Surgery Dr. Abdulwahid INTRODUCTION: AIRWAY, BREATHING The aims of war surgery: Save life Avoid infectious complications Save limbs Minimize residual disability The outcome is influenced by: Type of
More informationMechanical Ventilation. Which of the following is true regarding ventilation? Basics of Ventilation
Mechanical Ventilation Jeffrey L. Wilt, MD, FACP, FCCP Associate Professor of Medicine Michigan State University Associate Program Director MSU-Grand Rapids Internal Medicine Residency Which of the following
More informationFigure 1. A schematic diagram of the human respiratory system.
Introduction to Respiration In this experiment, you will investigate various aspects of normal breathing, hyperventilation, rebreathing the effect of changing airway resistance and ways in which to measure
More informationo An experienced and trained assistant is available to help you with induction.
Safe Surgery and Safe Anaesthesiia for Patiient Safety Check Liist before iinduciing anaesthesiia: o An experienced and trained assistant is available to help you with induction. o You have the correct
More informationFigure 1: LMA Unique (S) components. Figure 2: LMA Unique (S) Cuff Pilot components
EN English INSTRUCTIONS FOR USE LMA Unique (S) & LMA Unique (S) Cuff Pilot Figure 1: LMA Unique (S) components CAUTION: Federal (USA) law restricts this device to sale by or on the order of a physician.
More informationUnderstanding Tracheostomy Care
Understanding Tracheostomy Care Inside this guide: This guide will help you learn how to take care of your tracheostomy (trach). It is important to ask questions. You will be given time to learn. Working
More informationAstral in AirView: Improving patient care through connectivity. ResMed.com
Astral in AirView: Improving patient care through connectivity ResMed.com This guide will assist you with: Setting up the ResMed Connectivity Module for Astral 2 Troubleshooting the ResMed Connectivity
More informationLung recruitment maneuvers
White Paper Lung recruitment maneuvers Assessment of lung recruitability and performance of recruitment maneuvers using the P/V Tool Pro Munir A Karjaghli RRT, Clinical Application Specialist, Hamilton
More informationInitiation and Management of Airway Pressure Release Ventilation (APRV)
Initiation and Management of Airway Pressure Release Ventilation (APRV) Eric Kriner RRT Pulmonary Critical Care Clinical Specialist Pulmonary Services Department Medstar Washington Hospital Center Disclosures
More informationA Liter a Lung Measuring Lung Capacity
A Liter a Lung Measuring Lung Capacity OBJECTIVE In this investigation, students will compare the actual and expected vital capacities of their classmates. LEVEL Middle Grades Life Science CONNECTIONS
More informationDefinition An uninterrupted path between the atmosphere and the alveoli
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Airway Management (Class 9) Airway Definition An uninterrupted path between the atmosphere and the alveoli Methods of opening the airway Positioning Left lateral recumbent
More informationCapnography in the Veterinary Technician Toolbox. Katie Pinner BS, LVT Bush Advanced Veterinary Imaging Richmond, VA
Capnography in the Veterinary Technician Toolbox Katie Pinner BS, LVT Bush Advanced Veterinary Imaging Richmond, VA What are Respiration and Ventilation? Respiration includes all those chemical and physical
More informationOperation and Maintenance of the EPV200 Portable Ventilator
Operation and Maintenance of the EPV200 Portable Ventilator 1 Applications of the EPV200 The EPV200 Portable Ventilator is a gas powered electronically controlled mechanical ventilator, designed to provide
More informationVENTILATION STRATEGIES FOR THE CRITICALLY UNWELL
VENTILATION STRATEGIES FOR THE CRITICALLY UNWELL Dr Nick Taylor Visiting Emergency Specialist Teaching Hospital Karapitiya Senior Specialist and Director ED Training Clinical Lecturer, Australian National
More informationPulmonary Function I (modified by C. S. Tritt, April 10, 2006) Volumes and Capacities
I. Introduction Pulmonary Function I (modified by C. S. Tritt, April 10, 2006) Volumes and Capacities The volume of air a person inhales (inspires) and exhales (expires) can be measured with a spirometer
More informationClinical Benefits of Low- and Minimal- Flow Anesthesia
Protective Ventilation in the OR Clinical Benefits of Low- and Minimal- Flow Anesthesia General anesthesia using low fresh gas flows has been widely discussed with respect to the saving potential for anesthetic
