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Travelers and workers at high altitude
Published in Andrew M. Luks, Philip N. Ainslie, Justin S. Lawley, Robert C. Roach, Tatum S. Simonson, Ward, Milledge and West's High Altitude Medicine and Physiology, 2021
Andrew M. Luks, Philip N. Ainslie, Justin S. Lawley, Robert C. Roach, Tatum S. Simonson
The simplest way to produce oxygen to pump into a room is through the use of an oxygen concentrator, whose principle of operation is similar to that used in homes to provide oxygen for patients with chronic lung disease. Air is pumped at high pressure through a synthetic zeolite, which adsorbs nitrogen from the air. The result is that the effluent gas has a high oxygen concentration, typically 90–95%. After 20–30 seconds, the zeolite is unable to absorb more nitrogen and the compressed air is then switched to another cylinder containing the same material. The original cylinder is then purged of nitrogen by blowing air through it at normal pressures. In this way, a continuous supply of 90–95% oxygen is available. A typical commercial unit provides 5 L min−1 of over 90% pure oxygen at a power consumption of 350 W. It is also possible to provide the oxygen from liquid oxygen tanks, but this is more expensive and less convenient because the tanks need to be replenished. The main expense with the concentrators is the power required to run the systems.
Living with chronic lung disease: The experiences and needs of patients and caregivers
Published in Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein, Pulmonary Rehabilitation, 2020
Alda Marques, Roger S. Goldstein
I still enjoy driving, and I drive everywhere. I have a mobility scooter in the trunk of my car which I use when out shopping. I also have a walker which I use when attending doctors’ appointments or visiting my rehab facility. I flew recently, with my partner. I was a bit apprehensive about traveling with oxygen, but the airline was fantastic and my oxygen company made sure I had enough batteries for the portable oxygen concentrator. However, traveling is something I cannot do on my own.
Military Environments
Published in Kenneth D Boffard, Manual of Definitive Surgical Trauma Care: Incorporating Definitive Anaesthetic Trauma Care, 2019
Midazolam (0.02–0.05 mg/kg initially) can be used to maintain anaesthesia immediately following RSI in addition to fentanyl. Further boluses of 0.02 mg/kg can be titrated to anaesthetic effect. Anaesthesia for surgery is usually maintained with a volatile agent. In ongoing hypovolaemia, volatile use should be carefully titrated along with fentanyl according to physiological parameters. The Tri-Service Anaesthetic Apparatus (TSAA) (UK Defence Medical Services) can be used to administer a volatile anaesthetic without a supply of compressed gas. It can be used in conjunction with an oxygen concentrator that preserves supplies of cylinder oxygen. The US Defence Medical Services have ‘draw-over’ anaesthesia apparatus like the TSAA. An alternative to volatile anaesthesia is total intravenous anaesthesia (TIVA). In its simplest form, this could be bolus administration of ketamine for short cases. Syringe drivers are now in common use and allow for a variety of TIVA drugs to be used.
Effective training-of-trainers model for the introduction of continuous positive airway pressure for neonatal and paediatric patients in Kenya
Published in Paediatrics and International Child Health, 2019
Bernard Olayo, Caroline Kendi Kirigia, Jacquie Narotso Oliwa, Odero Nicholas Agai, Marilyn Morris, Megan Benckert, Steve Adudans, Florence Murila, Patrick T. Wilson
Two DeVilbiss IntelliPAP (Somerset, PA, USA) CPAP machines, approximately 50 Hudson RCI nasal prongs (Durham, NC, USA) of various sizes, two pulse oximeters and supplies needed to apply CPAP (head wrap, rubber bands, safety pins) were provided to each hospital. The CPAP machines were set-up and locked to deliver five centimeters of water pressure. Oxygen, if indicated, was administered via the CPAP inspiratory limb from the available oxygen source at each hospital (oxygen concentrator, oxygen cylinder or wall oxygen). Humidification was provided through nasal saline drops to the nares as needed or through humidified oxygen. Data on demographics, diagnosis, duration, outcome and adverse events of patients placed on CPAP from 16 July 2014 to 31 March 2016 were entered onto a one-page case report form by the healthcare provider applying the CPAP. Adverse events related to the use of CPAP were recorded prospectively by the treating clinician. Aspiration pneumonia was reported if an episode of emesis was followed by worsening respiratory status, regardless of chest radiograph findings.
Home oxygen therapy: re-thinking the role of devices
Published in Expert Review of Clinical Pharmacology, 2018
Andrea S. Melani, Piersante Sestini, Paola Rottoli
A relatively recent technology advancement is the production of oxygen concentrators able to fill an ambulatory cylinder with gaseous oxygen for subsequent usage outside home. Some characteristics of these devices have been reported in Table 3. The HomeFill II® (Invacare Corporation, Elyria, OH, U.S.A) has been shown to be as effective as conventional ambulatory cylinders of gaseous oxygen in COPD subjects during the 6MWT [20]. A survey from Scotland suggests that this device is easy to use in real life [21]. Another similar device is the UltraFill® (Respironics-Phillips, Murrysville, PA, U.S.A) system able to combine a stationary oxygen concentrator releasing a continuous low oxygen, and the filling of oxygen cylinders. The iFill® (DeVilbiss Healthcare LLC, Somerset, PA, U.S.A) differs from other self-fill systems as it operates as an independent fill station. It can be used in conjunction with any type of stationary concentrators.
Care of children with home mechanical ventilation in the healthcare continuum
Published in Hospital Practice, 2021
Benjamin Kalm, Khanh Lai, Natalie Darro
Regardless of elevation and geographic location, a home oxygen concentrator, typically used for long-term oxygen delivery, is not capable of delivering 100% oxygen, which is especially relevant at high flow rates. In addition to the theoretical maximum oxygen delivery, the actual delivered oxygen percent, and therefore equivalent flow rate, decreases without frequent maintenance to ensure maximal nitrogen removal [12,13].