Additional Information
Book Details
Abstract
The most clinically relevant respiratory care equipment textbook on the market, Mosby’s Respiratory Care Equipment, 10th Edition employs a "how-to" approach that moves beyond technical descriptions of machinery. Learn to identify equipment, understand how it works, and apply your knowledge to clinical practice with this comprehensive overview of the equipment and techniques used by respiratory therapists to treat cardiopulmonary dysfunction. The 10th edition includes updated information on the latest devices and equipment, which are divided into clearly defined sections including: ventilators, transport, home-care, neonatal and pediatric ventilators, and alternative ventilators. In addition, there’s a focus on specific ventilator characteristics such as mode, monitors and displays, alarms and indicators, graphics, special features, and troubleshooting for lesser-used ventilators.
- UNIQUE! Clinical Approach
- NEW! Thoroughly updated content reflects changes in the NBRC exam.
- NEW! Updated images and full-color design enhances your understanding of key concepts.
- NEW! Streamlined device coverage features the basics of the most widely used devices in a clearly segmented and bulleted format for easy access to this key information.
- NEW! Content on the latest devices and equipment includes: ventilators, transport, home-care, neonatal and pediatric ventilators, and alternative ventilators.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Mosby's Respiratory Care Equipment | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Contributors | vi | ||
| Reviewers | vii | ||
| Preface | viii | ||
| Features | viii | ||
| Organization | viii | ||
| Learning Aids | ix | ||
| Workbook | ix | ||
| Evolve Resources http://evolve.elsevier .com/Cairo/ | ix | ||
| For the Instructor | ix | ||
| For Students | ix | ||
| Acknowledgments | x | ||
| Table Of Contents | xi | ||
| I Introduction | 1 | ||
| 1 Basic Physics for the Respiratory Therapist | 2 | ||
| Outline | 2 | ||
| Objectives | 2 | ||
| Key Terms | 3 | ||
| I. Energy and Matter | 3 | ||
| Energy and Work | 3 | ||
| Kinetic and Potential Energy | 4 | ||
| II. States of Matter | 4 | ||
| Change of State | 5 | ||
| Sublimation | 5 | ||
| Evaporation and Condensation | 6 | ||
| Critical Temperature and Critical Pressure | 6 | ||
| Gases Versus Vapors | 7 | ||
| III. Physical Properties of Matter | 7 | ||
| Temperature | 7 | ||
| Temperature Scales | 8 | ||
| Pressure | 9 | ||
| Density | 10 | ||
| Buoyancy | 10 | ||
| Viscosity | 10 | ||
| Surface Tension | 11 | ||
| Laplace’s Law | 12 | ||
| IV. the Gas Laws | 12 | ||
| Boyle’s Law | 13 | ||
| Charles’ and Gay-Lussac’s Laws | 13 | ||
| Combined Gas Law | 14 | ||
| Dalton’s Law of Partial Pressures | 14 | ||
| Avogadro’s Law | 15 | ||
| Laws of Diffusion | 15 | ||
| Graham’s Law | 15 | ||
| Henry’s Law | 16 | ||
| Fick’s Law of Diffusion | 16 | ||
| V. Fluid Mechanics | 16 | ||
| Patterns of Flow | 16 | ||
| Poiseuille’s Law | 17 | ||
| Reynolds Number | 17 | ||
| Bernoulli Principle | 18 | ||
| Venturi Principle | 18 | ||
| Coanda Effect | 18 | ||
| VI. Principles of Electricity | 19 | ||
| Principles of Electronics | 19 | ||
| Ohm’s Law | 19 | ||
| Electrical Circuits | 19 | ||
| Electrical Safety | 20 | ||
| Preventing Electrical Hazards | 21 | ||
| Grounding | 21 | ||
| Ground-Fault Circuit Interrupters | 21 | ||
| Avoiding Contact With Transcutaneous Conductors | 21 | ||
| Key Points | 22 | ||
| Assessment Questions | 22 | ||
| References | 23 | ||
| 2 Principles of Infection Control | 24 | ||
| Outline | 24 | ||
| Objectives | 24 | ||
| Key Terms | 24 | ||
| I. Principles of Clinical Microbiology | 25 | ||
| Survey of Microorganisms | 25 | ||
| Bacteria | 25 | ||
| Viruses | 26 | ||
| Rickettsiae and Chlamydiae Spp. | 28 | ||
| Protozoa | 28 | ||
| Fungi | 28 | ||
| Transmission of Infectious Diseases | 28 | ||
| II. Infection Control Methods | 29 | ||
| Factors Influencing the Effectiveness of Germicides | 29 | ||
| Number and Location of Microorganisms | 29 | ||
| Microbial Resistance | 29 | ||
| Concentration and Potency of the Germicide | 30 | ||
| Physical and Chemical Factors | 30 | ||
| Cleaning | 30 | ||
| Disinfection | 31 | ||
| Pasteurization | 33 | ||
| Quaternary Ammonium Compounds | 33 | ||
| Alcohols | 33 | ||
| Acetic Acid | 33 | ||
| Phenols | 33 | ||
| Iodophors and Other Halogenated Compounds | 34 | ||
| Glutaraldehyde | 34 | ||
| Ortho-phthalaldehyde | 34 | ||
| Hydrogen Peroxide | 35 | ||
| Sterilization | 35 | ||
| Heat | 35 | ||
| Ethylene Oxide | 35 | ||
| Hydrogen Peroxide Gel Plasma | 36 | ||
| Identifying Infection-Risk Devices | 37 | ||
| III. Surveillance | 38 | ||
| IV. Isolation Precautions | 38 | ||
| Fundamentals of Isolation Protection | 39 | ||
| Standard Precautions | 42 | ||
| Airborne Precautions | 42 | ||
| Droplet Precautions | 42 | ||
| Contact Precautions | 42 | ||
| V. Infection Control Issues in Mass Casualty Situations | 42 | ||
| Key Points | 45 | ||
| Assessment Questions | 45 | ||
| References | 46 | ||
| II Medical Gases | 48 | ||
| 3 Manufacture, Storage, and Transport of Medical Gases | 49 | ||
| Outline | 49 | ||
| Objectives | 49 | ||
| Key Terms | 49 | ||
| I. Properties of Medical Gases | 50 | ||
| Air | 50 | ||
| Oxygen (O2) | 50 | ||
| Carbon Dioxide (CO2) | 51 | ||
| Helium (He) | 52 | ||
| Nitric Oxide (NO) | 52 | ||
| Nitrous Oxide (N2O) | 52 | ||
| II. Storage and Transport of Medical Gases | 52 | ||
| Cylinders | 53 | ||
| Construction and Maintenance of Compressed-Gas Cylinders | 53 | ||
| Filling of Medical Cylinders | 54 | ||
| Cylinder Sizes and Capacities | 54 | ||
| Cylinder Identification | 57 | ||
| Cylinder Valves | 58 | ||
| Pressure-Relief Valves | 58 | ||
| Safety Systems | 59 | ||
| Setting Up and Troubleshooting Compressed-Gas Cylinders | 60 | ||
| Determining the Volume of Gas Remaining in a Cylinder and the Duration of Cylinder Gas Flow | 61 | ||
| Liquid Oxygen Systems | 63 | ||
| Bulk Liquid Oxygen Systems | 63 | ||
| Portable Liquid Oxygen Systems | 64 | ||
| Medical Air Supply | 66 | ||
| Portable Air Compressors | 66 | ||
| Bulk Air Supply Systems | 69 | ||
| Central Supply Systems | 69 | ||
| Piping Systems | 70 | ||
| Station Outlets | 70 | ||
| Oxygen Concentrators | 73 | ||
| Key Points | 77 | ||
| Assessment Questions | 77 | ||
| References | 78 | ||
| 4 Administering Medical Gases | 80 | ||
