scholarly journals P1‐85: Knowledge, awareness and practices of nurses and respiratory therapists regarding administering inhaler gadget education to admitted patients prescribed with an inhaler device

Respirology ◽  
2021 ◽  
Vol 26 (S3) ◽  
pp. 108-108
Keyword(s):  
Inhaler Device ◽  
Respiratory Therapists

scholarly journals Assessment of Knowledge, Practice and Attitude about Biomedical Waste Management among Healthcare Professionals during COVID-19 Crises in Al-Ahsa

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 747
Author(s):  
Sahbanathul Missiriya Jalal ◽  
Fahima Akhter ◽  
Amal Ismael Abdelhafez ◽  
Ahmed Mansour Alrajeh
Keyword(s):  
Work Experience ◽  
Healthcare Professionals ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Cross Sectional ◽  
Biomedical Waste ◽  
Respiratory Therapists ◽  
Global Pandemic ◽  
Before And After ◽  
Knowledge Practice

Biomedical waste (BMW) management is an essential practice of healthcare professionals (HCPs) for preventing health and also environmental hazards. Coronavirus disease (COVID-19) has become a global pandemic, posing significant challenges for healthcare sectors. A cross-sectional study was performed to assess the knowledge, practice, and attitude on BMW management among HCPs when taking care of patients with COVID-19 and associated with demographic variables. From Al-Ahsa healthcare sectors, 256 HCPs were selected randomly, of which 105 (41%) had excellent knowledge, 87 (34%) had good knowledge, and 64 (25%) had poor knowledge with a mean score of 13.1 ± 3.6. A higher mean score was (14.4 ± 3.2) obtained by physicians, and (13.6 ± 3.8) nurses than the other HCPs. Regarding practice, 72 (28.1%) HCPs used and discarded PPE while handling biomedical wastes. Additionally, 88 (34.4%) followed proper hand hygiene before and after each procedure and whenever needed. Physicians, nurses, and respiratory therapists had a more favorable attitude than other HCPs. There was a statistically significant association found among knowledge level and educational qualification (p < 0.0001), gender (p < 0.001), and work experience (p < 0.05). Emphasis is needed to train all HCPs regarding proper BMW management during this pandemic to prevent infection transmission.

Prehospital Intubations Are Associated with Elevated Endotracheal Tube Cuff Pressures: A Cross-Sectional Study Characterizing ETT Cuff Pressures at a Tertiary Care Emergency Department

2021 ◽  
pp. 1-4
Author(s):  
Ruo S. Chen ◽  
Laurel O’Connor ◽  
Matthew R. Rebesco ◽  
Kara L. LaBarge ◽  
Edgar J. Remotti ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Cuff Pressure ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Endotracheal Tube Cuff ◽  
Cross Sectional ◽  
Tube Cuff ◽  
Respiratory Therapists ◽  
Significant Difference

Abstract Introduction: Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the average ETT cuff pressure of patients arriving at the study site who were intubated by EMS exceeds the safe pressure range of 20-30cmH2O. Objectives: While ETT cuff inflation is necessary to close the respiratory system, thus preventing air leaks and aspiration, there is evidence to suggest that over-inflated ETT cuffs can cause long-term complications. The purpose of this study is to characterize the cuff pressures of ETTs placed by EMS providers. Methods: This project was a single center, prospective observational study. Endotracheal tube cuff pressures were measured and recorded for adult patients intubated by EMS providers prior to arrival at a large, urban, tertiary care center over a nine-month period. All data were collected by respiratory therapists utilizing a cuff pressure measurement device which had a detectable range of 0-100cmH2O and was designed as a syringe. Results including basic patient demographics, cuff pressure, tube size, and EMS service were recorded. Results: In total, 45 measurements from six EMS services were included with ETT sizes ranging from 6.5-8.0mm. Mean patient age was 52.2 years (67.7% male). Mean cuff pressure was 81.8cmH2O with a range of 15 to 100 and a median of 100. The mode was 100cmH2O; 40 out of 45 (88.9%) cuff pressures were above 30cmH2O. Linear regression showed no correlation between age and ETT cuff pressure or between ETT size and cuff pressure. Two-tailed T tests did not show a significant difference in the mean cuff pressure between female versus male patients. Conclusion: An overwhelming majority of prehospital intubations are associated with elevated cuff pressures, and cuff pressure monitoring education is indicated to address this phenomenon.

