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雾化水和大容量喷雾器2雾化的概念•雾化吸入疗法的原理是利用气体射流原理，将水滴撞击的微小雾滴悬浮于气体中，形成气雾剂而输入呼吸道，以进行呼吸道湿化或药物吸入的治疗方法。•雾化吸入有消炎、化痰、解除气管平滑肌痉挛、减轻喉头水肿的效果.尤其是对于气管切开且长期卧床患者效果明显。•产生的微粒为2～15μm,平均6μm，能到达各级气道。3什么是大容量雾化治疗•Atypeofrespiratorytherapyusedinthehospital,long-termcareandhomeenvironments.一种用于医院,长期护理和家居护理的呼吸治疗方式•Providesvisibleparticlesofwatertotherespiratorytracttothinmucusandassistinthemobilizationofsecretions.向呼吸道提供可见的雾化水颗粒，以便稀释呼吸道分泌物，使其易于排出•Ablandaerosol(waterorsaline)iscreatedbyanebulizerandcarriedtothepatientvia22mmcorrugatedtubing.雾化器产生纯净的雾气(蒸馏水或生理盐水),由22mm直径的螺纹管连接输送雾气给患者•Deliveredviamask,facetentortrachmask雾化气体可通过面罩、氧气面帐或气切面罩送达患者LVNTherapy4专有名词•LVN-LargeVolumeNebulizer大容量喷雾器•Nebulizer–Adevicethattransformsaliquidintoanaerosol喷雾器–一种将液体转换成喷雾剂（雾气）的装置•Aerosol-Suspensionoffineliquidparticles喷雾剂、雾化颗粒–悬浮着的细小液体微粒•Blandaerosol-Soothingornon-irritating,nopharmacologicaction,usuallywaterorsalinesolution纯净的雾化治疗-不添加药物，舒缓、无刺激，通常用无菌水或生理盐水•RainOut-Aerosolparticlesthatdropoutofsuspensionandcollectinthe22mmtubing凝水-气雾颗粒沉积在22mm的螺纹管内LVNTherapy–Definitions5WhoBenefitsfromAerosolTherapy?雾化治疗适用与哪些病人？•Patientswithartificialairways:endotrachealortracheostomytube使用气管插管或气切插管建立人工气道的病人•Patientswiththicksecretionsacuteinfectionorunderlyingpulmonarydisease急性感染或器质性肺部疾病引起呼吸道分泌物浓稠的患者•Post-extubationduringarecoveryperiod拔管后处于恢复期的病人•Patientswhohavehadfiberopticbronchoscopy使用纤维支气管镜的病人•Patientswithinflammatoryobstruction,crouporlaryngitis炎症喉阻塞，义膜性喉炎或喉炎的患者。LVNTherapy–Benefits6WhataretheTherapeuticGoals?雾化治疗的目的•Hydratethick,drysecretionstofacilitatemobilizationupandoutoftheairways稀释粘稠的痰液或痰栓，使呼吸道分泌物容易排出•Sootheinflamedupperairwaytissues舒缓发炎的上气道组织•Improvemucociliaryfunction改善纤毛功能•Improvecougheffectiveness改善咳痰的能力•Aidinsputuminduction帮助痰液排出LVNTherapy–TherapeuticGoals7LVN大容量喷雾器治疗特点•使用無菌蒸餾水或生理盐水•氣動式，須連接流量表•氣霧粒子大小2-20μm•氣霧輸出量30~50mg/liter•28%-100%氧氣濃度可供選擇8湿化治疗和大容量喷雾器的区别•Humidifiers:addinvisiblewatervapor(molecularhumidity)toagasmixture.Molecularhumiditycannotcarrybacterialorviralpathogens湿化治疗：令不可见的水蒸气并与空气混合。湿化分子不能携带细菌和病毒•Nebulizers:addvisiblewaterparticlestothegasmixtureintheformofanaerosol.Aerosolparticlesarelargeenoughtocarrybacterialandviralpathogens雾化器：使可见的水滴与气体混合形成悬浮颗粒。