| Outline | 80 | ||
| Objectives | 80 | ||
| Key Terms | 80 | ||
| I. Regulators and Flowmeters | 81 | ||
| Regulators | 81 | ||
| Single-Stage Regulators | 81 | ||
| Multistage Regulators | 81 | ||
| Flowmeters | 82 | ||
| Thorpe Tube Flowmeters | 83 | ||
| Back pressure compensation. | 83 | ||
| Bourdon Flowmeters | 84 | ||
| Flow Restrictors | 84 | ||
| II. Devices for Administering Medical Gases | 84 | ||
| Oxygen Therapy | 84 | ||
| Low-Flow Versus High-Flow Devices | 86 | ||
| Low-Flow Devices | 87 | ||
| Low-flow nasal cannulas. | 87 | ||
| Oxygen-conserving devices. | 89 | ||
| Transtracheal catheters. | 90 | ||
| Reservoir cannulas. | 91 | ||
| Pulse-demand oxygen delivery systems. | 91 | ||
| Simple oxygen mask. | 92 | ||
| Partial rebreathing masks. | 92 | ||
| Nonrebreathing masks. | 93 | ||
| High-Flow Oxygen Systems | 93 | ||
| Air entrainment masks. | 93 | ||
| High-flow nasal cannulas. | 95 | ||
| Oxygen hoods. | 96 | ||
| Isolettes (incubators). | 97 | ||
| Oxygen tents. | 97 | ||
| Oxygen Proportioners | 98 | ||
| Oxygen adders. | 98 | ||
| Oxygen blenders and mixers. | 98 | ||
| Hyperbaric Oxygen Therapy | 98 | ||
| Physiological Principles | 98 | ||
| Effects on respiratory function. | 98 | ||
| Lung volumes. | 98 | ||
| Alveolar and arterial partial pressures of oxygen. | 99 | ||
| Gas temperatures. | 99 | ||
| Work of breathing. | 99 | ||
| Vascular function. | 99 | ||
| Immunological function. | 99 | ||
| Equipment | 100 | ||
| Monitoring devices. | 100 | ||
| Indications and Contraindications for Hyperbaric Oxygen Therapy | 101 | ||
| Inhaled Nitric Oxide Therapy | 101 | ||
| Helium–Oxygen (Heliox) Therapy | 103 | ||
| Carbon Dioxide–Oxygen (Carbogen) Therapy | 103 | ||
| Key Points | 104 | ||
| Assessment Questions | 104 | ||
| References | 106 | ||
| III Airway Management | 108 | ||
| 5 Airway Management Devices and Advanced Cardiac Life Support | 109 | ||
| Outline | 109 | ||
| Objectives | 109 | ||
| Key Terms | 110 | ||
| I. Airway Anatomy | 110 | ||
| II. Airway Examination | 112 | ||
| III. Establishing a Patent Airway and Mask Ventilation | 114 | ||
| Displacing the Tongue | 114 | ||
| Mask Ventilation | 114 | ||
| IV. Manual Resuscitators | 116 | ||
| Types of Manual Resuscitators (Bag-Valve Units) | 117 | ||
| Spring-Loaded Valves | 117 | ||
| Diaphragm Valves | 118 | ||
| Duckbill valves. | 118 | ||
| Leaf valves. | 118 | ||
| Standards for Manual Resuscitators | 119 | ||
| Oxygen-Powered Resuscitators | 120 | ||
| Hazards Associated With Manual Resuscitators | 121 | ||
| V. Oropharyngeal Airways | 121 | ||
| VI. Nasopharyngeal Airways | 124 | ||
| VII. Supraglottic Airways | 125 | ||
| Laryngeal Mask Airway | 125 | ||
| Fastrach Laryngeal Mask Airway | 128 | ||
| Combitube | 129 | ||
| VIII. Subglottic Airway Devices | 130 | ||
| Endotracheal Tubes | 130 | ||
| IX. Tools and Aids to Endotracheal Intubation | 132 | ||
| Laryngoscopes | 132 | ||
| Endotracheal Tube Guide/Intubating Stylet | 134 | ||
| Blind Intubation | 136 | ||
| X. Adjuncts to Endotracheal Intubation | 136 | ||
| Lighted Stylets or Lightwand | 136 | ||
| Indirect Laryngoscopy | 136 | ||
| Video Laryngoscopes | 137 | ||
| Flexible Fiberoptic Bronchoscopy | 138 | ||
| Retrograde Wire Intubation | 138 | ||
| Airway Ultrasonography | 138 | ||
| Determining Correct Endotracheal Tube or Tracheostomy Size | 140 | ||
| XI. Confirmation of Tracheal Intubation | 140 | ||
| XII. Specialized Endotracheal Tubes | 141 | ||
| XIII. Surgical Airway Devices | 142 | ||
| XIV. Tracheostomy Tubes | 146 | ||
| XV. Positioning Adjuvants | 147 | ||
| XVI. Equipment Used to Manage Artificial Airways | 148 | ||
| XVII. Complications of Airway Management | 148 | ||
| XVIII. Basic Life Support and Advanced Cardiac Life Support | 151 | ||
| Adult Basic Life Support | 151 | ||
| Adult Advanced Cardiac Life Support | 151 | ||
| Pediatric Life Support | 151 | ||
| Neonatal Resuscitation | 151 | ||
| Key Points | 152 | ||
| Assessment Questions | 152 | ||
| References | 154 | ||
| 6 Humidity and Aerosol Therapy | 156 | ||
| Outline | 156 | ||
| Objectives | 156 | ||
| Key Terms | 156 | ||
| I. Humidity Therapy | 158 | ||
| Physiological Control of Heat and Moisture Exchange | 158 | ||
| Indications for Humidification and Warming of Inspired Gases | 159 | ||
| Contraindications and Hazards of Humidity Therapy | 159 | ||
| Types of Humidifiers | 159 | ||
| Bubble Humidifiers | 161 | ||
| Aerosol Generators | 163 | ||
| Large-volume jet nebulizers. | 163 | ||
| Babington nebulizer. | 164 | ||
| Spinning disk devices. | 164 | ||
| Ultrasonic nebulizers. | 164 | ||
| Patient interface appliances. | 165 | ||
| Mist tents and hoods. | 166 | ||
| Problem solving and troubleshooting for bland aerosol systems. | 167 | ||
| Passover Humidifiers | 168 | ||
| Humidifier Heating Systems | 169 | ||
| Reservoir and Feed Systems | 169 | ||
| Manual systems. | 169 | ||
| Gravity feed system. | 170 | ||
| Condensation. | 170 | ||
| Heat and Moisture Exchangers | 172 | ||
| Active Heat and Moisture Exchangers | 174 | ||
| Setting Humidification Levels | 174 | ||
| Problem Solving and Troubleshooting for Humidification Systems | 175 | ||
| Cross-Contamination | 175 | ||
| Monitoring Proper Conditioning of the Inspired Gas | 175 | ||
| Selecting the Appropriate Humidity and Bland Aerosol Therapy | 176 | ||
| II. Aerosol Therapy | 177 | ||
| Characteristics of Therapeutic Aerosols | 177 | ||
| Aerosol Output | 177 | ||
| Particle Size | 177 | ||
| Deposition | 177 | ||
| Hazards of Aerosol Therapy | 178 | ||
| Infection | 178 | ||
| Airway Reactivity | 179 | ||
| Pulmonary and Systemic Effects | 179 | ||
| Drug Concentration Changes | 179 | ||
| Eye Irritation | 179 | ||
| Exposure to Secondhand Aerosol Drugs | 179 | ||
| Aerosol Drug-Delivery Systems | 179 | ||
| Metered-Dose Inhalers | 179 | ||
| Equipment design. | 180 | ||
| Aerosol delivery characteristics. | 180 | ||
| New pressurized metered dose inhaler technology. | 181 | ||
| Techniques of administration, cleaning, and maintenance. | 181 | ||
| Breath-Actuated Pressurized Metered-Dose Inhalers | 181 | ||
| Techniques of Administration | 181 | ||
| Pressurized Metered-Dose Inhaler Accessory Devices | 182 | ||
| Dose counters. | 182 | ||
| Spacers and holding chambers. | 183 | ||
| Types of spacers. | 183 | ||
| Soft-Mist Inhalers (Liquid Metered-Dose Inhalers) | 185 | ||
| Equipment design and function. | 185 | ||
