Respiratory therapies

1. RESPIRATORY THERAPIES
ANILKUMAR BR , LECTURER

2. SHREE JENUKAL

3. INTRODUCTION
 Numerous treatment modalities are used when
caring for clients with various respiratory conditions.
 The choice of treatment modalities is based on the
oxygenation disorder and whether there is a
problem with gas ventilation, diffusion or both.

4. CLASSIFICATION OF RESPIRATORY MANAGEMENT
MODALITIES
 Non-invassive respiratory therapies
 Invasive respiratory therapies

5. NON – INVASIVE RESPIRATORY THERAPIES
 Oxygen Therapy
 Incentive spirometry
 Mini – nebulizer Therapy
 Intermittent Positive –pressure breathing ( IPPB)
 Chest physiotherapy ( Postral drainage ,chest percussion,
breathing retraining

6. INVASIVE RESPIRATORY MODALITIES
 Endotracheal intubation
 Tracheostomy
 Mechanical ventilation

7. OXYGEN THERAPY
 Oxygen therapy is the administration of oxygen at a
concentration greater than that found in the environmental
atmosphere.

8. INDICATIONS OF OXYGEN THERAPY
 A change in the clients respiratory rate or pattern may be
one of the earliest indications of the need for oxygen
therapy.
 Hypoxemia or hypoxia

9. COMPLICATIONS OF OXYGEN THERAPY
 Oxygen toxicity
 Suppression of ventilation
 Combustion

10. METHODS OF OXYGEN ADMINISTRATION
 Low flow system
 High flow system

11. LOW FLOW SYSTEM
 Cannula
 Oropharyngeal catheter
 Simple mask
 Partial rebreather mask
 Non breather mask

12. HIGH FLOW SYSTEMS
 Transtracheal catheter
 Venturi mask
 Tracheostomy collar
 T – piece
 Face tent

13. INCENTIVE SPIROMETRY ( SUSTAINED MAXIMAL INSPIRATION)
 Incentive spirometry is a method of deep breathing that
provides visual feedback to encourage the clients to inhale
slowly and deeply to minimize lung inflation and prevent or
reduce atelectasis.

14. PURPOSE OF INCENTIVE SPIROMETRY
 The incentive spirometer that volume of air inhaled is
increased gradually as the patient takes deeper and
deeper breaths.

15. TYPPES OF INCENTIVE SPIROMETRY
 Volume or Flow spirometry

16. INDICATIONS OF SPIROMETRY
 Incentive spirometry is used after surgery, especially
Thoracic and abdominal surgery, to promote the
expansion of the alveoli and to prevent or trat atelectasis.

17. INSTRUCTIONS REGARDING SPIROMETRY USING
 Proper position
 Technique for using the spirometry
 Frequency of usage

18. MINI-NEBULIZER THERAPY
The mini-nebulizer is a handled appartus that disperses a
moisturizing agent or mediation, such as bronchodilator or
mucolytic agent, into microscopic particles and delivers it to
the lungs as the client inhales.

19. INDICATIONS OF MINI-NEBULIZER THERAPY
 In case of difficulty in clearing respiratory secreations
 Reduced vital capacity with ineffective deep breathing
and coughing.
 Most commonly used in COPD clients

20. INTERMITTENT POSITIVE PRESSURE BREATHING
 Intermittent Positive- pressure breathing ( IPPB) is an
older form of assisted or controlled Respiration in which
compressed gas is delivered under Positive pressure into
a person’s airways unitil a preset pressure is reached
today.
 It is infrequently used currently

21. CHEST PHYSIOTHERAPY ( CPT)
 Chest physiotherapy includes Postral drainage, chest
percussion, and chest vibration and breathing retraining.
 The goals of CPT are to remove bronchial secretions,
improve ventilation, and increases the efficiency of the
respiratory muscles.

22. INVASIVE RESPIRATORY MODALITIES

23. ENDOTRACHEAL INTUBATION
 Endotracheal intubation involves passing an endotracheal
tube through the mouth or nose into the trachea.
 Endotracheal intubation provides a patent airway when
the patient is having respiratory distress that cannot be
treated with simpler methods and is the method of choice
in emergency care.

24. TRACHEOSTOMY
 A tracheostomy is a surgical procedure in which an
opening is made into the trachea.
 The indwelling tube inserted into the trachea is called a
tracheostomy tube.
 A tracheostomy either Temporary or permanent.

25. COMPLICATIONS OF TRACHEOSTOMY
 Complications may occur early or late in the course of
tracheostomy tube management.
 They may even occur yees after the tube has been
removed.

26. EARLY COMPLICATIONS INCLUDING
 Bleeding
 Pneumothorax
 Air embolism
 Aspiration
 Subcutaneous or mediastinal emphysema
 Recurrent laryngeal nerve damage

27. LONG TERM COMPLICATIONS
 Airway instructions from accumulation of secretions
 Infection
 Rupture of the innominate artery
 Dysphagia
 Tracheoesophageal fistula
 Tracheal ischmia and necrosis

28. MECHANICAL VENTILATION
 Mechanical ventilation may be required for a variety of
reasons.
 To control the patient Respiration during surgery or during
treatment of severe head injury, to oxygenate the blood
when the patient ventilatory efforts are inadequate

29. MECHANICAL VENTILATION
 A mechanical ventilator is a Positive or negative pressure
breathing device that can maintain ventilation and oxygen
delivery for a prolonged period

30. INDICATIONS
 Continues decrease in oxygenation (PaO2), an
increase in arterial carbon dioxide levels ( PaCO2)
and persistent acidosis ( decreased pH) mechanical
ventilation may be necessary. ( Any dramatic
alterations in ABGs valves)

31. INDICATIONS
 Conditions such as Thoracic or abdominal surgery
 Drugs over dose
 Neuromuscular injury and inhalation ingury
 COPD , multiple trauma, shock, multisysstem failure and
coma.

32. CLASSIFICATION OF VENTILATORS
 Negative- pressure ventilators
 Positive- pressure ventilators

33. COMPLICATIONS
 Alterations in cardiac function
 Barotrauma ( trauma to the trachea or alveoli secondary
to Positive pressure)
 Ventilator associated pneumonia
 Pulmonary infection
 Sepsis

34. WEANING THE PATIENT FROM THE VENTILATOR
 Respiratory weaning, the process of withdrawing the
patient from dependncce on the ventilator, takes place in
three stages, the patient is gradually removed from the
ventilator, then from the tube, and finnaly from oxygen.

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