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Tanks hold 2,000-2,500 PSI

Standard working pressure of all 02 gas supply systems: 50 PSI

·      Increments used when determining tank pressure: 100

Regulator: controls the pressure of the flow– get to 50 PSI

Regulators:

1.        Thorpe

2.        Bourdon

3.        Grab & go

Bourdon:

·      Flow remains when turned on side– when occluded gauge indicates flow, but its not delivered

Thorpe:

·      Read in middle of ball

·      When turned on side, ball goes to top

·      Shows true flow

For every 1L of 02, Fi02 increases by 4%

E tank: PISS

H tank: ASSS

·      02: green

·      NO: light blue, nitrogen: black, helium: brown

·      Medical air: yellow (21% 02, 78% nitrogen)

Humidity & Aerosol

·      Two main types of artificial airways:

o   Endotracheal

o   Tracheostomy

·      Bypassing upper airway means: air/02 is not traveling via mouth, nose, or throat–goes directly to lower airway

·      During invasive mechanical ventilation, passive humidity is delivered via HME- recycling patient’s own heat and moisture by trapping it

·      HME: short term, overdose, post surgery, changed every 72 hours

·      Albuterol: delivered via HHN, SVN 2.5 mg in 3Ml

·      Breaking the circuit: opening or disconnecting the vent circuit–no longer closed system

·      Valve T-adapter: deliver aerosol med during NIV without breaking th circuit, placed as close to patient as possible

·      Briggs: delivers 50-100% 02 with humidity to artificial airway– needs reservoir tubing

o   T-adapter: connects equipment

·      Type of contiuous aersol interface for upper airway swelling and trauma:

o   Face tent

o   Trach collar

·      For bypassed upper airway: T-piece, trach collar

Bubble humidification: only adds moisture, no peep or flow support

Hyperinflation

Goal: inflate lungs (atelectasis)

Atelectasis breath sounds:

·      Crackles

·      Diminished

·      Bronchial

·      High 02 therapy can cause atelectasis

1.        IS

2.        EzPAP

3.        IPPB

4.        CPAP

EzPAP:

·      Breathe normally with breath holds

·      Ambu mask- tighter seal

·      Prevent/reverse atelectasis by positive pressure exhalation and increases FRC

·      Used with COPD or post surgery or alternative for IS

·      5-15 lpm

·      CPAP:Common uses: obstructive sleep apnea and hypoxemic respiratory failure

o   Continuous positive pressure