Home Infection Control - -Clean equipment daily
-wash with mild detergent
-rinse well with water
-soak in acetic acid (white vinegar) for 20 mins
-rinse, drain and air dry
Criteria for home oxygen therapy - -PaO2 <55 torr on RA
-SpO2 88% or less
-exercise limitation
-frequent oximetry required
-polycythemia or cor pulmonale
Reservoir Cannula - -maintain FiO2 at lower flowrates by using a
reservoir
Transtracheal Oxygen Catheters (TTO2) - -low flow oxygen directly into
the airway by surgically implanter catheter
-increase duration of cylinder flow
between 2nd and 3rd tracheal rings
-if SOB and increased WOB = obstructed + remove and clean
-reduced to 1/2 to 1/3 previous flowrate
Liquid bulk oxygen - -last longer than cylinders
,-can cause frostbite/skin damage
-if spilled, let it evaporate
oxygen concentrators - -electric and limited portability
-has molecular sieves
-1 to 2 LPM continuously
-if sieves are not working - analyze FiO2, check circuit breaker, fuse
Croup - -Viral
-Upper Respiratory infection
-During winter
-<3 yrs old
-Gradual Onset
-Stridor at rest
-Cool mist tent
-Dexamethasone (steroid)
-Racemic Epinephrine
-Subglottic Edema (STEEPLE/PENCIL)
Epiglottitis - -Bacterial
-No Upper Respiratory Infection
-Anytime
-3-7 Years old
-Sudden Onset
-Drooling
-Extended neck
-Suspicion of epiglottitis
,-Intubation and IV Ampicillin
-Supraglottic Edema
-Thumb Sign
-Obliterated vallecula
Mycobacterium Disease - Tuberculosis - -Night Sweats
-dry cough
-consolidation, fibrosis and cavity formation
-Respiratory Isolation
-Isoniazid, ethambutol, streptomycin, rifampin
Myasthenia Gravis - -Auto-immune response
-slow, fatigue improves with rest
-Descending (Mind to Ground)
-Positive Tensilon test
-Monitor VC/MIP
-Neostigmine, Pyridostigmine(MESTINON), short term mechanical vent
Guillain Barre Syndrome - -Delayed reaction to viral infection
-URI - Present
-Acute, Sudden weakness
-Ascending (Ground to Brain)
-Spinal tap - protein in spinal fluid
-Monitor VC/MIP
-Steroids, Prophylactic Antibiotics, long term mechanical vent/trach,
plasmapheresis
, ER Treatment for Asthma Attack - -Oxygen Therapy
-Aerosol therapy with A&A
-Oral Steroids
-Close Monitoring
-Intubation if respiratory arrest
-Heliox
Kussmaul's - -increased rate, depth, irregular rhythm, breathing sounds
labored
-Raspy voice
Apneustic - prolonged gasping inspiration followed by extremely short,
insufficient expiration
-respiratory center problems, trauma, tumor
cachectic - muscle atrophy/loss of muscle tone
retractions - -chest moves inward during inspiratory efforts instead of
outward
-blocked airway in adults = INTUBATE
-RDS in infants
Character of cough - -dry, non-productive cough may indicate tumor in
the lungs or asthma
-wash with mild detergent
-rinse well with water
-soak in acetic acid (white vinegar) for 20 mins
-rinse, drain and air dry
Criteria for home oxygen therapy - -PaO2 <55 torr on RA
-SpO2 88% or less
-exercise limitation
-frequent oximetry required
-polycythemia or cor pulmonale
Reservoir Cannula - -maintain FiO2 at lower flowrates by using a
reservoir
Transtracheal Oxygen Catheters (TTO2) - -low flow oxygen directly into
the airway by surgically implanter catheter
-increase duration of cylinder flow
between 2nd and 3rd tracheal rings
-if SOB and increased WOB = obstructed + remove and clean
-reduced to 1/2 to 1/3 previous flowrate
Liquid bulk oxygen - -last longer than cylinders
,-can cause frostbite/skin damage
-if spilled, let it evaporate
oxygen concentrators - -electric and limited portability
-has molecular sieves
-1 to 2 LPM continuously
-if sieves are not working - analyze FiO2, check circuit breaker, fuse
Croup - -Viral
-Upper Respiratory infection
-During winter
-<3 yrs old
-Gradual Onset
-Stridor at rest
-Cool mist tent
-Dexamethasone (steroid)
-Racemic Epinephrine
-Subglottic Edema (STEEPLE/PENCIL)
Epiglottitis - -Bacterial
-No Upper Respiratory Infection
-Anytime
-3-7 Years old
-Sudden Onset
-Drooling
-Extended neck
-Suspicion of epiglottitis
,-Intubation and IV Ampicillin
-Supraglottic Edema
-Thumb Sign
-Obliterated vallecula
Mycobacterium Disease - Tuberculosis - -Night Sweats
-dry cough
-consolidation, fibrosis and cavity formation
-Respiratory Isolation
-Isoniazid, ethambutol, streptomycin, rifampin
Myasthenia Gravis - -Auto-immune response
-slow, fatigue improves with rest
-Descending (Mind to Ground)
-Positive Tensilon test
-Monitor VC/MIP
-Neostigmine, Pyridostigmine(MESTINON), short term mechanical vent
Guillain Barre Syndrome - -Delayed reaction to viral infection
-URI - Present
-Acute, Sudden weakness
-Ascending (Ground to Brain)
-Spinal tap - protein in spinal fluid
-Monitor VC/MIP
-Steroids, Prophylactic Antibiotics, long term mechanical vent/trach,
plasmapheresis
, ER Treatment for Asthma Attack - -Oxygen Therapy
-Aerosol therapy with A&A
-Oral Steroids
-Close Monitoring
-Intubation if respiratory arrest
-Heliox
Kussmaul's - -increased rate, depth, irregular rhythm, breathing sounds
labored
-Raspy voice
Apneustic - prolonged gasping inspiration followed by extremely short,
insufficient expiration
-respiratory center problems, trauma, tumor
cachectic - muscle atrophy/loss of muscle tone
retractions - -chest moves inward during inspiratory efforts instead of
outward
-blocked airway in adults = INTUBATE
-RDS in infants
Character of cough - -dry, non-productive cough may indicate tumor in
the lungs or asthma