气溶胶颗粒足够大可携带细菌和病毒LVNTherapy–Humidificationvs.Nebulization9AquaPak®预装水雾化装置LVNTherapy–DeliveryOptions–AquaPak•Includesapre-filledsterilewaterbottleandnebulizeradapters包括预充无菌水瓶及雾化器接头•InterfaceswithAquathermnebulizerheaterandotheraccessories有雾化加热器和其它配件配套供应•SterileAquaPak®water/AquaPak®蒸馏水•Provideshotorcoldnebulization/有加热雾化和不加热雾化装置•Variableconcentrationadaptersandreservoirbottles多种可调浓度接头和不同剂量的储水瓶–AerosolMasks雾化面罩–TracheostomyMasks气切面罩–FaceTents氧气面帐–CorrugatedTubing螺纹管–DrainageSystems排水系统–Heaters加热器10AQUAPAKPrefilledLargeVolumeNebulizersAQUAPAK预装水大容量喷雾器•Convenient方便•Costeffective经济•Sterile无菌•Aseptictechnique无菌技术•Closedsystem密闭系统•Infectioncontrol感染控制•Varietyofoptions多种选择LVNTherapy–DeliveryOptions–AquaPak11EquipmentRequirements需要的配件1.Aerosolgenerator(nebulizer)includingavariableoxygenconcentrationfeature可以调节氧浓度的雾化发生器–Patientsneedingaerosoltherapyoftenneedsupplementaloxygen需要雾化治疗的病人往往需要供氧–Alwaysverifydeliveredoxygenlevels可控制氧气供给水平2.Corrugatedtubing螺纹管3.Aerosoldrainagebag雾化排水袋4.Patientinterface:facemask,trachmask,facetent连接病人端：面罩、气切面罩、面帐5.Externalheatercanbeaddedasneeded根据需要添加加热器–Greatlyincreasestheaerosoloutput大幅度提高雾化输出量–Alwaysverifyaerosoltemperatureatthepatient可控制病人端的雾化温度LVNTherapy–EquipmentRequirements12EquipmentRequirements需要的配件LVNTherapy–EquipmentRequirementsTemperatureMonitor温度监测器AerosolMask雾化面罩CorrugatedTubing螺纹管Reservoir雾化瓶Heater加热器Adapter雾化接头13JetNebulizerAdaptors雾化接头ReservoirBottleLVNTherapy–DeliveryOptions–AquaPakAdapters雾化接入系统输入氧气外部空气从通气口进入氧气,雾化水和外部空气到病人端有氧气进口和水进口的吸引器,调节到相应的角度,空气进口引导气流的管道刺尖进入雾化瓶多余水回流水流通路:当氧气通过吸引器端口时,水受负压被抽上来雾化水有440,760,1070和2200ml装14AquaPak®雾化水容量选择•Threesizes,440ml,760ml,1070mltomeeteveryclinicalsituation三种规格针对每种临床的情况–2200mLdiscontinued/2200ml不再提供•Threeblandsolutions,sterilewater,.45%NaCl,.9%NaCL三种不同配方：无菌水、0.45%NaCl、0.9%生理盐水•Colorcodedlabelsbysolution不同配方有不同颜色的标签•Availableseparatelyorpackagedwith028or033adapter有单独包装和与028/033接头一起的包装供应LVNTherapy–DeliveryOptions–AquaPak–ReservoirOptions15TwoNebulizerAdaptorOptions两种接头选择•Adjustableairentrainment可调节空气入口•Fullrangeofoxygenconcentrations:28to98%(yellow)黄色接头有28-98%的氧气浓度可选择•33to98%(blue)moresilent,morerainout蓝色接头氧浓度选择为33-98%，更安静，出雾更多•Easytouseself-sealingpuncturepins简单实用的封口穿刺针•Closedsystem:recycleslargeparticlesbacktothereservoir,infectioncontrol全密闭系统：回收多余的雾化粒子，便于感控•Idealparticlesizeforoptimalnebulization理想雾化颗粒达到最佳雾化效果•Specialbafflingsystemprovidesquietnebulization安静雾化•CompatiblewithallAQUAPAKreservoirs可与各种型号AQUAPAK雾化储水瓶相接•Sterileassembly,coveredpuncturepins部件都是消毒包装，穿刺针有针尖帽覆盖LVNTherapy–DeliveryOptions–AquaPakAdapters16031-28(028)NebulizerAdaptor雾化接头•Smallestparticlesize,fewerlargeparticlestorainoutintubing最小的颗粒，很少有大颗粒残留在管道内•Lowestrain-outlevels:lesswaste最低的大颗粒沉积比例，减少浪费•Mostefficientwaterconsumption:750mLbottlelastslongerthancompetitor’s1,000mLbottle水利用率更高：750ml装雾化水比竞争品牌1000ml装水使用时间更长•28%-98%oxygensettings/28-98%的氧浓度设置•Brightyellowentrainmentcollar明显的黄色标