| Technique, cleaning, and maintenance. | 185 | ||
| Atomizers and Spray Pumps | 185 | ||
| Dry Powder Inhalers | 185 | ||
| Equipment design and function. | 186 | ||
| New Dry Powder Inhaler Technologies | 186 | ||
| Technique, cleaning, and maintenance. | 188 | ||
| Nebulizers | 188 | ||
| Small-volume nebulizers. | 188 | ||
| Jet Nebulizers | 188 | ||
| Nebulizer design. | 189 | ||
| Flow. | 191 | ||
| Gas source (hospital versus home). | 191 | ||
| Gas density. | 191 | ||
| Humidity and temperature. | 192 | ||
| Characteristics of drug formulation. | 192 | ||
| Vibrating Mesh Nebulizers | 192 | ||
| Ultrasonic Nebulizers | 192 | ||
| Small-volume ultrasonic nebulizers. | 192 | ||
| Large-volume ultrasonic nebulizers. | 193 | ||
| Large-Volume Nebulizers | 193 | ||
| New Nebulizer Designs | 194 | ||
| Technique | 195 | ||
| Infection Control Issues | 195 | ||
| Selecting an Aerosol Drug-Delivery System | 196 | ||
| Special Considerations | 199 | ||
| Aerosol Delivery in Infants and Children | 199 | ||
| Aerosol Delivery With High-Flow Nasal Cannula | 200 | ||
| Aerosol Delivery in Mechanical Ventilation | 201 | ||
| Use of a Small-Volume Nebulizer During Mechanical Ventilation | 201 | ||
| Use of an Ultrasonic Nebulizer During Mechanical Ventilation | 202 | ||
| Use of a Vibrating Mesh Nebulizer During Mechanical Ventilation | 202 | ||
| Use of a Pressurized Metered-Dose Inhaler During Mechanical Ventilation | 203 | ||
| Aerosol Delivery in Noninvasive Positive-Pressure Ventilation | 203 | ||
| Aerosol Delivery During Intrapulmonary Percussive Ventilation and High-Flow Oscillatory Ventilation | 204 | ||
| Factors That Affect Aerosol Delivery During Mechanical Ventilation | 204 | ||
| Nebulizer type and position. | 204 | ||
| Controlling Environmental Contamination | 205 | ||
| Negative-pressure rooms. | 205 | ||
| Booths and stations. | 206 | ||
| Personal protective equipment. | 206 | ||
| Key Points | 206 | ||
| Assessment Questions | 207 | ||
| References | 208 | ||
| Internet Resources | 211 | ||
| Humidity | 211 | ||
| Aerosol | 211 | ||
| 7 Lung Expansion Therapy and Airway Clearance Devices | 212 | ||
| Outline | 212 | ||
| Objectives | 212 | ||
| Key Terms | 212 | ||
| I. Incentive Spirometers | 213 | ||
| Volume-Displacement Devices | 214 | ||
| Flow-Dependent Devices | 215 | ||
| II. Intermittent Positive-Pressure Breathing Devices | 215 | ||
| Puritan Bennett and Bird Devices | 217 | ||
| Vortran (IPPB) Device | 217 | ||
| III. Positive Airway Pressure Devices | 218 | ||
| Continuous Positive Airway Pressure | 218 | ||
| Expiratory Positive Airway Pressure | 219 | ||
| Positive Expiratory Pressure | 219 | ||
| IV. Chest Physiotherapy Devices | 220 | ||
| Manual Percussors | 221 | ||
| Pneumatically Powered Devices | 221 | ||
| Electrically Powered Percussors | 221 | ||
| V. High-Frequency Oscillation Devices | 222 | ||
| Intrapulmonary Percussive Ventilation | 222 | ||
| Flutter Valve Therapy | 224 | ||
| High-Frequency Chest Wall Oscillation Devices | 225 | ||
| VI. Mechanical Insufflation– Exsufflation | 226 | ||
| Key Points | 227 | ||
| Assessment Questions | 227 | ||
| References | 228 | ||
| IV Assessment | 230 | ||
| 8 Assessment of Pulmonary Function | 231 | ||
| Outline | 231 | ||
| Objectives | 231 | ||
| Key Terms | 231 | ||
| I. Respiratory System Mechanics | 232 | ||
| Volume and Flow Measurements | 232 | ||
| Water-Sealed Spirometers | 232 | ||
| Bellows Spirometers | 234 | ||
| Dry Rolling Seal Spirometers | 234 | ||
| Thermal Flowmeters | 234 | ||
| Turbine Flowmeters | 235 | ||
| Pneumotachographs | 236 | ||
| Point-of-Care (Office) Spirometers | 238 | ||
| Measurement of Residual Volume | 238 | ||
| Body Plethysmography | 238 | ||
| Inert Gas Techniques | 240 | ||
| Lung Function Testing Standards | 240 | ||
| Quality Control | 241 | ||
| Impedance Plethysmography | 242 | ||
| Respiratory Inductive Plethysmography | 244 | ||
| Pressure Measurements | 244 | ||
| Bedside Measurement of Respiratory Mechanics | 245 | ||
| Clinical Applications of Respiratory Mechanics Measurements | 245 | ||
| Lung Volume Measurements | 246 | ||
| Airway Pressures | 249 | ||
| Maximum Inspiratory and Expiratory Pressures | 249 | ||
| Peak Inspiratory Pressure, Mean Airway Pressure, and Plateau Pressure | 249 | ||
| Airway Resistance | 249 | ||
| Respiratory System Compliance | 250 | ||
| Work of Breathing | 251 | ||
| II. Measurement of Inspired Oxygen | 251 | ||
| Oxygen Analyzers | 251 | ||
| Electrochemical Analyzers | 251 | ||
| Electrical Analyzers | 253 | ||
| III. Measurement of Nitrogen Oxides | 253 | ||
| Chemiluminescence Monitoring | 253 | ||
| Electrochemical Monitoring | 255 | ||
| Exhaled Nitric Oxide Monitoring | 256 | ||
| IV. Capnography (Capnometry) | 256 | ||
| Infrared Spectroscopy | 257 | ||
| Mass Spectroscopy | 258 | ||
| Raman Spectroscopy | 259 | ||
| Physiological Basis of Capnography | 259 | ||
| Clinical Applications of Capnography | 260 | ||
| Capnogram contours. | 260 | ||
| Arterial to maximum end-expiratory PCO2 difference. | 261 | ||
| Volumetric capnography. | 263 | ||
| Single-breath carbon dioxide curve. | 263 | ||
| Single-breath carbon dioxide loop of inspiration and exhalation. | 264 | ||
| Trending CO2 production and alveolar minute ventilation over time. | 265 | ||
| V. Indirect Calorimetry and Metabolic Monitoring | 265 | ||
| Indirect Calorimetry | 265 | ||
| Closed-Circuit Calorimeters | 266 | ||
| Open-Circuit Calorimeters | 267 | ||
| Practical Applications of Indirect Calorimetry | 267 | ||
| Metabolic Monitoring | 268 | ||
| Energy Expenditure | 269 | ||
| Substrate Utilization Patterns | 269 | ||
| Key Points | 270 | ||
| Assessment Questions | 270 | ||
| References | 272 | ||
| 9 Assessment of Cardiovascular Function | 273 | ||
| Outline | 273 | ||
| Objectives | 273 | ||
| Key Terms | 273 | ||
| I. Principles of Electrocardiography | 274 | ||
| Electrophysiology of the Heart | 274 | ||
| Cardiac Action Potentials | 274 | ||
| Pacemaker Action Potentials | 275 | ||
| Conduction Pathways of the Heart | 275 | ||
| The Electrocardiograph | 276 | ||
| Electrodes | 276 | ||
| Lead Configurations | 277 | ||
| Electrocardiographic Recorders | 279 | ||
| The Normal Electrocardiogram | 280 | ||
| Waves, Complexes, and Intervals | 281 | ||
| P wave. | 281 | ||
| PR interval. | 281 | ||
| QRS complexes. | 281 | ||
| ST segment. | 281 | ||
| T wave. | 281 | ||
