Forsyth Medical Center transitioned a 38 bed pulmonary unit from traditional jet nebulizers to BAN nebulizers and developed a medication dosing and frequency protocol. Albuterol was converted to 0.5 ml of a 0.5% solution with 1ml normal saline. Atrovent was converted to one half unit dose. The breath actuated mode via mouthpiece or mask interface with normal saline increased to 2 ml and continuous mode was used. Frequencies were changed from Q4 to Q6 and QID to TID. BANs were changed weekly versus daily with traditional nebulizers. Average hourly rate, treatment time, drug costs, and device costs for June through November 2008 were compared to 2007. To ensure effectiveness of therapy we compared the average number of both scheduled and PRN treatments per patient per day. Subsequently, we utilized this model to convert all impatient beds to BAN in June 2010 and compared data to a similar time period in 2009. Click here to view the White Paper.
For many years Pressure Support has been a popular form of assisted ventilation. This partial ventilatory support breath type uses physiologic inputs to determine breath delivery timing so that the ventilator’s activity can be synchronized with that of the patient.1 Improved patient ventilator synchrony can reduce sedation needs which can result in earlier liberation from the ventilator. When it functions as intended, Pressure Support can be useful for helping patients overcome the excessive load associated with acute disease states, working as a pump that takes care of most of the load, but still allowing the patient to breathe spontaneously and in a physiological pattern that seems to preserve the integrity of the diaphragm. 2,3 In cases of diaphragm atrophy, disuse or fatigue, the unloading of respiratory muscles provided by pressure support can also be of help, by providing work support while the patient buildsthe strength needed to breathe without the ventilator. 4,5 Click here to read full white paper.
An analyzers QC system helps to ensureand verify that analytical processes are performing according to expectations, and more importantly, that all patient test results obtained are accurate.Any instrument QC program generally incorporates a variety of processes to help ensure performance quality. These processes include instrument calibration, calibration verification, system functionality checks, preventative maintenance, proficiency testing, and the routine analysis of materials of known concentration, referred to as controls. Click here to download.
J P Armitstead, PhD; G N Richards, MB ChB; A Wimms, BSc; A V Benjafield, PhD
Applied Research and ResMed Science Center, ResMed Ltd, Sydney, Australia
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