Aerosol
Minute particles or liquid droplets suspended in a gas
Bland Aerosol therapy involves the delivery of:
Sterile water, Saline(Hypertonic, Hypotonic, & Isotonic)
Output
The weight or mass of aerosol particles produced by a nebulizer.
LVN output (heated)
33-55 mg/L
Devices that deliver aerosol
Trach mask, T-piece, Aerosol mask, Face tent
Troubleshooting aerosol delivery
1) insuffcient flow to nebulizer
2) condensation in aerosol tubing
3) No water in reservoir
4)clogged capillary tube
How do you check for adequate aerosol flow?
See if the mist is still present during pt inspiration.
Amt of source gas flow that can go thru a LVN
12-14 L/min
How do you increase source L/min flow through an LVN ?
1)Tandem set-up
2) Misty-Ox setup/high flow setup, Misty Ox allows for 40L/min source gas flow
Water in the delivery tubing causes 2 results.
1)Decreases total flow
2)Less air is entrained and the FIO2 delivered is increased.
USN are powered by what?
Piezoelectric crystal
What does a Piezoelectric crystal in a USN do?
Creates vibrations in the liquid that creates the aerosol droplets.
Particle size created by USN?
4 - 6 microns
When is it indicated to use a USN?
When thick secretions need to be mobilized.
Troubleshooting for a USN
1) Check the amplitude
2) Check the blower flow or source gas flow
3) check the filter
4) Check the fluid/med level
5) Check for condensation in aerosol tubing.
Hazards of bland aerosol therapy
Infection, Airway reactivity, Overhydration, airway obstruction, and noise levels.
What's the type of relationship of aerosol density to gas flow?
Inverse
3 factors that aerosols are dependent on to do their job:
1) particle size
2) penetration
3) deposition
Whats the most important factor for aerosol to do its job?
particle size
What does MMAD stand for?
Mass Median Aerodynamic Diameter
What's the Recommended MMAD for the Up airway?
> 10-15 microns
What's the Recommended MMAD for the larynx, trachea, and larger airways?
5 - 10 microns
What's the Recommended MMAD for the Lower airway?
2 - 5 microns
What's the Recommended MMAD for the lung parencyhma?
1 - 2 microns
What happens to particles < 1 micron in the airways?
They are exhaled from the lungs w/out depositing.
What's the therapeutic range for med aerosol?
2 - 8 microns
What are the 3 factors of deposition
1) Inertial impact
2) sedimentation
3) Brownian diffusion
What should the patient do to increase deposition&sedimentation while inhaling an aerosol Tx?
Hold their breath on inspiration for a few seconds.
What are the indications for aerosol drug therapy?
They are directly related to the med being delivered to the airway.
What are the hazards for aerosol drug therapy?
They are directly related to the med being delivered to the airway.
What do you do first when adm a MDI Tx?
Mix the MDI by shaking and warm the MDI by rolling it in yourr hands.
How long should a pt wait in between puffs?
30 - 60 seconds
How long should a pt hold in their breath during drug adm of an MDI?
Up to 10 seconds
How should a pt inhale when using a DPI?
They should inhale deeply and rapidly
How should a pt inhale when using a MDI?
They should inhale normally with an occasional inspiratory breath hold of up to 10 seconds.
How should a patient breathe in to get a med to the upp airway?
short and quick
How should a patient breathe in to get a med to the alveolar area?
slow and deep
What type of gas source do you use for patients with chronic hypoxemia?
Room air or air compressor
What type of pt interface do you use if a pt cant hold the mjouthpiece in their mouth during aerosol therapy?
Simple face mask
What type of mask is an air-entrainment mask?
Venturi mask
What are the reasons for using a holding chamber/spacer ?
To help the adm of the inhalant and to decrease deposition in the oral area.
What patients can't take a med via DPI?
Neonate, comatose, or elderly
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