| QT interval. | 282 | ||
| U wave. | 282 | ||
| Interpretation of Electrocardiograms | 282 | ||
| Determination of the Heart Rate | 282 | ||
| Mean electrical axis. | 283 | ||
| Pattern Regularity | 283 | ||
| Sinus rhythms. | 284 | ||
| Supraventricular arrhythmias. | 285 | ||
| Ventricular rhythms. | 288 | ||
| Heart blocks. | 289 | ||
| Sinoatrial blocks. | 289 | ||
| AV blocks. | 289 | ||
| Intraventricular blocks. | 290 | ||
| Myocardial ischemia and infarction. | 290 | ||
| II. Hemodynamic Monitoring | 290 | ||
| The Cardiac Cycle | 290 | ||
| Ventricular Events | 291 | ||
| Atrial Events | 292 | ||
| Heart and Lung Sounds | 293 | ||
| Pressure Measurements | 293 | ||
| Noninvasive Measurement of Arterial Blood Pressure | 293 | ||
| Invasive Measurement of Arterial Blood Pressure | 294 | ||
| Right-Heart Catheterization | 296 | ||
| Left-Heart Catheterization | 299 | ||
| Pressure Transducers | 299 | ||
| Cardiac Output Measurements | 300 | ||
| Invasive Techniques | 300 | ||
| Direct Fick method. | 300 | ||
| Indicator dilution methods. | 301 | ||
| Noninvasive Techniques | 302 | ||
| Impedance plethysmography. | 302 | ||
| Transesophageal doppler. | 302 | ||
| Indirect fick method. | 303 | ||
| Interpretation of Hemodynamic Profiles | 304 | ||
| Cardiac Output | 304 | ||
| Mixed Venous Oxygen Saturation | 305 | ||
| Oxygen Delivery | 305 | ||
| Shunt Fraction | 305 | ||
| Vascular Resistance | 305 | ||
| Ejection Fraction | 306 | ||
| Cardiac Work | 306 | ||
| Key Points | 306 | ||
| Assessment Questions | 306 | ||
| References | 308 | ||
| 10 Blood Gas Monitoring | 309 | ||
| Outline | 309 | ||
| Objectives | 309 | ||
| Key Terms | 309 | ||
| I. Invasive Blood Gas Analysis | 310 | ||
| II. Sampling Techniques and Collection Devices | 310 | ||
| III. Modern in vitro Blood Gas Analyzers | 313 | ||
| pH and Hydrogen Ion Concentration | 314 | ||
| pH Electrode | 314 | ||
| Partial Pressures of Carbon Dioxide and Oxygen | 315 | ||
| PCO2 Electrode | 315 | ||
| PO2 Electrode | 316 | ||
| Derived Variables | 317 | ||
| Oxygen Saturation of Hemoglobin | 317 | ||
| P50 Determinations | 317 | ||
| Bicarbonate, Buffer Base, and Base Excess | 318 | ||
| Whole-Blood Analysis: Electrolytes and Glucose | 318 | ||
| Quality Assurance of Blood Gas Analyzers | 318 | ||
| Temperature Correction of Blood Gases | 321 | ||
| In vivo Blood Gas Monitors | 321 | ||
| Calibration of Intraarterial Blood Gas Monitors | 322 | ||
| Point-of-Care Testing | 322 | ||
| IV. CO-Oximetry | 322 | ||
| Calibration of CO-Oximeters | 324 | ||
| V. Noninvasive Assessment of Arterial Blood Gases | 324 | ||
| Pulse Oximetry | 324 | ||
| Theory of Operation | 325 | ||
| Physiological and Technical Considerations | 325 | ||
| Low perfusion states. | 325 | ||
| Dysfunctional hemoglobins. | 325 | ||
| Dyes. | 326 | ||
| Ambient light. | 326 | ||
| Calibration of Pulse Oximeters | 326 | ||
| Clinical Applications of Pulse Oximetry | 326 | ||
| Transcutaneous Monitoring | 327 | ||
| Transcutaneous PO2 | 327 | ||
| Transcutaneous PCO2 | 328 | ||
| Technical Considerations for Transcutaneous Monitoring | 328 | ||
| VI. Interpretation of Blood Gas Results | 329 | ||
| Acid–Base Status | 329 | ||
| Ventilatory Status | 330 | ||
| Oxygenation Status | 330 | ||
| Key Points | 331 | ||
| Assessment Questions | 332 | ||
| References | 333 | ||
| 11 Sleep Diagnostics | 335 | ||
| Outline | 335 | ||
| Objectives | 335 | ||
| Key Terms | 335 | ||
| I. Physiology of Sleep | 335 | ||
| Effect of Sleep on Breathing | 338 | ||
| Effect of Sleep on Cardiovascular Function | 338 | ||
| II. Diagnosis of Sleep Apnea | 339 | ||
| Polysomnography | 340 | ||
| Electrocardiography | 340 | ||
| Electroencephalography | 341 | ||
| Respiratory Activity | 342 | ||
| Electromyography | 342 | ||
| Electrooculography | 342 | ||
| Calibration of Polysomnography Signals | 343 | ||
| III. Pathophysiology of Sleep Apnea | 343 | ||
| Obstructive Sleep Apnea | 343 | ||
| Central Sleep Apnea | 346 | ||
| Mixed Sleep Apnea | 348 | ||
| Key Points | 349 | ||
| Assessment Questions | 350 | ||
| References | 351 | ||
| V Critical Care and Extended Care Devices | 352 | ||
| 12 Introduction to Ventilators | 353 | ||
| Outline | 353 | ||
| Objectives | 353 | ||
| Key Terms | 353 | ||
| I. Physical Characteristics of Ventilators | 354 | ||
| Introduction to Ventilators | 354 | ||
| Power Source—Input Power | 355 | ||
| Pneumatically Powered Ventilators | 355 | ||
| Electrically Powered Ventilators | 355 | ||
| Pneumatically Powered Microprocessor- Controlled Ventilators | 355 | ||
| Ventilator control systems. | 355 | ||
| Pressure Delivery | 355 | ||
| Positive-Pressure Ventilators | 355 | ||
| Negative-Pressure Ventilators | 356 | ||
| Combined-Pressure Devices | 356 | ||
| Control Systems and Circuits | 356 | ||
| Open-Loop and Closed-Loop Systems | 356 | ||
| Control Panel | 358 | ||
| Pneumatic Circuit | 358 | ||
| Internal circuit. | 358 | ||
| External circuit. | 358 | ||
| Drive Mechanisms | 359 | ||
| Compressors or Blowers | 360 | ||
| Volume-Displacement Designs | 360 | ||
| Pistons | 361 | ||
| Flow-Control Valves | 361 | ||
| Proportional solenoid valves. | 362 | ||
| Fluidic Elements in Power Transmission Design | 363 | ||
| Contemporary Drive Mechanisms and Control Valves | 363 | ||
| Additional Devices Used During Patient Ventilation | 363 | ||
| Expiratory Valves for Providing Positive End-Expiratory Pressure | 364 | ||
| Spring-loaded valves. | 364 | ||
| Diaphragm expiratory valves. | 365 | ||
| Continuous Positive Airway Pressure Devices | 365 | ||
| II. How Ventilators Deliver Breaths | 366 | ||
| Perspectives on Ventilator Classification | 366 | ||
| Phases of a Breath (Phase Variables) | 368 | ||
| Beginning of Inspiration: the Trigger Variable | 370 | ||
| Time triggering. | 370 | ||
| Pressure triggering. | 370 | ||
| Flow triggering. | 370 | ||
| Volume triggering. | 371 | ||
| Other triggering mechanisms. | 371 | ||
| Inspiratory Phase | 371 | ||
| Sloping or ramping. | 372 | ||
| Waveforms and graphics. | 372 | ||
| Limit variable. | 374 | ||
| Maximum safety pressure/high pressure alarm setting. | 375 | ||
| Termination of the Inspiratory Phase: Cycle Variable | 376 | ||
| Pressure cycling. | 376 | ||
| Time cycling. | 377 | ||
| Volume cycling. | 377 | ||
| Flow cycling. | 378 | ||
| Inspiratory pause. | 378 | ||
| Expiratory Phase: Baseline Variable | 379 | ||