More informationPatient Information for the: Humanitarian Device for use in the Control of Air Leaks
Patient Information for the: Humanitarian Device for use in the Control of Air Leaks Glossary Airway: The tubes in the lungs that pass air to and from the lung tissue. Anesthesia: Technique to make the
More informationAstral in AirView: Improving patient care through connectivity. ResMed.com
Astral in AirView: Improving patient care through connectivity ResMed.com Using Astral in AirView via the ResMed Connectivity Module (RCM) Astral is ResMed s portable, invasive and non-invasive life support
More informationMonitoring, Ventilation & Capnography
Why do we need to monitor? Monitoring, Ventilation & Capnography Keith Simpson BVSc MRCVS MIET(Electronics) Torquay, Devon. Under anaesthesia animals no longer have the ability to adequately control their
More informationAPRV: Moving beyond ARDSnet
APRV: Moving beyond ARDSnet Matthew Lissauer, MD Associate Professor of Surgery Medical Director, Surgical Critical Care Rutgers, The State University of New Jersey What is APRV? APRV is different from
More informationThe NuMask is as effective as the Face Mask in
SCIENTIFIC ARTICLES The NuMask is as effective as the Face Mask in Achieving Maximal Preoxygenation Usharani Nimmagadda 1,2, M. Ramez Salem 1,2, Dimitry Voronov 1 and Nebojsa Nick Knezevic 3** Abstract
More informationየIትዮዽያ የደረጃዎች ኤጀንሲ ETHIOPIAN STANDARDS AGENCY ES DRAFT UPLOAD REQUEST FORM FOR PUBLIC COMMENTS
OF/ESA/SDD/04 EHS This form is used to maintain uniformity and consistency in uploading the list of draft documents for the development of Ethiopian standards for public comment. 1. The draft documents
More informationSection 2.9 Decannulation
Bite- sized training from the GTC Section 2.9 Decannulation This is one of a series of bite- sized chunks of educational material developed by the Global Tracheostomy Collaborative. The GTC has developed
More informationVT PLUS HF performance verification of Bunnell Life-Pulse HFJV (High Frequency Jet Ventilator)
VT PLUS HF performance verification of Bunnell Life-Pulse HFJV (High Frequency Jet Ventilator) VT PLUS HF provides a special mode for evaluating the performance of high frequency ventilators while connected
More informationUnderstanding Tracheostomy Care for your Child
Understanding Tracheostomy Care for your Child 2 Inside this guide: This guide will help you learn how to take care of your child s tracheostomy (trach). It is important to ask questions. You will be given
More informationVentilating the Sick Lung Mike Dougherty RRT-NPS
Ventilating the Sick Lung 2018 Mike Dougherty RRT-NPS Goals and Objectives Discuss some Core Principles of Ventilation relevant to mechanical ventilation moving forward. Compare and Contrast High MAP strategies
More informationChest Drains. All Covenant Health Intermediate Care Nursery staff. Needle Aspiration
Approved by: Chest Drains Gail Cameron Director, Maternal, Neonatal & Child Health Programs Neonatal Nursery Policy & Procedures Manual : April 2013 Next Review April 2016 Dr. Ensenat Medical Director,
More informationLiquid Medical Oxygen Medicinal gas, cryogenic Package Leaflet: Information for the User
Liquid Medical Oxygen Medicinal gas, cryogenic Package Leaflet: Information for the User Liquid Medical Oxygen, Oxygen 99.5%, Medicinal gas, cryogenic Read all of this leaflet carefully before you start
More informationPERFORMANCE EVALUATION #34 NAME: 7200 Ventilator Set Up DATE: INSTRUCTOR:
PERFORMANCE EVALUATION #34 NAME: 7200 Ventilator Set Up DATE: 1. **Identify and name the filters on the 7200ae. 2. **Explain how each filter is sterilized. 3. **Trace the gas flow through the ventilator
More informationNotes on BIPAP/CPAP. M.Berry Emergency physician St Vincent s Hospital, Sydney
Notes on BIPAP/CPAP M.Berry Emergency physician St Vincent s Hospital, Sydney 2 DEFINITIONS Non-Invasive Positive Pressure Ventilation (NIPPV) Encompasses both CPAP and BiPAP Offers ventilation support
More informationVideo. Respiration System. You will use 3 pages of your journal for this lesson. 1. One page for hand written notes onto a journal page
Respiratory System Video Respiration System You will use 3 pages of your journal for this lesson. 1. One page for hand written notes onto a journal page 2. 2 nd page for diagram 3. 3 rd page for chart
More informationHistorically, rebreathing anesthesia systems
ISSN 2466-488X (Online) doi:10.5937/sjait1608193h Revijalni članak/review article LOW FLOW ANESTHESIA Cristian Hönemann 1, Marie-Luise Rübsam 1 1 Klinikum Leer ggmbh, Klinik für Anästhesie und Intensivmedizin,
More information