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The patient with acute respiratory problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
All patients receiving oxygen therapy must have their oxygen saturation levels measured regularly and the concentrations of inspired oxygen titrated accordingly, with extra caution taken with individuals at risk of hypercapnia. While oxygen therapy is not beneficial to non-hypoxaemic individuals, a sudden drop in oxygen saturation of 3% or more is an early sign of acute deterioration, which should prompt further assessment. The target oxygen saturation rate is 94–98% unless the individual is at risk of hypercapnia, in which case the target is 88–92%. In serious illness with milder degrees of hypoxaemia, oxygen can be administered through nasal cannulae at 1–6L/min or by a simple face mask at 5–10L/min (a simple face mask must not be used at flow rates less than 5L/min, as this may result in carbon dioxide rebreathing). The medical team may also prescribe 24%, 28%, 35%, 40% or 60% oxygen via a venturi mask. When administrating oxygen via a venturi mask, it is important that the nurse sets the correct flow rate to ensure the correct percentage. The correct flow rates are indicated on the mask (2L/min for 24%, 4L/min for 28%, 8L/min for 35%, 10L/min for 40% and 15L/min for 60%). For individuals in respiratory distress with RR greater than 30/min, the flow of gas needs to be increased to meet the raised demand for flow. When using the venturi mask, this can be achieved by doubling oxygen flow rate; the design of the air entrainment port in the mask means that the percentage of oxygen delivered will remain the same.
Human–Robot Interaction for Rehabilitation Robots
Published in Pedro Encarnação, Albert M. Cook, Robotic Assistive Technologies, 2017
Wing-Yue Geoffrey Louie, Sharaf Mohamed, Goldie Nejat
A study with older adult participants from a retirement home was conducted with a PeopleBot robot to investigate the participants’ perceptions and attitudes regarding the facial features of a medicine delivery robot (Zhang et al. 2010). The robot had one of three different anthropomorphic features when delivering medicine to the participants: a simple face mask with cameras for eyes (Figure 2.4), voice capabilities via a speech synthesizer, or a touch display for user interactivity. Participant perceptions of the robot features were measured using a customized perceived anthropomorphism questionnaire, and participant emotional responses were measured using the SAM questionnaire. Results of the study showed that human-like features such as a face and voice promoted positive emotional responses based on the SAM questionnaire. Furthermore, when features became more human-like, user perceptions of anthropomorphism increased based on the perceived anthropomorphism questionnaire.
The patient with acute respiratory problems
Published in Ian Peate, Helen Dutton, Acute Nursing Care, 2014
Oxygen is administered to correct hypoxaemia with the correct inspired oxygen concentration given to achieve a target saturation: the British Thoracic Society has published guidelines (O’Driscoll et al. 2008). In critical illness where saturations are below 85% in patients without risk of hypercapnia failure high-flow oxygen should be administered using a reservoir mask at 15 L/min. In serious illness with milder degrees of hypoxaemia oxygen can be administered through nasal cannulae at 2– 6 L/min or by a simple face mask at 5 –10 L/min (a simple face mask must not be used at flow rates less than 5 L/min as this may result in carbon dioxide rebreathing). The aim is to achieve normal or near-normal oxygen saturations for all acutely ill patients (apart from those at risk of hypercapnic failure) with a target oxygen saturation of 94 – 98%.
High flow nasal cannula versus non- invasive ventilation in prevention of intubation in immunocompromised patient with acute hypoxemic respiratory failure
Published in Egyptian Journal of Anaesthesia, 2021
Ashraf Elsayed Elagamy, Sameh Salem Taha, Dalia Mohamed Elfawy
Oxygen support for patients of both groups was continued for at least 48 hours, then according to the respiratory state of the patient, could be weaned from oxygen support or need mechanical ventilation. Patients of both groups could be weaned from HFNC and NIV and switched to conventional oxygen therapy in the form of simple face mask or nasal cannula with oxygen flow from 4 to 10 L/min, when RR is less than 25 breaths/min and SpO2 equal or more than 92% with FiO2 equal or less than 0.5 and flow less than 50 L/min in HFNC or stopped NIV with maintenance of the same respiratory parameters. In case of respiratory distress or desaturation after weaning of oxygen support in the form of HFNC or NIV, patient was shifted again to oxygen support according to his randomization group.
High-flow nasal cannula versus conventional oxygen therapy in patients with dyspnea and hypoxemia before hospitalization
Published in Expert Review of Respiratory Medicine, 2020
Qi Liu, Changju Zhu, Chao Lan, Rongchang Chen
Shortness of breath or dyspnea is a common condition in emergency departments [1]. Patients often have different degrees of hypoxemia or even acute respiratory failure, which increases afferent reflex from the peripheral sensors and provokes the insula and cortical network to generate higher neural output to the respiratory system to compensate for respiratory insufficiency. However, if this increased central neural output does not compensate enough airflow or ventilation attributed to the dysfunction of respiratory mechanics and the increased work of breathing, a sensation of dyspnea occurs [2]. Dyspnea not relieved and hypoxemia not corrected in time damage the function of important organs and leads to a poor clinical prognosis [3,4]. Oxygen therapy is a commonly applied supportive treatment to correct hypoxemia and relieve dyspnea [5]; however, how to perform oxygen therapy is controversial, and may affect the curative potential and even patients’ prognosis. Oxygen inhalation via low-flow devices (up to 15 L/min) including nasal cannula or a simple face mask is the most commonly used method, but its efficacy is limited by low oxygen concentration and insufficient humidification [6]. Additionally, the low flow associated with conventional oxygen therapy (COT) does not produce enough resistance during expiration to introduce a positive pressure effect [6].
Does the mode of anesthesia affect the feto-maternal outcome in category-1 caesarean section? A prospective non-randomized study comparing spinal versus general anesthesia
Published in Egyptian Journal of Anaesthesia, 2021
Samar Rafik Mohamed Amin, Ramy Mousa Saleh, Yehya Shahin Dabour
For spinal anesthesia: all parturients were coloaded with 500 mL of colloid solution. In the left lateral position, the patients’ back was cleaned with povidone iodine. In the meantime, the spinal anesthetic drug and local anesthetic drug were prepared. After wiping povidone iodine with alcohol, a single rapid shot of 2.2 mL of 0.5% hyperbaric bupivacaine was administered intrathecally using 22 G spinal needle. Later, the patients were kept in supine position with pelvic wedge. Oxygen was administered using simple face mask till the delivery of the baby.