| Baseline pressure. | 379 | ||
| Positive end-expiratory pressure. | 379 | ||
| Continuous positive airway pressure. | 379 | ||
| Subambient pressure (negative end-expiratory pressure). | 380 | ||
| Continuous gas flow during exhalation. | 380 | ||
| Expiratory hold (end-expiratory pause). | 380 | ||
| Time-limited exhalation. | 380 | ||
| Examples of Classifying a Mode | 385 | ||
| III. Descriptions of Commonly Encountered Modes of Ventilation | 386 | ||
| Continuous Mandatory Ventilation With Set-Point Targeting | 386 | ||
| Volume-Controlled Continuous Mandatory Ventilation With Set-Point Targeting) and Pressure-Controlled Continuous Mandatory Ventilation With Set-Point Targeting | 386 | ||
| Pressure-Controlled Inverse Ratio Ventilation | 389 | ||
| Intermittent Mandatory Ventilation With Set-Point Targeting | 390 | ||
| Volume-Controlled Intermittent Mandatory Ventilation With Set-Point Targeting and Pressure-Controlled Intermittent Mandatory Ventilation With Set-Point Targeting | 390 | ||
| Automatic Tube Compensation | 391 | ||
| Airway Pressure Release Ventilation | 391 | ||
| Dual-Targeting Modes | 392 | ||
| Continuous Mandatory Ventilation With Adaptive Targeting | 393 | ||
| Intelligent Targeting | 393 | ||
| Volume-Controlled Intermittent Mandatory Ventilation With Adaptive Targeting: Mandatory Minute Ventilation | 393 | ||
| Pressure-Controlled Intermittent Mandatory Ventilation With Adaptive Targeting | 393 | ||
| Optimal and Intelligent Targeting | 394 | ||
| Pressure-Controlled Continuous Spontaneous Ventilation With Set-Point Targeting | 396 | ||
| Pressure Support Ventilation (All Ventilators): PC-CSVs | 396 | ||
| Adaptive Continuous Spontaneous Ventilation | 397 | ||
| Pressure-Controlled Continuous Spontaneous Ventilation With Servo Targeting | 398 | ||
| IV. High-Frequency Ventilation | 400 | ||
| High-Frequency Positive-Pressure Ventilation | 400 | ||
| High-Frequency Jet Ventilation | 401 | ||
| High-Frequency Oscillatory Ventilation | 401 | ||
| High-Frequency Percussive Ventilation | 402 | ||
| Mechanisms of Action of High-Frequency Ventilation | 403 | ||
| Key Points | 404 | ||
| Assessment Questions | 404 | ||
| References | 407 | ||
| 13 Mechanical Ventilators: | 409 | ||
| Outline | 409 | ||
| Common Features of Ventilators | 409 | ||
| Common Internal Mechanisms | 409 | ||
| Patient Parameters and Displays | 410 | ||
| Modes of Ventilation | 410 | ||
| Alarms | 410 | ||
| Understanding Individual Ventilators | 410 | ||
| Presentation of Specific Ventilators | 410 | ||
| Carefusion AVEA (Formerly Cardinal AVEA), | 410 | ||
| Overview of Controls | 412 | ||
| Primary Breath Controls | 412 | ||
| Monitoring and Alarms | 412 | ||
| Alarms and Indicators | 412 | ||
| Extended Monitoring | 412 | ||
| Standard Modes of Ventilation | 412 | ||
| Extended Modes and Features | 413 | ||
| Machine Volume | 413 | ||
| PSV TMAX | 413 | ||
| Independent Lung Ventilation | 413 | ||
| Heliox | 414 | ||
| Neonatal Application | 414 | ||
| Key Points | 414 | ||
| References | 415 | ||
| Dräger Evitaxl | 415 | ||
| Overview of Controls | 416 | ||
| Monitoring and Alarms | 416 | ||
| Standard Measured and Displayed Parameters | 416 | ||
| Extending Monitoring | 416 | ||
| Alarms | 417 | ||
| Standard Modes of Ventilation | 417 | ||
| Extended Modes and Features | 417 | ||
| AutoFlow | 417 | ||
| Mandatory Minute Ventilation | 418 | ||
| Neonatal Applications- | 418 | ||
| Automatic Leakage Compensation | 418 | ||
| Sigh (Intermittent PEEP) | 419 | ||
| SmartCare | 419 | ||
| Automatic Tube Compensation | 419 | ||
| Key Points | 419 | ||
| References | 419 | ||
| Dräger Evita Infinity V500 and N500, | 419 | ||
| Overview of Controls | 419 | ||
| Monitoring and Alarms | 420 | ||
| Extended Monitoring | 421 | ||
| Alarms | 421 | ||
| Standard Modes of Ventilation | 421 | ||
| Extended Modes and Features | 421 | ||
| AutoFlow | 422 | ||
| Mandatory Minute Ventilation | 422 | ||
| Automatic Leakage Compensation | 422 | ||
| Intermittent PEEP | 422 | ||
| Proportional Pressure Support | 422 | ||
| SmartCare | 422 | ||
| Automatic Tube Compensation | 422 | ||
| Neonatal Application | 422 | ||
| Key Points | 422 | ||
| References | 422 | ||
| GE Healthcare Carescape R860 (Previously Known as the Engström Carestation) | 422 | ||
| Overview of Controls | 423 | ||
| Monitoring and Alarms | 423 | ||
| Extended Monitoring | 423 | ||
| Alarms | 423 | ||
| Standard Modes of Ventilation | 423 | ||
| Extended Modes and Features | 424 | ||
| BiLevel With Volume Guaranteed | 424 | ||
| Tube Compensation | 424 | ||
| Leak Compensation | 424 | ||
| Trigger Compensation | 425 | ||
| Neonatal Applications | 425 | ||
| Key Points | 425 | ||
| Reference | 426 | ||
| Hamilton-G5 | 426 | ||
| Overview of Controls | 426 | ||
| Monitoring and Alarms | 426 | ||
| Extended Monitoring | 426 | ||
| Standard Modes of Ventilation | 426 | ||
| Extended Modes and Features | 426 | ||
| Adaptive Pressure Ventilation | 427 | ||
| Leak Compensation | 427 | ||
| Adaptive Support Ventilation | 427 | ||
| Neonatal Application | 429 | ||
| Key Points | 429 | ||
| Reference | 430 | ||
| Hamilton-C3 | 430 | ||
| Overview of Controls | 430 | ||
| Monitoring and Alarms | 430 | ||
| Extended Monitoring | 430 | ||
| Alarms | 430 | ||
| Standard Modes of Ventilation | 430 | ||
| Extended Modes and Features | 433 | ||
| Leak Compensation | 433 | ||
| Adaptive Support Ventilation | 434 | ||
| Neonatal Application | 434 | ||
| Key Points | 434 | ||
| Reference | 434 | ||
| Medtronic Minimally Invasive Therapies Puritan Bennett 840 and 980 | 434 | ||
| Controls and Alarms | 435 | ||
| Primary Breath Controls | 435 | ||
| Monitoring and Parameters | 436 | ||
| Extended Monitoring | 436 | ||
| Alarms | 436 | ||
| Standard Modes of Ventilation | 437 | ||
| Extended Modes and Features | 437 | ||
| Proportional Assist Ventilation | 438 | ||
| Tube Compensation | 438 | ||
| Volume Support | 438 | ||
| Neonatal Application | 438 | ||
| Key Points | 438 | ||
| References | 439 | ||
| Maquet Servo-i, Servo-s, and Servo-U | 439 | ||
| Overview of Controls | 439 | ||
| Monitoring and Alarms | 439 | ||
| Extended Monitoring Features | 440 | ||
| Alarms | 440 | ||
| Standard Modes of Ventilation | 440 | ||
| Extended Modes and Features | 440 | ||
| AutoMode | 442 | ||
| Neonatal Application | 442 | ||
| MRI Capability | 442 | ||
| NAVA | 442 | ||
| Key Points | 443 | ||
