Ik vond, tijdens een snelle zoektocht, op een website de volgende tekst(lees door, staat ook iets in over klachten bij gebruik.)
citaat:The uses of bland aerosols [those that do not contain medication] include the delivery of sterile water, isotonic, hypotonic or hypotonic saline to the airways on a continuous bases with or without artificial airways
Bland aerosols may be given with Fi02 .21 or more
Bland aerosols may be given continuously or administered for 10 to 20 minutes at scheduled intervals
Indications for large volume aerosols
· Cool mist to the upper airways
o Via an aerosol mask or a face shield
o Post-op patients get cool mist to reduce the irritation that can result in swelling and edema from extubation. In this circumstance we use sterile water but sterile saline is less irritating to those who wheeze
o Croup, laryngitis or laryngotrachitis [as long as they don’t wheeze.
o Induce coughing for sputum sample in persons whose secretions are too scanty to produce easily.
Very common for cytology studies to find lung cancers.
Hypotonic or hypertonic saline solutions are used to induce coughing because they are so irritating
o Heated aerosols: generally once the patient’s airway has been bypassed a heated aerosol is preferred to avoid the humidity deficient. More properly these folks might be better served with a heated high flow humidifier---but these devices are more expensive.
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Cautions & contraindications to all types of aerosols but particularly cool ones
· Any aerosol that is not a bronchodilator has the potential to cause reflex Bronchospasm.
· Aerosols carry microbe down to the lower airways
· They are associated with the spread of infections to caretakers [TB]
· They are irritating to some persons
NOTE Try to induce a cough without an aerosol first…you would be surprised how often no one has asked the patient to cough or no one has taught the patient how to cough into a sputum cup.
From my experience as an asthmatic, the worst thing you could do to me is to administer a cool aerosol with sterile water…but that is the routine 02 administration device of choice in the recovery room.
SO--- Check the patient’s history for asthma or COPD before giving the standard 40%-60% aerosol in the REC Room, or if he presents with SOB, and wheezing after the addition of the aerosol, you should change 02 deliveries to device with cool humidifier.
Some facts about aerosol generators:
They create particles of water droplets
The 02 devices attached to aerosol generators have large aerosol hoses that will require draining every 3 hours. More often if heated aerosol
Fi02 adjustment on pneumatic aerosol generators [the most common] are forms of entrainment—like the entrainment mask.
As the Fi02 is raised the total flow rate to the patient drops.
As Fi02 drops the total flow rate increases.
The ratio is identical to that of entrainment mask [venturi-mask]
As water builds up in the tubing there is increased pressure inside the entrainment device so that the lateral pressure rises and less air is entrained.
The 02 delivery devices all share the same generator and entrainment port, but the actual interface [Brigg’s adaptor, or aerosol mask or face shield] has it’s own entrainment problems so the delivered Fi02 can vary.
Fi02 on this devices will vary from 28% to 100% based on the actual entrainment ports of the aerosol generator
Bland aerosols may be given with Fi02 .21 or more
Bland aerosols may be given continuously or administered for 10 to 20 minutes at scheduled intervals
Indications for large volume aerosols
· Cool mist to the upper airways
o Via an aerosol mask or a face shield
o Post-op patients get cool mist to reduce the irritation that can result in swelling and edema from extubation. In this circumstance we use sterile water but sterile saline is less irritating to those who wheeze
o Croup, laryngitis or laryngotrachitis [as long as they don’t wheeze.
o Induce coughing for sputum sample in persons whose secretions are too scanty to produce easily.
Very common for cytology studies to find lung cancers.
Hypotonic or hypertonic saline solutions are used to induce coughing because they are so irritating
o Heated aerosols: generally once the patient’s airway has been bypassed a heated aerosol is preferred to avoid the humidity deficient. More properly these folks might be better served with a heated high flow humidifier---but these devices are more expensive.
--------------------------------------------------------------------------------
Cautions & contraindications to all types of aerosols but particularly cool ones
· Any aerosol that is not a bronchodilator has the potential to cause reflex Bronchospasm.
· Aerosols carry microbe down to the lower airways
· They are associated with the spread of infections to caretakers [TB]
· They are irritating to some persons
NOTE Try to induce a cough without an aerosol first…you would be surprised how often no one has asked the patient to cough or no one has taught the patient how to cough into a sputum cup.
From my experience as an asthmatic, the worst thing you could do to me is to administer a cool aerosol with sterile water…but that is the routine 02 administration device of choice in the recovery room.
SO--- Check the patient’s history for asthma or COPD before giving the standard 40%-60% aerosol in the REC Room, or if he presents with SOB, and wheezing after the addition of the aerosol, you should change 02 deliveries to device with cool humidifier.
Some facts about aerosol generators:
They create particles of water droplets
The 02 devices attached to aerosol generators have large aerosol hoses that will require draining every 3 hours. More often if heated aerosol
Fi02 adjustment on pneumatic aerosol generators [the most common] are forms of entrainment—like the entrainment mask.
As the Fi02 is raised the total flow rate to the patient drops.
As Fi02 drops the total flow rate increases.
The ratio is identical to that of entrainment mask [venturi-mask]
As water builds up in the tubing there is increased pressure inside the entrainment device so that the lateral pressure rises and less air is entrained.
The 02 delivery devices all share the same generator and entrainment port, but the actual interface [Brigg’s adaptor, or aerosol mask or face shield] has it’s own entrainment problems so the delivered Fi02 can vary.
Fi02 on this devices will vary from 28% to 100% based on the actual entrainment ports of the aerosol generator
]?) Het belangrijkste is volgens mij de particle size van de rook. Des te groter, des te meer men er last van kan hebben. Ik hoop dat je hier wat aan hebt.
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