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The Science of HMEs
 

The Science of HMEs

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    The Science of HMEs The Science of HMEs Presentation Transcript

    • February 2012 1
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    • Arab medical textbookFebruary 2012 3
    • Treatment for Respiratory AilmentsWere Common During the Late 1800s February 2012 4
    • “Scientific adjustment to oxygen and nitrogen” Drs. Starkey and Palen, 1888February 2012 5
    • The public wasencouraged to come totheir Philadelphia salonfor inhalationtreatments. February 2012 6
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    • The Iron Lung was first used in 1928February 2012 14
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    • Active? Passive? Both?It is very important for respiratory therapists to evaluate each patient individually and choose the correct device. February 2012 44
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    • MAUDE Adverse Event ReportDevice Event Key: 2562848MDR Report Key: 2535472Event Key: 2432225Report Number: 2535472Device Sequence Number: 1Product Code: BTTReport Source: User FacilityReporter Occupation: RISK MANAGER February 2012 57
    • MAUDE Adverse Event ReportA sample report:Manufacturer: XXX HUMIDIFIERModel Number: XXXEvent Date: 04/09/2012Event Description: Patient is trachea-ventilatordependent. The circuit was changed by respiratorytherapy #1. Three days later, at approx 1 am, respiratorytherapist #2 noted the tubing connecting the humidifierfrom the water reservoir was clamped. February 2012 58
    • MAUDE Adverse Event ReportRespiratory therapist #2 unclamped the tubing. At approx 4am, patient became hypoxic and the heart rate decreased.Code Blue was called.Patient was resuscitated including suctioning thick copioussecretions. Patient went back to baseline. No sequelaenoted. February 2012 59
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    • 30/30February 2012 74
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    • Not to be confused with...February 2012 82
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    • HME • heat and moisture exchanger • least amount of moisture returned HMEF • filtered heat and moisture exchanger • second lowest amount of moisture returned HCH • hygroscopic condensing humidifier • second highest amount of moisture returned HCHF • filtered hygroscopic condensing humidifier • highest amount of moisture returnedFebruary 2012 85
    • Bypass “BHCH” • Gas flow may be redirected Active “AHCH” • Heat and water is added to the HCHFebruary 2012 86
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    • The brown center February 2012 97
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    • Inhalation pathways are not obstructed. Droplets of moisture or secretions may block the exhalation pathway.February 2012 99
    • Inconsistent Therapy? Passive humidifiers and inaccurate active humidification settings may lead to undesirable sputum outcomes, endotracheal tube occlusions and/or pneumothorax.February 2012 100
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    • Filter Design Cost Dead space Resistance Moisture outputFebruary 2012 104
    • HME HMEF HCH HCHF lowest highestFebruary 2012 105
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    • How do You Know Your Humidifier is Humidifying?February 2012 109
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    • This patient and HCHF were featured on The Learning Channel. 2ndand 3rd degree burns over 60% of the body and 3 months LOS –(tracheal not comprised.) Only used this product was used tohumidity the patient. February 2012 111
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    • Richard Branson’s evaluation of 21 HMEs, Table 2. (Respir Care 1996; 41:736-743)February 2012 115
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    • This form charts sputum trends; watery, moderate or tenacious. This form will also trend condensation indications and provides suggestions for copious and tenacious secretions.February 2012 117
    • Clear White Yellow Green Cream BrownFebruary 2012 118
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    • MAUDE Adverse Event ReportFebruary 2012 121
    • MAUDE Adverse Event ReportFebruary 2012 122
    • Ah Ha!February 2012 123
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    • Electron Micrographs of Three Filtration Media Taken at Identical Magnification Clockwise from lower left: RBCF filter medium, hygroscopic condenser humidifier medium and Filtrete medium Demers R R Chest 2001;120:1377-1389 February 2012 136©2001 by American College of Chest Physicians
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    • arcinfo@arcmedical.comFebruary 2012 138