| References | 443 | ||
| Assessment Questions | 443 | ||
| 14 Infant and Pediatric Devices | 447 | ||
| Outline | 447 | ||
| Objectives | 447 | ||
| Key Terms | 447 | ||
| Infant and Pediatric Devices in This Chapter | 447 | ||
| Continuous Positive Airway Pressure Systems | 448 | ||
| Carefusion Infant FLOW SiPAP System | 450 | ||
| Available Configurations | 450 | ||
| Power Source | 450 | ||
| Mechanism of Operation | 450 | ||
| Patient Interface and Humidification | 452 | ||
| Control Settings | 452 | ||
| Alarms | 452 | ||
| Modes of Ventilation | 453 | ||
| Summary: Infant Flow SiPAP | 453 | ||
| Fisher & Paykel Healthcare Bubble CPAP System | 453 | ||
| Delivery System | 453 | ||
| Patient Interface | 454 | ||
| The Infant Ventilator | 455 | ||
| Carefusion V.I.P. Bird Infant/Pediatric Ventilator | 458 | ||
| Noteworthy Internal Functions | 458 | ||
| Control and Alarm Panel | 459 | ||
| Modes of Ventilation | 461 | ||
| Volume-Cycled Modes | 461 | ||
| Time-Cycled Modes | 461 | ||
| Graphics Displays | 462 | ||
| Special Features of the V.I.P. Ventilator | 462 | ||
| Bird Partner IIi Monitor | 462 | ||
| Carefusion V.I.P. Bird Sterling and Gold Infant/Pediatric Ventilators | 463 | ||
| Changes in Controls/Alarms | 464 | ||
| Ventilator Modes and the Mode Select Switch | 465 | ||
| Pressure Support/VAPS Time Limit Control | 467 | ||
| Rise Time Control | 467 | ||
| Tidal Volume Control | 467 | ||
| Volume Mode Waveform Switch | 467 | ||
| Apnea Indicator and Apnea Interval Switch | 467 | ||
| Bias Flow, Assist Sensitivity, and Triggering | 467 | ||
| Flow Display/Compensation | 468 | ||
| Inspiratory/Expiratory Hold | 468 | ||
| Inspiratory Pause | 468 | ||
| Leak Compensation Control | 468 | ||
| Dräger Babylog 8000 Infant Ventilator | 469 | ||
| Noteworthy Internal Functions | 469 | ||
| Control and Alarm Panel | 469 | ||
| Modes of Ventilation | 472 | ||
| Graphics Displays | 472 | ||
| Special Features | 473 | ||
| Dräger Babylog 8000 Plus Infant Ventilator | 473 | ||
| High-Frequency Ventilators | 473 | ||
| Bunnell Life Pulse High Frequency Ventilator | 473 | ||
| Control and Alarm Panel | 474 | ||
| Monitoring Display | 474 | ||
| Alarm Display | 474 | ||
| Control Parameters | 476 | ||
| Humidification | 476 | ||
| Patient Box and Pinch Valve | 477 | ||
| Rear Panel | 477 | ||
| Special Features | 477 | ||
| Hi-Lo Jet Endotracheal Tube | 477 | ||
| LifePort Endotracheal Tube Adapter | 478 | ||
| Carefusion 3100A High Frequency Oscillatory Ventilator | 478 | ||
| Noteworthy Internal Functions | 478 | ||
| Circuit Design | 479 | ||
| Controls | 479 | ||
| On/Off Switch | 479 | ||
| Piston Centering | 479 | ||
| Bias Flow | 480 | ||
| FIO2 | 480 | ||
| Mean Pressure Adjust | 480 | ||
| Mean Pressure Limit | 480 | ||
| Power/ΔP | 481 | ||
| Percentage of Inspiratory Time | 481 | ||
| Frequency | 481 | ||
| Start/Stop | 481 | ||
| Reset | 481 | ||
| Alarms | 481 | ||
| 45-Second Silence | 481 | ||
| Set Maximum and Minimum | 481 | ||
| PAW <20% SET MAX PAW | 482 | ||
| PAW >50 cm H2O | 482 | ||
| Power Failure | 482 | ||
| Battery Low | 482 | ||
| Source Gas Low | 482 | ||
| Oscillator Overheated | 482 | ||
| Troubleshooting | 482 | ||
| Carefusion 3100B High Frequency Oscillatory Ventilator | 482 | ||
| Differences Between 3100A and 3100B Models | 483 | ||
| Chapter Summary | 484 | ||
| Key Points | 484 | ||
| Assessment Questions | 485 | ||
| References | 487 | ||
| 15 Transport, Home Care, and Noninvasive Ventilatory Devices | 488 | ||
| Outline | 488 | ||
| Objectives | 488 | ||
| Key Terms | 488 | ||
| I. Transport Ventilators | 489 | ||
| Airon pneuton | 489 | ||
| Power Source | 489 | ||
| Controls and Alarms | 490 | ||
| PEEP/CPAP | 490 | ||
| Peak Pressure | 490 | ||
| Tidal Volume and Respiratory Rate | 490 | ||
| Percentage Oxygen | 491 | ||
| Mandatory Breaths Control | 491 | ||
| Pressure Gauge | 491 | ||
| Alarms | 491 | ||
| Modes of Operation | 491 | ||
| Bio-Med Crossvent | 491 | ||
| Electrical Power Source | 491 | ||
| Internal Mechanism/Oxygen Source | 492 | ||
| Controls and Alarms | 492 | ||
| Flow Control | 492 | ||
| PEEP Control | 492 | ||
| Maximum Pressure | 493 | ||
| Display Interface and Menus | 493 | ||
| Alarms | 493 | ||
| Modes | 494 | ||
| Continuous Mandatory Ventilation | 494 | ||
| Intermittent Mandatory Ventilation | 494 | ||
| Sigh Breaths | 494 | ||
| CPAP/Manual Mode | 494 | ||
| Pressure Support | 494 | ||
| Bio-Med MVP-10 | 494 | ||
| Power Source | 495 | ||
| Controls and Alarms | 495 | ||
| Mode Switch | 495 | ||
| PEEP/CPAP | 496 | ||
| Inspiratory and Expiratory Time Controls | 496 | ||
| Maximum Pressure Control and Pressure Gauge | 496 | ||
| Oxygen and Air Flowmeters | 496 | ||
| Modes | 496 | ||
| Dräger Oxylog 3000 Plus | 496 | ||
| Power Source | 497 | ||
| Internal Mechanism | 497 | ||
| Oxygen Supply | 498 | ||
| Controls | 498 | ||
| Start/Standby Key and LED Indicators | 498 | ||
| Inspiratory Hold | 498 | ||
| O2 Inhalation | 498 | ||
| Alarms: Reset and Silence | 498 | ||
| Mode Keys | 498 | ||
| Rotary Selection/Settings | 498 | ||
| Additional Controls | 498 | ||
| Curves/Volumes (Ventilator Graphics) | 499 | ||
| Alarms | 499 | ||
| Supply Pressure Low | 499 | ||
| High Peak Airway Pressure | 499 | ||
| Low Airway Pressure | 499 | ||
| Apnea Alarm | 499 | ||
| Leakage | 499 | ||
| High Frequency | 499 | ||
| Modes of Ventilation | 499 | ||
| VC-CMV (VC-AC) | 500 | ||
| VC-SIMV | 500 | ||
| PC-BIPAP | 500 | ||
| SPN-CPAP | 500 | ||
| Zoll 731 Series EMV | 500 | ||
| Power Source | 500 | ||
| Internal Mechanism | 501 | ||
| Oxygen Source | 501 | ||
| Controls and Displays | 502 | ||
| Power On/Off | 502 | ||
| Heart Rate (HR) | 502 | ||
| SpO2 | 503 | ||
| FIO2 | 503 | ||
| Peak Inspiratory Pressure (PIP) | 503 | ||
| Pressure Support | 503 | ||
| Tidal Volume (VT) | 503 | ||
| Breath Rate (BPM) | 503 | ||
| Rise time. | 503 | ||
| MODE | 503 | ||
| CONFIRM/SELECT | 504 | ||
| MANUAL BREATH | 504 | ||
| ROTARY ENCODER | 504 | ||
| MUTE/CANCEL | 504 | ||
| MENU | 504 | ||
| Alarms | 504 | ||
| Alarm Priorities | 504 | ||
| Modes of Ventilation | 505 | ||
| Carefusion LTV 1000 | 505 | ||
| Power Source | 506 | ||
| Patient Circuit | 506 | ||
| Controls and Alarms | 507 | ||
| Front-Panel Controls | 507 | ||
| Alarms | 510 | ||
| Set Value Knob | 511 | ||
| Airway Pressure Bar Graph and Display Window | 511 | ||
| Select Button—Display Screen | 511 | ||
