Spirometry is one of the best and common lung function test. It is a test used for lung conditions such as asthma and chronic obstructive pulmonary disease (COPD). It has been reluctantly accepted in the day to day practice of both general and specialty medicine. It primarily measures expiratory airflow from fully inflated lungs and also can measure inspiratory airflow. The objective of spirometry is to assess ventilatory function. Spirometry provides an objective measurement of lung function.
The indications for spirometry include the need to
- detect the presence or absence of lung dysfunction suggested by history or physical signs and symptoms (eg, age, smoking history, family history of lung disease, cough, dyspnea, wheezing) and/or the presence of other abnormal diagnostic tests (eg, chest radiograph, arterial blood gas analysis);
- quantify the severity of known lung disease; assess the change in lung function over time or following administration of or change in therapy;
- assess the potential effects or response to environmental or occupational exposure;
- assess the risk for surgical procedures known to affect lung function;
- assess impairment and/or disability (eg, for rehabilitation, legal reasons, military).
- An aerosol is a suspension of liquid or solid particles in a gas such as smoke or smog. It exists all around us such as pollen, spores, dust, smoke, fogs, mists and viruses.
- We can create aerosols for therapeutic uses by physically shattering or sharing matter or liquid into small particles and dispensing it into a suspension.
- The equipment used to produce aerosols are nebulizers, generally produce aerosolize particles, which varies diameter and shapes.
- Aerosols are frequently needed to provide an ideal route for drug administration. In many cases aerosols are superior in terms of efficacy and safety to the same systematically administered drugs used to treat pulmonary disorder.
- Aerosol deliver a high drug concentration to the airway directly, while providing very low systemic doses are minimizing systemic side effects. As a result, aerosol drug delivery has a high therapeutic index.
- Drugs can be delivered by aerosol using small volume nebulizers, large volume nebulizer’s or metered dose inhaler.
Patient’s presenting with the following conditions:
- retained secretions
- asthma and other reactive airway diseases
- bronchitis and emphysema
- cystic fibrosis
- severe laryngitis, trachetitic and croup
- smoke inhalation or chemical trauma to the airways
- physical trauma to the upper airway
- post extubation therapy to prevent laryngical edema
General Goals of Aerosol Therapy
- Improve Bronchial Hygiene
- Hydrate retained secretions
- Improve efficiency of cough mechanism
- Restore and maintain normal function of mucociliary escalator
- Humidity gases delivered to patients with artificial airways
- Deliver medication
Hazards of Aerosol Therapy
- Precipitation of brochoconstriction
- Is most common in Asthmatic Patients
- May follow administration of certain drugs
- May result in hypoxemia
- Increased airway obstruction
- Systemic fluid overload
- Cross contamination
- When administering bronchodilator one should be cautious of the side effect associated with bronchodilator therapy
In patients who are critically ill because of the disease, trauma, or drugs, breathing may become depressed, absent or inefficient as a result of the energy required to cause breathing to occur. It is under this circumstances that alternate methods of providing ventilation are implemented. These methods are called artificial ventilation is caused by a machine, called mechanical ventilation.
Mechanical Ventilation is indicated to prevent patients from going into respiratory failure or to provide life support and stabilize the patients who are already in respiratory failure.
- Diseases and conditions leading to respiratory failure
- Impaired ventilation
- Impaired alveolar-capillary gas exchange
- Ventilation perfusion abnormalities
- PaO2 of <70 torr
PaCO2 of >50 torr while patient is breathing room air
PFT (Pulmonary Function Testing)
- Includes the study of all respiratory function and determination of obstruction and restriction of lungs through the use of Spirometer.
- Spirometer is the instrument used to measure the volume of air inhaled and exhaled.
ABG (Arterial Blood Gas)
- This test includes the extraction of blood to determine the level of oxygen. ABG is mostly indicated for critical conditions and the results can be done in a small period of time.
- Simple portable oxygen are used for patient who is able to breath by himself without the support of respirator
- The major importance of weaning is to have the patient in complete discontinuance from the ventilator support
- Is a procedure done to help keeping the lungs healty after surgery or when you have a lung illness, such as pneumonia.
- The incentive spirometer teaches you how to take slow deep breaths. After surgery, it may be too painful to take deep breaths.
PEAK EXPIRATORY FLOW RATE
- It is a test that measures how fast a person can exhale (breath out). This test checks lung functionin, and is often used by patients who have asthma.
- It is performed using a handheld device called peak flow meter. The device is easy to use and most patients even children over the age of five can take an accurate reading.
- It is used to help diagnose and monitor lung problems, such as asthma, chronic obstructive lung desease (COPD) and sometimes a lung transplant that is not working properly.
- Oygen saturation
- Airway Management
- Airway suctioning (Nasal and oral)
- Artificial suctioning (E.T. Tube and Tracheostomy)
- Tracheostomy care
- Chest Physiotherapy
- Lavage (Artificial airway)
- Transporting intubated patients