Intermittent Positive Pressure Breathing Report

8/9/2019 Intermittent Positive Pressure Breathing Report

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Intermittent PositiveIntermittent Positive

Pressure BreathingPressure Breathing


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IPPBIPPB

Intermittent positive pressure breathing (IPPB)Intermittent positive pressure breathing (IPPB)therapy consists of the use of a pressuretherapy consists of the use of a pressure--limited respirator to deliver a gas, with orlimited respirator to deliver a gas, with or

without humidity and/or an aerosol solution, atwithout humidity and/or an aerosol solution, atvarious preset intervals to mechanically aidvarious preset intervals to mechanically aidlung expansion, to deliver drugs, or to assistlung expansion, to deliver drugs, or to assistrespirator. It is commonly administeredrespirator. It is commonly administeredthrough a mouthpiece for short periods of timethrough a mouthpiece for short periods of timein a spontaneously breathing and cooperativein a spontaneously breathing and cooperativepatient.patient.


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SETTINGSSETTINGS

IPPB can be administered in settings thatIPPB can be administered in settings that

include hospital, clinic, extended care facility,include hospital, clinic, extended care facility,

and home.and home.


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INDICATIONS:INDICATIONS:

1.1. The need to improve lung expansionThe need to improve lung expansion

2.2. Pulmonary atelectasisPulmonary atelectasis

3.3. Inability to clear secretionsInability to clear secretions

4.4. The need to deliver aerosol medicationThe need to deliver aerosol medication

5.5. IPPB may be used to deliver aerosolIPPB may be used to deliver aerosol

medications to patients with fatigue as amedications to patients with fatigue as aresult of ventilatory muscle weaknessresult of ventilatory muscle weakness

6.6. In patients with severe hyperinflationIn patients with severe hyperinflation


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CONTRAINDICATIONS:CONTRAINDICATIONS:

1.1. Tension pneumothorax (untreated)Tension pneumothorax (untreated)

2.2. Intracranial pressure (ICP) > 15 mm HgIntracranial pressure (ICP) > 15 mm Hg

3.3. Hemodynamic instabilityHemodynamic instability

4.4. Recent facial, oral, or skull surgeryRecent facial, oral, or skull surgery5.5. Tracheoesophageal fistulaTracheoesophageal fistula

6.6. Recent esophageal surgeryRecent esophageal surgery

7.7. Active hemoptysisActive hemoptysis

8.8.

NauseaNausea9.9. Air swallowingAir swallowing

10.10. Active untreated tuberculosisActive untreated tuberculosis

11.11. Radiographic evidence of blebRadiographic evidence of bleb

12.12. Singulation (hiccups)Singulation (hiccups)


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HAZARDS/COMPLICATIONS:HAZARDS/COMPLICATIONS:

1.1. Increased airway resistance and work of breathingIncreased airway resistance and work of breathing

2.2. Barotrauma, pneumothoraxBarotrauma, pneumothorax

3.3. Nosocomial infectionNosocomial infection

4.4. HypocarbiaHypocarbia

5.5. HemoptysisHemoptysis

6.6. Hyperoxia when oxygen is the gas sourceHyperoxia when oxygen is the gas source

7.7. Gastric distentionGastric distention

8.8. Impaction of secretionsImpaction of secretions

9.9. Psychological dependencePsychological dependence

10.10. Impedance of venous returnImpedance of venous return

11.11. Exacerbation of hypoxemiaExacerbation of hypoxemia

12.12. Hypoventilation or hyperventilationHypoventilation or hyperventilation

13.13. Air trapping, autoAir trapping, auto--PEEP, overdistended alveoliPEEP, overdistended alveoli


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MONITORING:MONITORING:

1.1. Respiratory rateRespiratory rate

2.2. Delivered tidal volumeDelivered tidal volume

3.3. Pulse rate and rhythm from ECG if availablePulse rate and rhythm from ECG if available

4.4.

Patient subjective response to therapy:

pain, discomfort, dyspneaPatient subjective response to therapy:

pain, discomfort, dyspnea5.5. Sputum production: quantity, color, consistencySputum production: quantity, color, consistency

6.6. Mental functionMental function

7.7. Skin colorSkin color

8.8. Breath soundsBreath sounds

9.9. Blood pressureBlood pressure

10.10. Arterial hemoglobin saturation by pulse oximetry (if hypoxemia isArterial hemoglobin saturation by pulse oximetry (if hypoxemia issuspected)suspected)

11.11. Intracranial pressure (ICP) in patients for whom ICP is of criticalIntracranial pressure (ICP) in patients for whom ICP is of criticalimportanceimportance

12.12. Chest radiographChest radiograph


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INFECTION CONTROL:INFECTION CONTROL:

1.1. Implement Standard Precautions and appropriate guidelinesImplement Standard Precautions and appropriate guidelinesfor prevention of tuberculosis transmission.for prevention of tuberculosis transmission.

2.2. Observe all infection control guidelines posted for patient.Observe all infection control guidelines posted for patient.

3.3. All reusable equipment should be disinfected betweenAll reusable equipment should be disinfected between

patients.patients.4.4. Nebulizers/IPPB circuits should be changed betweenNebulizers/IPPB circuits should be changed between

patients, when visibly soiled, or according to institutionalpatients, when visibly soiled, or according to institutionalinfection control policy.infection control policy.

5.5. IPPB machines can be fitted with a scavenger or filterIPPB machines can be fitted with a scavenger or filter

system to prevent aerosol from being released outside thesystem to prevent aerosol from being released outside theimmediate treatment areasimmediate treatment areas

6.6. Nebulizers should not be rinsed with tap water betweenNebulizers should not be rinsed with tap water betweentreatments, but may be rinsed with sterile water or steriletreatments, but may be rinsed with sterile water or sterilesaline and allowed to air drysaline and allowed to air dry


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SelfSelf--administration ofIPPBadministration ofIPPB


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SelfSelf--administration ofIPPB:administration ofIPPB:

1.1. PositioningPositioning

2.2. Proper technique for administrationProper technique for administration

3.3. Proper use of equipmentProper use of equipment

4.4. Proper cleaning of equipmentProper cleaning of equipment

5.5. Ability to measure and mix medicationAbility to measure and mix medication

6.6. Optimal breathing patterns and coughing techniquesOptimal breathing patterns and coughing techniques

7.7. Technique modification in response to adverseTechnique modification in response to adverse

reactions and duration or frequency modification inreactions and duration or frequency modification in

response to severity of symptomsresponse to severity of symptoms


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ADVERSEAFFECTS:ADVERSEAFFECTS:

1.1. HyperventilationHyperventilation

2.2. Interruption of hypoxic driveInterruption of hypoxic drive3.3. Decreased Cardiac OutputDecreased Cardiac Output

4.4. ICPICP

5.5. PneumothoraxPneumothorax


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CHARTING:CHARTING:

1.1. Date and time of administrationDate and time of administration

2.2. Medication amount and dilutionMedication amount and dilution3.3. Duration of therapyDuration of therapy

4.4. RespiratorTidal volumeRespiratorTidal volume

Intermittent Positive Pressure Breathing Report

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