| Front-Panel Indicators | 511 | ||
| Extended Features | 512 | ||
| Breath Types | 512 | ||
| Modes of Ventilation | 513 | ||
| Special Features | 513 | ||
| Troubleshooting | 513 | ||
| General Troubleshooting | 513 | ||
| Carefusion LTV 1200 | 514 | ||
| Power Source | 514 | ||
| Internal Mechanism | 514 | ||
| Oxygen Source | 515 | ||
| Operations | 515 | ||
| Controls and Alarms | 515 | ||
| Front-Panel Controls | 515 | ||
| Select (Volume/Pressure) Button | 515 | ||
| Select Mode Control | 516 | ||
| Inspiratory/Expiratory Hold Button | 516 | ||
| Manual Breath Button | 517 | ||
| Low-Pressure O2 Source Button | 517 | ||
| Selecting the low-pressure O2 source. | 517 | ||
| O2% (O2 Flush) Button | 517 | ||
| PEEP Control | 517 | ||
| Upper-Row Parameters | 517 | ||
| Breath rate. | 517 | ||
| Tidal volume. | 517 | ||
| Pressure control button. | 517 | ||
| Inspiratory time. | 518 | ||
| Pressure support. | 518 | ||
| O2% button. | 518 | ||
| Sensitivity | 518 | ||
| Leak compensation. | 518 | ||
| Alarms. | 518 | ||
| Airway pressure bar graph and display window. | 518 | ||
| Select Button—Display Screen | 518 | ||
| Breath Types and Modes of Ventilation | 518 | ||
| Additional Features | 518 | ||
| Carefusion Revel | 518 | ||
| Power Source | 519 | ||
| Internal Mechanism | 519 | ||
| Oxygen Source | 520 | ||
| Operations | 520 | ||
| Controls and Alarms | 520 | ||
| Front-Panel Controls | 521 | ||
| Display window. | 521 | ||
| Control panel. | 521 | ||
| Control panel parameters. | 521 | ||
| Breath rate. | 521 | ||
| Inspiratory time. | 521 | ||
| Tidal volume. | 521 | ||
| Pressure control. | 521 | ||
| Pressure support. | 521 | ||
| PEEP control. | 521 | ||
| O2% and flush control. | 521 | ||
| Sensitivity control. | 523 | ||
| Breath mode. | 523 | ||
| Breath type. | 523 | ||
| Front-Panel Alarms | 523 | ||
| Low peak pressure. | 523 | ||
| High airway pressure limit. | 523 | ||
| Low FIO2. | 523 | ||
| Low exhaled minimum volume. | 523 | ||
| NIV LED indicator. | 523 | ||
| Breath Types and Modes of Ventilation | 523 | ||
| Smiths Medical Pneupac Ventipac | 525 | ||
| Power Source | 525 | ||
| Internal Mechanism | 525 | ||
| Oxygen Source | 525 | ||
| Controls | 525 | ||
| Respiratory Rate | 525 | ||
| Tidal Volume | 525 | ||
| Air Mix Control | 526 | ||
| Pressure Relief | 526 | ||
| Alarms | 526 | ||
| High-Pressure Alarm | 526 | ||
| Low Inflation Pressure (Disconnect) Alarm | 526 | ||
| Breathing Detector | 526 | ||
| Low Battery Alarm | 526 | ||
| Low Gas Supply Indicator | 526 | ||
| Synchronized Minimum Mandatory Ventilation/Demand | 526 | ||
| Summary of Transport Ventilators | 526 | ||
| II. Home Care Ventilators | 527 | ||
| Newport HT50 | 527 | ||
| Power Source | 527 | ||
| Internal Mechanism | 528 | ||
| Oxygen Source | 528 | ||
| Humidifier | 528 | ||
| Patient Circuit | 528 | ||
| Control Panel and Alarms | 529 | ||
| Control Parameters | 529 | ||
| Airway Pressure and Minute Ventilation Alarms | 530 | ||
| Additional Alarms | 531 | ||
| High baseline pressure alarm. | 531 | ||
| Occlusion alarm. | 531 | ||
| Low baseline pressure alarm. | 531 | ||
| Check proximal line alarm. | 531 | ||
| Apnea alarm. | 531 | ||
| PCV not reached alarm. | 531 | ||
| Device alert. | 531 | ||
| Alarm/silence-reset. | 531 | ||
| Modes of Ventilation | 531 | ||
| Newport HT70 | 532 | ||
| Power Source | 532 | ||
| Internal Mechanism | 532 | ||
| Oxygen Source | 532 | ||
| Control Panel | 533 | ||
| Alarms | 533 | ||
| Domains | 534 | ||
| Modes | 534 | ||
| Back-up Ventilation | 535 | ||
| Back-up Ventilation in A/CMV and SIMV Modes | 535 | ||
| Back-up Ventilation in Spontaneous Mode | 535 | ||
| Cancellation of Back-up Ventilation | 535 | ||
| User canceled. | 535 | ||
| Patient canceled. | 535 | ||
| Newport HT70 Plus | 535 | ||
| Carefusion LTV 800 | 536 | ||
| Power Source | 536 | ||
| Internal Mechanism | 536 | ||
| Controls/Displays | 536 | ||
| On/Standby | 536 | ||
| Mode-Selection Key | 536 | ||
| Control Lock | 536 | ||
| Set Value | 537 | ||
| Parameter Controls | 537 | ||
| Respiratory rate. | 537 | ||
| Tidal volume. | 537 | ||
| Inspiratory time. | 537 | ||
| Sensitivity. | 538 | ||
| Leak compensation. | 538 | ||
| PEEP/CPAP. | 538 | ||
| Airway Pressure Bar Graph and Display Window | 538 | ||
| Select Button—Display Screen | 538 | ||
| Front-Panel Indicators | 538 | ||
| Alarms | 538 | ||
| Vent-Inop Display | 538 | ||
| Alarm Silence | 538 | ||
| Modes of Ventilation | 538 | ||
| Control and Assist/Control | 538 | ||
| Assist/Control | 539 | ||
| SIMV | 539 | ||
| CPAP | 539 | ||
| Pressure Support | 539 | ||
| Apnea Backup | 539 | ||
| NIV | 539 | ||
| Summary of the LTV 800, 900, 950, 1000, and 1200 | 539 | ||
| Puritan Bennett 540 | 539 | ||
| Power Source | 539 | ||
| Internal Mechanism | 539 | ||
| Oxygen Source | 540 | ||
| Operation of the Ventilator | 540 | ||
| Initiating Ventilation | 541 | ||
| Operational Controls | 541 | ||
| Alarms | 541 | ||
| Modes of Ventilation | 542 | ||
| III. Noninvasive Ventilation | 542 | ||
| The Patient Interface | 543 | ||
| Ventilators | 545 | ||
| Respironics BiPAP Focus | 545 | ||
| Power Source | 545 | ||
| Internal Mechanism | 546 | ||
| Oxygen Source | 546 | ||
| Leak Compensation | 546 | ||
| Tidal Volume Estimation | 547 | ||
| Controls and Displays | 547 | ||
| Alarms | 548 | ||
| Modes of Ventilation | 548 | ||
| Respironics V60 | 548 | ||
| Power Source | 548 | ||
| Internal Mechanism | 548 | ||
| Oxygen Source | 549 | ||
| Leak Compensation | 549 | ||
| Controls and Displays | 550 | ||
| Alarms | 550 | ||
| High peak airway pressure alarm. | 551 | ||
| Low inspiratory pressure alarm. | 551 | ||
| Tidal volume alarms. | 551 | ||
| High rate alarm. | 551 | ||
| Low rate alarm. | 551 | ||
| Lo VE (low minute ventilation alarm). | 551 | ||
| LIP T (low inspiratory pressure delay time). | 551 | ||
| Setting Definitions | 551 | ||
| Modes | 551 | ||
| CPAP. | 551 | ||
| PCV. | 551 | ||
| AVAPS mode. | 552 | ||
| PPV mode (optional). | 552 | ||
| IV. Home Bilevel Devices | 552 | ||
| Respironics Synchrony | 552 | ||
| Power Source | 552 | ||
| Internal Mechanism | 552 | ||
| Oxygen Source | 552 | ||
| Operations/Controls | 552 | ||
| Display Screen | 552 | ||
| Alarms | 553 | ||
| Modes of Ventilation | 553 | ||
| CPAP | 553 | ||
| Spontaneous Ventilation | 553 | ||
| Spontaneous/Timed | 554 | ||
| Timed Mode | 554 | ||
| Pressure-Controlled | 554 | ||
