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Tidal Volume (TV) 500 mL, is the depth of breathing or the volume of gas
inspired or expired during each respiratory cycle.
Residual Volume (RV) 1200 mL, is the amount of gas remaining in the
lungs at the end of maximal expiration (amount that cannot be squeezed out
of the lung). Even a collapsed lung contains 500 to 600 mL.
Lung Volumes and Capacities
Important capacities (addition of various lungs volumes) to consider are also
shown in the figure.
Total Lung Capacity (TLC) 600 mL, is the amount of gas contained in the
lungs at the end of maximal inspiration and is the sum of inspiratory capacity
(IC) and functional residual capacity (FRC).
Vital Capacity (VC) 4800 mL, is the maximal amount of gas that can be
expelled from the lungs by forceful effort from maximal inspiration.
Inspiratory Capacity (IC) 3600 mL, is the maximal amount of gas that can be
inspired from the resting expiratory level and is the sum of TV and IRV.
Inhalators
Ventilators
Respirators
Positive Pressure Breathing Apparatus
Resuscitators
Humidifiers
Nebulizers
Aspirators
Many of these instruments however have overlapping functions and the name
used for a particular device may vary among manufacturers.
Inhalators
An inhaler or puffer is a medical device used for delivering medication into
the body via the lungs.
Inhalators are used when concentration of oxygen higher than the air is
required.
Inhalators
The inhalator consists of:
2. Equipment for reducing the pressure and controlling the flow of the gas,
Devices for administering the gas to patients include nasal cannula and
catheters, face masks that cover the nose and mouth, and, in certain
settings such as pediatric, oxygen tents.
pulmonary tree.
Ventilators & Respirators
A medical ventilator may be defined as an automatic machine designed to
mechanically move breathable air into and out of the lungs, to provide the
mechanism of breathing for a patient who is physically unable to breathe, or is
breathing insufficiently.
Power input
Control scheme
1. Assist Mode
2. Control Mode
3. Assist-Control Mode
Ventilators & Respirators
Modes of Ventilators
1. Assist Mode
Thus the respirator helps the patient inspire when he wants to breathe.
The assist mode is used for patients who are able to control their
breathing but are unable to inhale a sufficient amount of air without
assistance.
Ventilators & Respirators
Modes of Ventilators
2. Control Mode
This mode required for patients who are unable to breath on their own.
In this mode the respirator has complete control over the patients respiration
and does not respond to any respiratory effort on the part of the patient.
Ventilators & Respirators
Modes of Ventilators
3. Assist-Control Mode
Thus patient controls his own breathing as long as he can, but if he fail to do
so, the machine is able to take over for him.
2.A predetermined volume of gas has been delivered to the patient. A ventilator
that operates in the mode is said to be volume-cycled ventilator.
3.The air or oxygen has been applied for a predetermined period of time. A
ventilator that operates in the mode is said to be time-cycled ventilator.
Intermittent Positive Pressure
Breathing Apparatus
Intermittent positive pressure breathing (IPPB) therapy involves special
procedures and equipment.
IPPB is a type of assisted breathing pattern in which the lungs are inflated
by positive pressure during inspiration and, on release of the pressure,
expiration occurs passively.
IPPB is indicated for patients with the following problems: chest disorders,
such as bronchitis. bronchiectasis, asthma, pulmonary emphysema. and
edema: central nervous system disorders (e.g.. drug overdose); chronic
broncho-pulmonary diseases (e.g., bronchial infections, respiratory
acidosis); and postoperative conditions (to prevent pneumonia).
Intermittent Positive Pressure
Breathing Apparatus
The objectives of IPPB are to assist and promote more uniform ventilation,
facilitate better O2 and CO2 exchange and aspiration of antibiotic drugs,
relieve broncho-spasm, assist in removal of broncho-pulmonary secretions
(drainage), and exercise respiratory muscles.
Medical gases commonly used are oxygen, compressed air, and oxygen-
helium mixtures.
Cardiopulmonary Resuscitation
This is a technique used to maintain blood flow and oxygenation when heart
attack (fibrillation) or respiratory arrest is present.
Virtually all inhalators and respirators include equipment to humidify the air.
1.A generator that produces a radio frequency current to derive the ultrasonic
transducer.
2.A transducer that generates the ultrasound energy that is applied to the water
or medication.
Nebulizers
Ultrasonic Nebulizers
Unlike the conventional nebulizer, the ultrasonic nebulizer does not depend on
the breathing gas for operation.
The following regulating agencies and acts are important to the therapist:
Gas cylinders are made from seamless tubing (brazed or welded) or from flat
sheets of drawn steel shaped into a cylinder.
Gas cylinders ore dangerous and if mishandled may result in fire and
explosion.
Markings on gas cylinders are required. For example, first line: ICC spec 3AA,
2015 psig; second line: H 396042: third line: BAP (manufacture marking): and
fourth line: 8-10 (month and year of qualification test).
Medical Gases and Safety Systems
Piping systems, as shown in the Figure, are used throughout the hospital.
Medical Gases and Safety Systems
Piping Systems
The main supply must have a shutoff valve and an alarm system.
All personnel must be educated as to the placement and use of these valves.
Medical Gases and Safety Systems
Therapeutic Gases
The Pin-Index Safety System (PISS) is the two-pin approach that prevents
incorrect interchange of medical gas cylinders with flush-type valves.