Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Care of the person with Respiratory Compromise in disaster
Document related concepts
Transcript
Care of the person with functional needs in disaster situations: The respiratory system Rachel K. Vanek, RN, BS, BSN, MSN Acute Care Nurse Practitioner Medical Intensive Care Unit University/Case Medical Center Great Dismal Swamp Fire Apartment Fire • Large apartment complex caught fire • >100 elderly and poor evacuated • Many had respiratory and other illnesses making them vulnerable in emergency situations • Evacuated to hospitals and nursing homes for care/access to medical supplies Heat Waves Cold Snaps Floods Weather Illness outbreaks • Flu • Cold season • Water-borne illness • Crowded living situations Dust/Environmental Disasters • Dust storms • Toxic chemical leaks • Santa Anna winds • Other exposures that may require evacuation or special treatment Purpose • Learn a bit about normal respiratory functions • Determine strategies to plan for the management vulnerable persons in the event of an emergency • Answer YOUR questions Respiratory Anatomy and Physiology • Respiratory system comprised of conducting system and gas exchange system • Upper airway filters and warms air • Gas exchange occurs at the level of the alveoli Functions of Respiratory System • Warm and humidify air • Provide oxygen • Remove carbon dioxide • Cough and sneeze reflex to clear foreign material • Filters blood of small material in the circulation • Release and convert special hormones Respiratory Disorders • • • • • COPD Asthma Heart Failure Pulmonary Hypertension Pneumonia • • • • • • Pulmonary embolism Pneumonia Sleep apnea Lung Cancer Fibrosis Cystic fibrosis Medical Technologies • Enabling many people with severe disease to live longer, better lives • Patient is dependent on technology to survive • May be simple to complex • Most are fairly compact and portable now Medications • Always have a supply on hand • Always carry a list of medications and allergies • Have name and number of pharmacy Intravenous Medications • Some medications are infused into veins • Insulin pumps infuse subcutaneously • Flolan pumps require cassettes and special handling and infuse into central line IV medication safety • Running out of insulin or medication for pulmonary hypertension is an emergency • Patients have premixed supply • Needs refrigeration • Needs special handling to prevent overdose or infection • Friends, family or aides to assist Medication Safety • Child proof caps • Never mix different medicines in one container • Never share or take someone else’s medications • Expiration dates should be on the bottle • Never alter medication unless instructed to do so Oxygen • Used in a variety of health situations • May be used constantly or as needed, for example with exercise • Delivered via nasal cannula • Can be used with CPAP or BiPap at home • Can be used with mechanical ventilator Oxygen Delivery • Nasal Cannula • Simple Mask – used for O2 and nebulizer • Venturi Mask • Increased O2 needs requires specialty care • May have concentrator or storage tank Oxygen Safety • Keep tanks 5-10 feet from heat source or open flames • Secure an oxygen cylinder to a solidly fixed object • No smoking in car or home when O2 in use • Do not use petroleum based products near O2 use Oxygen Safety • Be careful when long lengths of tubing in use to avoid tripping • If O2 is pressurized avoid touching iced areas Oxygen concentrators Inhalers/Nebulizers • Medications delivered directly into the lung • Used in a variety of respiratory illnesses • Inhalers deliver medications in aerosol form to effect the airways • Nebulizer delivers the medication in a mist • Drugs and method of delivery are prescribed Ventilators • Provides gas movement in and out of lungs • Replaces work of breathing for person who can’t breathe or can’t breathe effectively • It is a life critical machine Ventilators • Person will have a tracheostomy • Require specialized training • People on ventilators have family, friends, or aides trained in the care and management • Battery packs can last up to 8 hours Mechanical Ventilator Safety • Airway must be secured • Machines have alarms • Airway requires suctioning at times • If disconnected easy to reconnect • Bag valve mask can replace the ventilators work in an emergency • Back up power source Ventilator Safety • Avoid loops of tubing – can be hazardous • Homes that have patients on ventilators have special emergency plans • Same safety precautions for oxygen if they have it as well CPAP and BPAP • CPAP is now a common modality for the treatment of obstructive sleep apnea • BPAP is used as an adjunctive modality to assist in ventilatory support • Machines have settings preset • Can be attached to oxygen CPAP and BPAP • BPAP is used to assist ventilatory support when sleeping • CPAP is used to stent open airways for obstructive sleep disorders • May have different uses in the hospital CPAP and BPAP saftey • Never use someone else’s machine • Avoid long loops of tubing • Most have built in humidity that need to be maintained and refilled • Masks and tubing can be cleaned with soap and water Key Points • O2 safety • People with medical needs will generally have the equipment they need • Providing safe haven • Enlist the assistance of family and friends Thank you for your kind attention Questions????
