Lines and devices in acute and critical care setting (unfinished)

Nasal Cannula (NC)

-Remove/Disconnect:Yes, temporary line management and organization

-Purpose/Flow: 0.25-6.0LPM or

0.24 – 0.44 FiO2

-Common Problems:Epistaxis, obstruction of nares limits flow, skin breakdown above ears

-Precautions/Contraindications: Limited flow rate (6LPM), hygiene, delivery rate dependent on patient RR

Hi-Flow Nasal Cannula (HFNC)

-Remove/Disconnect: Yes, temporary line management and organization

-Purpose/Flow: 6 – 15LPM

-Common Problems: Epistaxis, nasal irritation, skin breakdown above ears

-Precautions/Contraindications: Hyperoxemia, Limited flow rate (15LPM), delivery rate dependent on patient RR

Venturi Mask (VM)

-Remove/Disconnect: Yes, temporary line management and organization

-Purpose/Flow: 0.24 – 0.50 FiO2

-Common Problems: Inability to feed, claustrophobia

-Precautions/Contraindications: Hyperoxemia, FiO2 limitation, delivery rate dependent on patient RR

Oxymizer

-Remove/Disconnect: Yes, temporary line management and organization

-Purpose/Flow: 0.25 – 15LPMPotentially reduce amount of oxygen flow required due to reservoir and larger lumen

-Common Problems: Nasal irritation, Epistaxis

-Precautions/Contraindications: Limited flow rate (15LPM), delivery rate dependent on patient RR

Partial Rebreather (PRB)

-Remove/Disconnect: Yes, temporary line management and organization

-Purpose/Flow: 7 – 25LPM

-Common Problems: Inability to feed, claustrophobia

-Precautions/Contraindications: Limited flow rate (25LPM), delivery rate dependent on patient RR

Hi-Flow (OptiFlow)

-Remove/Disconnect: Yes, if alternate O2 device is readily available

-Purpose/Flow: Ability to deliver specific FiO2 a with humidification and warmth (100% FiO2)

-Common Problems: Claustrophobia, irritation, requires proximity to high-flow O2 system, bulky equipment

-Precautions/Contraindications: Hyperoxemia, nasal irritation

Tracheostomy Tube

-Remove/Disconnect: No, requires RT if plan to switch to portable ventilator

-Purpose/Flow: Maintains patent airway, provides positive pressure and supplemental O2

-Common Problems: Causes gag, mucous plug, , cuff leaks, barotrauma

-Precautions/Contraindications: Avoid pressure or moving tube, ensure security prior to mobilization (CONTRAINDICATION)

Endotracheal Tube (ETT)

-Remove/Disconnect: No, requires RT if plan to switch to portable ventilator,

-Purpose/Flow: Placed for anticipated long term mechanical support, can allow for patient speech (passy-muir valve)

-Common Problems: Mucous plug, cuff leaks, bleeding

-Precautions/Contraindications:

-Avoid pressure or moving tube, ensure security prior to mobilization (CONTRAINDICATION)

-Note the incremental markings on ETT for migration