| Puritan Bennett Goodknight 425 | 554 | ||
| Power Supply | 554 | ||
| Oxygen | 554 | ||
| Internal Mechanism | 554 | ||
| Operations/Controls | 554 | ||
| Alarms | 554 | ||
| Modes of Ventilation | 554 | ||
| CPAP | 554 | ||
| Spontaneous Mode | 554 | ||
| Resmed Stellar 100 | 555 | ||
| Power Supply | 555 | ||
| Oxygen Supply | 555 | ||
| Internal Mechanism | 555 | ||
| Operations/Controls | 555 | ||
| Alarms | 555 | ||
| Modes of Ventilation | 556 | ||
| Spontaneous/Timed | 556 | ||
| PAC | 556 | ||
| CPAP | 556 | ||
| Spontaneous Mode | 556 | ||
| Timed Mode | 556 | ||
| Summary of Home Care Equipment | 556 | ||
| Key Points | 556 | ||
| Assessment Questions | 557 | ||
| References | 559 | ||
| Appendix A Suggested Answer Key for Clinical Scenarios | 560 | ||
| Authors’ Note | 560 | ||
| Chapter 1 Basic Physics for the Respiratory Therapist | 560 | ||
| Clinical Scenario 1-1 | 560 | ||
| Clinical Scenario 1-2 | 560 | ||
| Clinical Scenario 1-3 | 560 | ||
| Clinical Scenario 1-4 | 560 | ||
| Chapter 2 Principles of Infection Control | 560 | ||
| Clinical Scenario 2-1 | 560 | ||
| Clinical Scenario 2-2 | 560 | ||
| Clinical Scenario 2-3 | 561 | ||
| Clinical Scenario 2-4 | 561 | ||
| Chapter 3 Manufacture, Storage, and Transport of Medical Gases | 561 | ||
| Clinical Scenario 3-1 | 561 | ||
| Clinical Scenario 3-2 | 561 | ||
| Clinical Scenario 3-3 | 561 | ||
| Chapter 4 Administering Medical Gases: Regulators, Flowmeters, and Controlling Devices | 561 | ||
| Clinical Scenario 4-1 | 561 | ||
| Clinical Scenario 4-2 | 561 | ||
| Clinical Scenario 4-3 | 561 | ||
| Clinical Scenario 4-4 | 561 | ||
| Chapter 5 Airway Management Devices and Advanced Cardiac Life Support | 561 | ||
| Clinical Scenario 5-1 | 561 | ||
| Clinical Scenario 5-2 | 562 | ||
| Clinical Scenario 5-3 | 562 | ||
| Chapter 6 Humidity and Aerosol Therapy | 562 | ||
| Clinical Scenario 6-1 | 562 | ||
| Clinical Scenario 6-2 | 562 | ||
| Clinical Scenario 6-3 | 562 | ||
| Clinical Scenario 6-4 | 562 | ||
| Clinical Scenario 6-5 | 562 | ||
| Chapter 7 Lung Expansion Therapy and Airway Clearance Devices | 562 | ||
| Clinical Scenario 7-1 | 562 | ||
| Clinical Scenario 7-2 | 562 | ||
| Clinical Scenario 7-3 | 562 | ||
| Chapter 8 Assessment of Pulmonary Function | 563 | ||
| Clinical Scenario 8-1 | 563 | ||
| Clinical Scenario 8-2 | 563 | ||
| Clinical Scenario 8-3 | 563 | ||
| Clinical Scenario 8-4 | 563 | ||
| Clinical Scenario 8-5 | 563 | ||
| Chapter 9 Assessment of Cardiovascular Function | 563 | ||
| Clinical Scenario 9-1 | 563 | ||
| Clinical Scenario 9-2 | 563 | ||
| Clinical Scenario 9-3 | 563 | ||
| Clinical Scenario 9-4 | 563 | ||
| Chapter 10 Blood Gas Monitoring | 563 | ||
| Clinical Scenario 10-1 | 563 | ||
| Clinical Scenario 10-2 | 564 | ||
| Clinical Scenario 10-3 | 564 | ||
| Chapter 11 Sleep Diagnostics | 564 | ||
| Clinical Scenario 11-1 | 564 | ||
| Clinical Scenario 11-2 | 564 | ||
| Chapter 12 Introduction to Ventilators | 564 | ||
| Clinical Scenario 12-1 | 564 | ||
| Clinical Scenario 12-2 | 564 | ||
| Clinical Scenario 12-3 | 564 | ||
| Clinical Scenario 12-4 | 564 | ||
| Clinical Scenario 12-5 | 564 | ||
| Clinical Scenario 12-6 | 564 | ||
| Clinical Scenario 12-7 | 565 | ||
| Clinical Scenario 12-8 | 565 | ||
| Clinical Scenario 12-9 | 565 | ||
| Clinical Scenario 12-10 | 565 | ||
| Clinical Scenario 12-11 | 565 | ||
| Chapter 13 Mechanical Ventilators: General Use Devices | 565 | ||
| Chapter 14 Infant and Pediatric Devices | 565 | ||
| Clinical Scenario 14-1 | 565 | ||
| Clinical Scenario 14-2 | 565 | ||
| Clinical Scenario 14-3 | 565 | ||
| Clinical Scenario 14-4 | 565 | ||
| Clinical Scenario 14-5 | 566 | ||
| Chapter 15 Transport, Home Care, and Noninvasive Ventilatory Devices | 566 | ||
| Clinical Scenario 15-1 | 566 | ||
| Clinical Scenario 15-2 | 566 | ||
| Clinical Scenario 15-3 | 566 | ||
| Clinical Scenario 15-4 | 566 | ||
| Clinical Scenario 15-5 | 566 | ||
| Clinical Scenario 15-6 | 566 | ||
| Clinical Scenario 15-7 | 566 | ||
| Clinical Scenario 15-8 | 566 | ||
| Clinical Scenario 15-9 | 566 | ||
| Appendix B Answer Key for Chapter Assessment Questions | 567 | ||
| Chapter 1 Basic Physics for the Respiratory Therapist | 567 | ||
| Chapter 2 Principles of Infection Control | 567 | ||
| Chapter 3 Manufacture, Storage, and Transport of Medical Gases | 567 | ||
| Chapter 4 Administering Medical Gases: Regulators, Flowmeters, and Controlling Devices | 568 | ||
| Chapter 5 Airway Management Devices and Advanced Cardiac Life Support | 568 | ||
| Chapter 6 Humidity and Aerosol Therapy | 568 | ||
| Chapter 7 Lung Expansion Therapy and Airway Clearance Devices | 568 | ||
| Chapter 8 Assessment of Pulmonary Function | 569 | ||
| Chapter 9 Assessment of Cardiovascular Function | 569 | ||
| Chapter 10 Blood Gas Monitoring | 569 | ||
| Chapter 11 Sleep Diagnostics | 570 | ||
| Chapter 12 Introduction to Ventilators | 571 | ||
| Chapter 13 Mechanical Ventilators: General Use Devices | 571 | ||
| Chapter 14 Infant and Pediatric Devices | 572 | ||
| Chapter 15 Transport, Home Care, and Noninvasive Ventilatory Devices | 572 | ||
| Appendix C Normal Reference Ranges | 573 | ||
| Appendix D Frequently Used Formulae and Values | 576 | ||
| Gas Laws | 576 | ||
| Gas Cylinders | 576 | ||
| Flow Rates, and Mixing Air and Oxygen | 576 | ||
| Formulae Used With Gas Laws | 576 | ||
| Formula Used When Mixing Air and Oxygen | 576 | ||
| Formulae Used When Calculating Humidity | 577 | ||
| Formulae Used With Mechanical Ventilation | 577 | ||
| Formulae Used With Compliance and Resistance | 577 | ||
| Formulae Used When Calculating Dead Space | 577 | ||
| Glossary | 578 | ||
| A | 578 | ||
| B | 579 | ||
| C | 579 | ||
| D | 580 | ||
| E | 581 | ||
| F | 581 | ||
| G | 582 | ||
| H | 582 | ||
| I | 583 | ||
| J | 584 | ||
| K | 584 | ||
| L | 584 | ||
| M | 584 | ||
| N | 585 | ||
| O | 585 | ||
| P | 586 | ||
| Q | 587 | ||
| R | 587 | ||
| S | 587 | ||
| T | 588 | ||
| U | 589 | ||
| V | 589 | ||
| W | 590 | ||
| Index | 591 | ||
| A | 591 | ||
| B | 592 | ||
| C | 593 | ||
| D | 596 | ||
| E | 597 | ||
| F | 598 | ||
| G | 599 | ||
| H | 599 | ||
| I | 600 | ||
| J | 601 | ||
| K | 601 | ||
| L | 601 | ||
| M | 602 | ||
| N | 603 | ||
| O | 604 | ||
| P | 605 | ||
| Q | 607 | ||
| R | 607 | ||
| S | 608 | ||
| T | 609 | ||
| U | 610 | ||
| V | 610 | ||
| W | 611 | ||
| X | 611 | ||
| Z | 611 | ||
| Inside Back Cover | ibc1 |