scholarly journals Examining Variations in Surfactant Administration (ENVISION): A Neonatology Insights Pilot Project

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 261
Author(s):  
Priya Patel ◽  
Andrew Houck ◽  
Daniel Fuentes
Keyword(s):  
Clinical Practice ◽  
Nurse Practitioners ◽  
Pilot Project ◽  
The United States ◽  
Institution Type ◽  
Respiratory Therapists ◽  
Respiratory Management ◽  
Surfactant Administration ◽  
Practice Variations ◽  
Almost All

Variability in neonatal clinical practice is well recognized. Respiratory management involves interdisciplinary care and often is protocol driven. The most recent published guidelines for management of respiratory distress syndrome and surfactant administration were published in 2014 and may not reflect current clinical practice in the United States. The goal of this project was to better understand variability in surfactant administration through conduct of health care provider (HCP) interviews. Questions focused on known practice variations included: use of premedication, decisions to treat, technique of surfactant administration and use of guidelines. Data were analyzed for trends and results were communicated with participants. A total of 54 HCPs participated from June to September 2020. In almost all settings, neonatologists or nurse practitioners intubated the infant and respiratory therapists administered surfactant. The INSURE (INtubation-SURrfactant-Extubation) technique was practiced by 83% of participants. Premedication prior to intubation was used by 76% of HCPs. An FiO2 ≥ 30% was the most common threshold for surfactant administration (48%). In conclusion, clinical practice variations exist in respiratory management and surfactant administration and do not seem to be specific to NICU level or institution type. It is unknown what effects the variability in clinical practice might have on clinical outcomes.

On Teaching Endotracheal Intubation

PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 656-656
Author(s):  
Gerald H. Katzman
Keyword(s):  
Patient Care ◽  
Endotracheal Intubation ◽  
Clinical Situation ◽  
Staff Nurses ◽  
House Staff ◽  
Respiratory Therapists ◽  
Human Neonate

Teaching endotracheal intubation to a large number of house staff, nurses, and respiratory therapists is often a difficult task. The difficulty is mainly in finding appropriate situations for practice while at the same time not compromising patient care. The anesthetized kitten1 has been suggested as a good model for teaching intubation. Although practice on the kitten is useful, in my experience transference of the intubation skill to a clinical situation with a human neonate has been less than satisfactory.

Real life data on the use of inhaler device, the satisfaction and the adherence of treatment evaluated by the pharmacists

2021 ◽  
Author(s):  
Bilun Gemicioglu ◽  
Nejdiye Mazican ◽  
Gunay Can ◽  
Ilkay F. Alp Yildirim ◽  
Sonmez B. Uydes Dogan
Keyword(s):  
Real Life ◽  
Inhaler Device ◽  
Life Data ◽  
Real Life Data

Computational Study of Atomization Models and Optimal Design of a Pressurized Inhaler

2021 ◽  
Vol 50 ◽  
pp. 123-134
Author(s):  
Anurag Tiwari ◽  
Siddharth Sharma ◽  
Vivek Kumar Srivastav ◽  
Anuj Jain ◽  
Akshoy Ranjan Paul
Keyword(s):  
Drug Delivery ◽  
Particle Production ◽  
Computational Study ◽  
Nozzle Diameter ◽  
Inhalation Therapy ◽  
Respiratory Drug Delivery ◽  
Minimum Diameter ◽  
Inhaler Device ◽  
Swirl Atomizer ◽  
Pressure Swirl

Respiratory drug delivery has been under the spotlight of research for the past few decades, mainly due to rapid increase of pulmonary diseases. This type of drug delivery offers the highest efficiency for treatment. Despite its numerous benefits, there are some drawbacks in the method of respiratory drug delivery-the most important being poor delivery efficiency and high drug deposition in undesirable regions, such as the oropharynx. This study is focused on improving pressurized inhaler device, which is one of the most used devices for inhalation therapy throughout the world using the results and findings obtained from numerical analysis. In this study, three atomizer models are investigated and found that pressure swirl atomizer model closely represents the atomization phenomenon from a pressurized inhaler device. Parametric study is carried out using three parameters: nozzle diameter, dispersion angle and sheet constant to optimize the performance of the device. It is revealed that a reduction in nozzle diameter and dispersion angle help in generating fine (smaller diameter) particles, whereas increase in sheet constant is responsible for fine particle production. The values of nozzle diameter, dispersion angle and sheet constant are tuned to get the particles with minimum diameter as output which is desirable for the drug particles to get deposited in the smaller airways of lungs and increase the efficiency of drug delivery and improve the device performance.

Abstract 170: Temperature Maintenance and Oxygen Use in Newborns at Birth: A Surveillance of Clinical Practice and Compliance with Neonatal Resuscitation Guidelines

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Georg M Schmölzer ◽  
Roxanne Pinson ◽  
Marion Molesky ◽  
Heather Chinnery ◽  
Karen Foss ◽  
...  
Keyword(s):  
Body Temperature ◽  
Knowledge Transfer ◽  
Oxygen Saturation ◽  
Neonatal Resuscitation ◽  
Positive Pressure ◽  
Respiratory Therapists ◽  
Vaginal Deliveries ◽  
Resuscitation Guidelines ◽  
The Right ◽  
Continuous Positive Pressure

Background: Guidelines of neonatal resuscitation are revised regularly. Gaps in knowledge transfer commonly occur when the guidelines are communicated to the clinical practitioners. Maintaining body temperature and supporting oxygenation are main goals that clinical practitioners aim to achieve in assisting newborns during the feto-neonatal transition at birth. Objectives: In this study, we aim to examine the compliance to guidelines in neonatal resuscitation regarding the temperature maintenance and oxygen use in newborns at birth. Methods: From October to November 2013, a prospective questionnaire surveillance was conducted in all attended deliveries at all four hospitals in Edmonton, Alberta, Canada. All clinical practitioners (registered nurses, physicians and respiratory therapists) were requested to complete the questionnaires immediately after the attended delivery regarding temperature maintenance and oxygenation monitoring. Descriptive statistics were used with mean±SD (range) and % presented. Results: During the 14-days study period, data was obtained in 518 of 712 (73%) attended deliveries of newborns with gestational age 38.6±2.0 (23-42) weeks and birth weight 3324±589 (348-6168) g. Of these deliveries, 58% were normal vaginal deliveries and 29% were cesarean sections. There were 8.8% and 8.4% newborns who required positive pressure ventilation and continuous positive pressure, respectively. Radiant warmer heat was used in 81% (419/518) with 63% (266/419) turned to full power. Room temperature was 21.6±1.6 (17-31)°C. Body temperature at 30-60 min after birth was 36.8±0.5 (32.4-38.1)°C with hypothermia (<36.5°C) in 17%. Percutaneous oxygen saturation was measured in 15% newborns and 96% had sensors placed at the right wrist. At the initiation of resuscitation, 21% oxygen was used in 76% and the oxygen concentration was adjusted according to an oxygen saturation chart in 17%. In 70% of the cases, clinical practitioners commented that this chart was not helpful. Conclusions: Gaps in knowledge transfer contribute to non-compliance in the guidelines of neonatal resuscitation for temperature maintenance and oxygen use. Caution is needed to avoid hypothermia and hyperoxia in at-risk populations such as prematurity.

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